By Kaitlyn Clark
The Haldimand Press
HALDIMAND—Registered nurses (RN) and other health unit staff held an hour-long protest against RN shortages during their lunch break on Friday, November 13, 2020 in Simcoe.
The Ontario Nurses’ Association said in a press release that Haldimand Norfolk Health Unit’s (HNHU) RNs have “been working short-staffed since (the pandemic) began.” They further criticized the Board of Health (BOH), operated by Norfolk County on behalf of Norfolk and Haldimand, who had already cut three full-time RN positions for budgetary reasons before the pandemic was in full swing.
In addition to the three positions previously cut, there are currently eight vacancies at HNHU: two in the permanent school team for general health issues, two in the new provincially funded COVID-19 school-focused nurse team, one in the infectious disease division, and three in the newly announced COVID-19 team approved by the BOH. Two of the vacancies were created when existing staff successfully applied for two of the five school-focused nurse positions, leaving their original positions open.
“Most HUs (health units) have filled all RN positions with the funding they received months ago. Some HUs have hired upwards of 20-plus nurses within weeks of receiving the funding,” said Melanie Holjak, RN, Bargaining Unit President for HNHU. “Our feedback and suggestions to complete the work more efficiently has been ignored…. We are exhausted and running on empty.”
Matt Terry, Director of Corporate Communications for Norfolk County, stated, “The COVID-19 pandemic has presented all health units with an unprecedented challenge. As has been discussed publicly, the ongoing nature of the response to COVID-19 is resulting in significant challenges for Health Unit staff, including workload and capacity issues.”
Holjak said previously all public health nurse work in the infectious disease team was done by nurses and she is concerned with the redeployment of non-nurses to this team to assist with COVID-19 needs, such as assessments for individuals isolating due to potential COVID-19 exposure.
“The BOH and HU management teams’ solution to ‘not enough nurses’ has been to assign health assessments, monitoring calls – nursing work – to redeployed Norfolk County staff,” said Holjak. “We need more nurses performing nursing work. The community expects the highest standard of care and when you get a telephone call from the HU…. Our community deserves better. Residents who are ordered to isolate due to high risk exposure or positive test result need thorough assessment to ensure they can safely manage their symptoms at home and get direction when to seek medical attention. Isolation is associated with mental health breakdown and we support our patients in that respect as well.”
Terry said the “nurses are being supported by a small number of non-clinical staff (including paramedics and public health inspectors) trained to make wellness check phone calls to low-risk individuals,” adding that this practice is similar to other health units in handling COVID-19. The wellness check gauges a resident’s health to identify any concerns by following a script developed by public health staff. Terry noted that “a nurse is available to these staff at all times to assist” with the wellness checks or perform follow up assessments, “as needed.”
“To maximize provincial funding, the Health Unit plans to hire a mix of RNs and RPNs (registered practical nurses), although the Ontario Nurses Association has indicated that it does not support the hiring of RPNs,” added Terry. “So that has delayed the hiring process for a number of these positions…. At the moment a number of positions are currently up (to receive applications), but other positions that we want to hire RPNs haven’t been able to move forward.”
Holjak said that, under the union agreement, RPNs are only to be used in the vaccine program and not as public health nurses: “The HU cannot violate a collective agreement they agreed to.”
“(It) is legislated in the Health Protection and Promotion Act and requires a degree-prepared RN to fulfill the roles and responsibilities of public health nurses,” added Holjak on the difference between RNs and RPNs. “The scope of practice of an RN is broader and encompasses caring for clients … (and) public health nurses provide higher level of critical thinking for unpredictable scenarios.”
One participant of the protest held a sign questioning the provincially funded pandemic pay doled out by Norfolk County to nurses, suggesting only a small portion went to nurses of the approximately $64,900 received. Terry noted that the Province had a specific formula and criteria for eligibility that they “were bound by” in distributing the funds, so only six nurses received a portion of the pay. He added that any remaining funds would have to be returned to the Province.
Terry concluded that “the Health Unit will continue to take any reasonably necessary measures to respond to, prevent, and alleviate the outbreak of the coronavirus in our community” as authorized by the Province.
Holjak remains steadfast that more needs to be done, however: “We live and work in the communities of Haldimand and Norfolk and the decisions being made regarding work assignments put residents at risk and compromise the care they receive. We are calling for all RN vacancies to be filled immediately, for staff suggestions to be implemented to eliminate inefficiencies, and for a workplace culture that respects and values each profession.”