Whatever direction incoming Premier Doug Ford may choose for long-term care in Ontario, he faces a juggernaut ahead. For too long, long-term care has limped along as the ever-poor and dowdy cousin to acute care.
Historically in Ontario and the rest of the country, long-term care settings were home to a mix of ambulatory and less-mobile seniors having a range of chronic and episodic acute conditions. Let's be frank: the reality is that long-term care settings have not always been seen as the most interesting places for nurses to practise compared with the rapid pace and shimmer of cure-focused acute care.
At one time, the needs of long-term care residents could be managed with fewer human, technological and financial resources, and a mix of staff having less advanced education.
But this is 2018. Millions of people across Canada now live well into their 90s — spending many of their final 20 years with a growing number of chronic health conditions. And, of course, among those in long-term care settings, most will live with the complications of dementia. We need a hard course correction and a plan to manage these realities of aging in Ontario in the 21st century.
It is not just wrong to continue to fund and staff long-term care as though we were still in the 1950s, it is unsafe and dangerous.
The care in nursing homes and other long-term care settings is growing increasingly complex. Many aspects of it would have been managed in hospitals just 20 years ago. So, it is not just wrong to continue to fund and staff long-term care as though we were still in the 1950s, it is unsafe and dangerous.
While the Public Inquiry into the Safety and Security of Resident in the Long-Term Care Homes System is still studying the causes of the recent deaths in nursing homes in the province, we can be sure there will be recommendations for change for all those involved in delivering long-term care — employers, unions, the nursing regulatory body and professional associations — so that the crimes perpetrated by Elizabeth Wettlaufer never happen again.
Canadians, including Ontarians, accord higher trust to nurses than any other profession — and they should. Nurses are educated in a rigorous system of accredited university and college programs and their work is based on strict standards, a common entry-to-practice examination, a robust Code of Ethics and ongoing monitoring of their practice.
The Canadian Nurses Association is horrified by the deaths being investigated by the inquiry and we are fully committed to ensuring that everyone can leave their friends, children and elderly parents in nurses' care with confidence. We know that trust has been rattled; it cannot be allowed to shatter.
The incoming government and the next minister responsible for long-term care have a unique opportunity to work with stakeholders, including the Canadian Nurses Association, to deploy the right mix of providers delivering the right kinds of care at the right time.
Long-term care cannot be left impoverished and with the hope that the sector somehow will cobble basic resources together to deliver some minimal standard of care. In Ontario and across Canada, tens of thousands of dedicated nurses and support workers deliver amazing, informed and high-quality care to elderly people every hour of every day. They need strong and reliable support — "any warm body" is not a safe or ethical way to staff nursing homes or provide great care.
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Ford was elected partially on a promise of creating thousands of long-term care beds across Ontario. These are complex, interdependent decisions that demand careful and smart planning.
As the organization that represents nurses nationally, the Canadian Nurses Association is ready to roll up its sleeves and work with premier-elect Ford, his new government and the opposition parties to deliver on the aims of better and safer care, and better value for taxpayer dollars. And just as urgently, we will help deliver for Ontarians and Canadians a nursing workforce that will continue to earn their highest trust.
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