Opinion

Ontario’s plan to hire 4,000 LTC staff is misguided. Here’s why.

The Ontario government’s plan to invest $260 million and hire 4,000 staff within a year in the long-term care sector is, simply put, misguided.

The reason given for this financial injection is to meet the goal of providing long-term care residents with an average of four hours direct care per day.  Long-Term Care Minister Rod Phillips, in his Oct. 6 announcement, also stated, “This investment will allow all homes to hire and retain the staff they need.”

This is simply not true. What this announcement and funding scheme reflect is yet another ineffective attempt to solve the crisis of the worker shortage without addressing the bigger issue – retaining the folks in these positions.

Retaining personal support workers (PSWs) – a persistent and steadily growing issue –  matters. Educating and training them is costly but government spending in the past year and more has focused mainly on recruitment, leaving retention planning and strategizing lower on the list of priorities.

Health-care providers at all levels are burned out as the pandemic continues and are taking medical leave or quitting their jobs. Despite cries of help from industry stakeholders, politicians and decision-makers are ignoring the data. Why?

Critics and advocates like myself are dumbfounded by the indecision and political banter that skirts the issues.

Frankly, it’s exasperating. Since this is my area of specialty, I am going to focus on PSWs – the workers who provide personal care (bathing, feeding, dressing, positioning and toileting) of patients. Without them, residents and patients would suffer desperately as their dignity and independence often depend mainly on PSWs.

The shortage of this level of unregulated worker was documented even before the pandemic, and COVID-19 has exacerbated the situation. 

In Ontario, government initiatives to “solve” this included temporary pay increases, a voluntary registry to regulate PSWs and, worst of all, more educational programs to accelerate learning or water the programs down for new levels of worker. 

Temporary pay increases, with extensions given every few months, are like dangling a carrot and saying thanks for your hard work dear “unsung heroes and front-line angels,” but please keep working. And when the pandemic is over, we will end the pay increase. How insulting. 

It is because most of this workforce is made up of women and minorities that this kind of political nonsense flies. Marginalized groups know this all too well.

This is yet another ineffective attempt to solve the crisis without addressing the bigger issue – retaining the folks in these positions.

Instead of providing a higher level of regulation similar to that afforded to nurses and doctors, Bill 283, which became law in the spring, creates an oversight authority with questionable disciplinary frameworks for PSWs and is based on voluntary registration. This will not protect the public; the lack of clarity on regulations is an example of flimsy planning.

Accelerated PSW programs, Supportive Care Assistant programs, online learning options for weekend courses and the creation of even more names to add to the list of 50+ titles used for this class of worker has created the need for a national organization for unregulated care providers (UCPs), a designation used in College of Nurses of Ontario documents that covers all titles and levels of unregulated workers who provide care. That would be a worthwhile investment. 

National initiatives like the Employment and Social Development Canada-funded project to create a framework of occupational standards for this level of worker are a start, but they are under constant pressure to get deliverables out there. I sit on the working group and can tell you first hand that there is a lot of hard work being put into this, but the work often feels incomplete. I mean no disrespect to my peers, but this is an opinion piece and here is an example of a rushed outcome – the title used for PSWs in this national document is currently “personal care provider” (PCP). Yep, the commonly used acronym for angel dust, not a great one to knowingly assign. And the title is not even representative of what this worker does (which is more than personal care).

There is a need for a national association of unregulated care providers in Canada – a professional, national voice like the Canadian Nurses Association in which the focus is to advance the profession with the public interest in mind. Having this type of organization would promote the profession and positively impact recruitment and retention challenges since it would encourage formal UCP leadership. Organizations like OLTCA and AdvantAge Ontario and unions like SEIU, CUPE and OPSEU/SEFPO have spoken up on the need for working conditions to be improved. Having a national, professional organization along with one protected title would be an investment that helps keep the PSW workforce strong.

Retaining employees is critical to the success of the health-care team and to patient outcomes. It’s now time to focus more on retention … Who is listening?

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37 Comments
  • Islamiyat Razaq - GBC PSW Student says:

    I have heard personal stories of PSWs, and their experiences are not necessarily good ones. They talk about poor working conditions and pay for the essential role in clients’ care despite enjoying their roles very much, especially during the pandemic. It’s simply not right. Being a student myself, I have come to acknowledge and understand the need for PSWs to ensure that clients receive the care they truly deserve. It is comforting that Laura’s article advocates for PSWs and hopes an effective and efficient change comes about.

    Furthermore, I believe that there should be a national framework that oversees unregulated health providers ensure that there are measures to describe the scope of practices, ensure adequate certification and hold health providers accountable.

  • Maria San Gaspar - GBC PSW Student says:

    Reading through this article will make you see how hard PSW’s work. Not many people understand how important they are in the healthcare field. The COVID-19 pandemic just showed the little care and recognition they receive when shortages were reported and although the pay increases certainly helps, it is still not enough.

  • Jennifer McTaggart (GBC PSW) says:

    There were so many feelings associated with reading this article. I wholeheartedly agree that we need to be regulated, and that the government needs to go back into LTC homes to do inspections. I understand holding the title of an RN means more, but PSWs provide so much care on the ‘front lines’ of things, but it often feels like it’s ‘behind the scenes’. Schooling my not be as long, but considering we are providing care to clients, residents, and patients there should be a regulation that sets standards for care. Regulation is beneficial to everyone — and PSW’s deserve a pay increase as per the demands of their jobs. You are never going to have experienced or worker’s that want to stay without some type of provincial standard.

  • Natasha Cameron- Powell GBC Psw student C112 says:

    I totally agree 100% Psw does not get the recognition they deserve. They are over worked and underpaid, I believe Psw are the backbone of the health care system and yet still they are not regulated, the government needs to do more for Psw and show a lot more gratitude.

  • Lisa Reynolds says:

    I agree with Ms. Bulmer on the majority of the issues she raised. I am personally aware of the dedication and hard work of a lot of PSW’s and through out this pandemic, they have showed up and worked tirelessly to ensure that their Clients are well taken care of and kept safe. The temporary raise in pair has been confusing and was poorly implemented by those in charge.
    Many health care providers have been paying the temporary pay increases in incruments and at their own pace, so PSW”s wait months to be paid the increases. This increase should be permanent and be paid out on a regular basis.

  • Lauren Basamot Gbc Com Skills Class 1023 Psw C112 says:

    The temporary quick solutions the Ontario Government is implementing will not be the solution [long-term] wise to long-term care homes, PSW retaining their job, and so forth. I believe more should be done to ensure PSW has better salaries, benefits, job title, working conditions, and furthermore because it reflects onto our elder people. Every human deserves to be treated with care and dignity [DIPPS]. Personal [support] workers are the [support] of the healthcare team, they are a vital [vital signs] part of the healthcare team. What Laura Bulmer has written highlights significant issues within the healthcare system that needs to be addressed, advocated, and what changes need to be made for the betterment of the PSW career path.

  • Latoya Clarke says:

    It’s quite unsettling to know that a temporary pay increase and accelerated programs are the ‘rewards’ for such a demanding profession. PSW’s are the foundation of care, the eyes and ears, and without them the unforeseen could happen at anytime. It’s even more difficult to comprehend why such a heavily-tasked healthcare profession is unregulated. Hoping this article receives all the attention it deserves by allowing PSW’s to be fairly rewarded for the high demands of the profession.

  • Rheana Nicole Casabar - GBC PSW Student says:

    As a PSW student, I completely agree with this article. Having a temporary increase will not make every PSW stay in their field. For me PSW deserve more appreciation and recognition than what it is receiving right now. PSW is and always be a part of a health care team, it should be acknowledge as how doctors and nurses are acknowledge. All fields in a health care team should be regulated specifically PSW’s (unregulated) as it also plays an important role in our health care system.

  • monica omorogieva GBC PSW says:

    PSW’s do not get the recognition they deserve. I don’t understand why this profession keeps being treated like babysitters when we know that they are highly trained caregivers

  • Tracy Boateng says:

    Making PSWs regulated workers is essential in the health care team because, they play a big role in health care team, The roles of a PSWs by taking care of patient is needed in health care team. Bathing, feeding, making beds and other daily activities of clients are being done by PSWs. Assisting clients with their needs are willingly, and professionally done by PSWs. Recognition of PSWs should be advocated, I agree 100% with this article, Laura.
    Thanks, Laura

  • Jay Simon - GBC PSW Student says:

    I agree wholeheartedly with everything in this article. There is a shortage of PSWs, and it has been happening since before the pandemic. No one seems to be listening to their voices, or advocating for them. And no one seems to recognize their hard work, or appreciate it.
    The article was very insightful about the issues PSWs face, thank you Mx. Laura Bulmer.

  • Flarezeal Agasen, GBC-PSW says:

    I completely agree with the message this article is trying to convey. PSWs are needed as much as other Health Care professions. PSWs are involved in personal care tasks and incidental activities of daily living such as housekeeping, preparation of meals, and companionship. These tasks deserve to be acknowledged and recognized by our leaders and that they should provide better support in order to keep PSWs working in the field. The world faces a lot of unprecedented events such as the pandemic and I can say that PSWs are an essential part of every communities’ success when it comes to health.

  • Catherine Chan says:

    As a PSW student, I completely agree with this article. PSW works just as hard as any medical worker and they deserve to get paid more especially during this time.

  • Mikey Farrell GBC PSW Student says:

    As a student training to be a PSW I would have to agree with the sentiment of this article. Without government incentives, I would likely have not started this program. I am excited to be a part of healthcare as a PSW but with low pay, difficult conditions, and no regulatory body I could see myself leaving healthcare in the future. If we want lots of PSWs they need to be appreciated or the PSWs will quit as fast as they were hired.

  • Adelhysza Barranda - GBC - PSW says:

    PSW must belong to a College or association that will truly take care of them and hear their voice. Support workers do all the ADL’s of the client and sometimes more but they are paid less and are mostly part- timers which causes them to apply for other jobs either as a PSW or not just to get by. It is nor merely about the pay, the government need to fund PSW because for me we are the first contact of all clients. We are at risk of everything because we provide bed side care. Due to the pandemic PSW’s workload increases, with less recognition, less pay and the least prioritized among health care. Part- time employment in an agency/ facility is also a great impact especially during pandemic since work pay is not enough they tend to find more work hours which they became susceptible and more prone acquiring/ be the carrier of the virus and get sick.

    PSW may be the “lowest” job among health care but without them health care will not function as well as they think.

  • Prerna Majumdar GBC PSW student says:

    Many don’t realize how important and valuable PSWs are in the healthcare system. They along with nurses are truly the backbone of patient and client care. Without them the system would be crumbling more than it already is, so yes making PSWs regulated workers is a worthwhile investment. Thank you for this insightful article Laura!

  • Aysel Orhan, GBC PSW says:

    PSW almost sees some lectures as PRN in colleges. So there are fewer differences between those programs. So why PSW’s does not regulate the health care profession. Because there is no governing body that sets standards for the skills or knowledge? We know that! You do need to progress those steps as soon as possible for PSW to become a regulated worker.

  • Marisela Umana, GBC PSW says:

    Thank you, I completely agree, more needs to be done.

  • Kusum Regmi says:

    PSW, the backbone of the Canadian health care system needs to be regulated.

  • maria leonor Capispisan says:

    Maria leonor Capispisan, GBC PSW
    Thank you, Prof Laura , this article gives people the idea of how PSW worked hard in their profession to provide quality care to their clients and that’s the main reason why PSW should be recognized and be regulated, they should be paid well because PSW deserves that with all the hard work they do.

  • Shanti Panta, PSW Student, George Brown Clooege, Toronto, Ontario says:

    Thank you so much Professor Bloomer for speaking up for us.

  • Tamara Henry, GBC PSW says:

    Personal Support Workers (PSW) have a very important role in the health care system. The fact that they’re not getting paid as well as they should is very upsetting & unfair because they work so hard and perform certain task that many individuals wouldn’t be comfortable with. Laura made some excellent points and made others looking in learn more about how Personal Support Workers (PSW) are being treated.

  • Natasha Hardyal, GBC PSW says:

    This article is an eye opener as to what the real issues are regarding Personal Support Workers. Their time, worth, expertise aren’t being valued and it’s concerning that as a future PSW it makes me wonder where do I stand? Will my voice count? How will my future employers or the government see me and the thousands of Personal Support Workers across the country?

  • Caroline Tachejiian says:

    I applaud your honesty addressing the issues that often fall through the cracks. It’s definitely a band-aid on a bullet wound situation. I understand that there are politicians involved, but why not listen to the voices of those who have been doing the work? I wish there was a safe space where front line PSW’s could share their stories without repercussion (which happens to be one of their Bill of Rights). I hope more join in your advocacy so that we can create that safe space.
    Thank you for your advocacy!

  • Mickelah Rowe GBC PSW says:

    As a student of the GBC I have to agree with your concerns. It is very unacceptable that PSW’s are only getting a temporary raise. PSW’s are so underrated but yet still they are the one’s that spends the most time with the client/patients. This is one of the main reasons why PSW’s changes their career choice to a higher paying jobs.

  • Kamille Moises, GBC PSW says:

    The band-aid approach won’t solve the problem. Concrete plans need to be implemented. To begin with, the government should regulate Personal Support Workers.

  • Dhelzy Dyan Celi GBC - PSW says:

    the government announce before that they guarantee to increase the wage permanent to healthcare workers, but seems like jump to temporary, how about those people who encourage to study PSW because they’re expecting more ? As a PSW student I’m expecting not just the wage increase to be permanent but they need to give us a value to the community. Government needs to implement PSW as a regulated worker not unregulated.

  • Ronan C-112 says:

    Never trust a Conservative to do the right thing when it comes to Health Care or the Environment!

  • Janki Patel - GBC PSW says:

    As PSW student I know that PSW’s play a very crucial role in the health care system as they also provide and help clients with everyday needs (bathing,feeding,dressing etc) yet they are not paid well and respected. I know that the government and has temporarily increased the pay of PSW’s due to the pandemic but what after the pandemic is over?

    • Tess Puntanen GBS PSW says:

      As a PSW student I’m grateful for the grants provided by the government to help fund my schooling, but what happens after I graduate? PSW wages can be very low sometimes. How could such a vital role be so undervalued?

  • Alanna Cole - GBC PSW says:

    As someone who is new to the Health Care world I was saddened to learn after all that Personal Support Workers(PSW) do that they are only having a “temporary pay increase” as this article by Laura Bulmer stats. Depending where a PSW works they may only be making a little over minimum wage, as I have learned in class. If PSW’s are in such a high demand then agencies or higher authorities should recognize this and consider not having this wage increase be temporary but have it be permanent. I know a lot of students in the PSW program are planning to move forward within the Health Care field to other higher paying jobs. If people keep using this as a doorway to just get to the next job there will always be a shortage of PSW workers. If there is incentives for them to stay(fair wages, more support, appropriate working hours, etc.) more people will be happy providing important and meaningful care and this may cause them to reconsider changing fields.

  • Andrea Lok GBC PSW C112 says:

    We’ve always had trouble retaining personal support worker employees and the new measures (grants, etc) seem like a temporary measure just to “pump out” new workers, just so that the government can say “we did invest in creating new PCPs workers” especially in light of the nature of PSWs in a pandemic for long term care.

    Regulations and a proper protected and defined title would go a long way in protecting vulnerable patients and also ensuring the PSW profession is respected.

  • Novia Rhule-Gambiza says:

    It is quiet frustrating that the powers that be can’t see through your eyes. We have gotten to the point where we are reactive instead of planning to make life and situation easier for the clients and even for ourself.

    Being a Personal Support Worker is indeed a life changing experience and more needs to be done to have the best and capable individuals to serve our most vulnerable in society and that comes with being regulated, which will lead to accountability. I find myself asking, why is it a nail bitting issue to have Support Workers regulated? Even-though it is a clear indication that we are apart of the lifeline for the health care team and system.

    Laura you have always stood to fight for support workers and I applaud your dedication in what at times seems like a hopeless fight. Keep pushing forward and thank you for the knowledge you imparted on me during my studies to become a Personal Support Worker.

  • Tracey Ogus says:

    Incredible points Laura. You make complete sense here! I enjoyed listening and I hope enough people listen to put your thoughts in to reality!

    Thanks Laura!

  • jarred alter says:

    What Laura has written in this piece is really understated on the crisis that is going on in the field and on the field that Personal Support Workers (PSW) face everyday in the instititions they work for.
    One huge deficit at Long Term Care Facilities (LTC) is the institutionalized objectification of the staff that are in care of the residents.
    Being in a work enviroment that is not dignified and based in compassionate care of its employees comes at a great cost to the vulnerable people living at the facilities who are entitled as human beings to the best care possible.

    The trickle down effect of being objectified is that the human beings (residents) that are in need of care now become the objects of being negelected.

    Last time I checked in the mirror,
    I didn’t see a thing.
    I saw a living human being.

Author

Laura Bulmer

Contributor

Laura Bulmer is a full-time professor at a Toronto community college and chair of the Canadian Association of Continuing Care Providers (CACCE). She has received the RNAO Best Practice Award for her work in palliative care and is a recipient of the Crystal Apple Teaching Award. She would love to hear your stories and is always looking for fellow PSW advocates to join her on this journey. You can reach her at vanbulmer@hotmail.com.

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