My father was a nurse. I’ve spent my life thinking about how to help address the challenges faced by nursing staff, how to provide economic security for these dedicated professionals who deserve better pay and benefits. I’ve researched why nurses are quitting in large numbers, and I was inspired by a journalist’s account of how the government of Quebec’s Health Care Charter removed job security and a degree of job satisfaction from nursing jobs. Now, in Ontario, we have a similar challenge.
Ontario’s most recent provincial election saw the Liberals ousted by the Progressive Conservatives. All parties campaigned in these elections on promises to give doctors, teachers and other public-sector workers a raise. Yet those same parties have failed to address problems with nurses, which have risen even higher up on their lists of priorities. So, when I saw the Nurses’ Post’s headline “Who earned the most in Ontario in 2018” in the Postmedia newsroom, I had a sense of where I was headed. If the media has largely ignored the plight of nurses, the nurses themselves haven’t done much better in highlighting their demands.
In fact, in late 2018, the Ontario government declared its intention to pass legislation in March that would take away the binding arbitration process used by nurses and allow Health Minister Christine Elliott to impose unfair labor contracts on the bargaining units of unions, striking nurses and midwives. If these independent bargaining methods aren’t replaced, we’ll see increased hiring of outsourced or contracted nurses to take over duties now performed by nurses.
The loss of arbitration will make it even harder for nurses to be taken care of and protected in the workplace. Nurses are a dependable, skilled, dedicated group of professionals. But what, they wonder, will be the consequences of this situation for patients? Many jurisdictions, including New York, are even considering adopting models such as home care, where nurses aren’t even provided a union voice in bargaining.
The idea that by moving nurse skills out of the hospital to home care can reduce emergency room visits and other costs seems like a good idea. But the proposed privatization of nurse-to-patient care is the wrong way to handle nurse shortages. There is ample evidence that longer stays in the hospital and short hospital stays can cause more harm and result in higher costs. Studies demonstrate that personal nurses are safer, help patients get back to care faster and eliminate many of the costs associated with discharges. For example, personal nurses use medication management to avoid common hospital-acquired infections, hand hygiene, and durable medical equipment (DME) purchases. Those savings would come back to the taxpayer in savings on the hospital care the personal nurse would prevent.
Ontario’s Health Care Charter in Quebec, instituted in 2007, was supposed to address the nurse shortage that led to high turnover rates and low pay and benefits. Few families who sent their children to nursing homes appreciated the disruption in their family life that led to a nursing home. And both spouses felt a sense of inferiority as they watched one parent struggle with the stress and loss of a cherished member of the family.
With the passage of the Quebec charter, nurses became the first public employees to gain the ability to collectively bargain, and to bargain on a more equal footing with public sector unions and employers. They were granted unions that could bargain over other work that could save lives, but not the essential part of their job: they could not bargain for pay, sick leave, or retention of workers. The new rules have led to improved wages, but also to smaller job security, longer wait times for patients to receive their care, and suffering for the families who have to deal with this uncertainty.
My father used to joke about how we may need a revision of the health care charter if nurses get their day in court. (Of course, it was a metaphorical interpretation, but I remember him re-enacting it.) While the Canadian Nurses Association is pursuing a legal challenge to this decision, the time has come for Ontario’s nurses to turn the page on this injustice and get a fair deal. Otherwise, we will have lost a generation of future nurses.
We need more nurses on the frontline of our health care system to make it better. We need more nurses who know how to protect and advocate for patients, and create dignity in care for those who come into our system.
Sydney Hundley is an emergency room nurse in London, Ontario, and president of the Ontario Nurses Association.