RNAO call for RN-only care is irresponsible

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TORONTO, May 19, 2016 /CNW/ - In response to an inflammatory report by the Registered Nurses Association of Ontario (RNAO), Jerry Dias, Unifor National President, has written to Ontario Health Minister Eric Hoskins calling on the Minister to convene a stakeholder panel.

The request calls for a representative panel of the appropriate regulatory bodies, professional associations, trade unions and provincial employer associations in the health sector to develop recommendations to immediately enhance and promote collaboration and collegiality as integration and restructuring proceeds across Ontario.

Unifor is concerned that years of austerity in the provincial health budget and uncertainty around federal transfers without a renewed Health Accord are beginning to foster violence and an increasingly toxic work environment in many health care settings.

"This is a critical period for a fragile and over-stressed health system," said Dias. "Leadership and vision are critical to maintaining our collective will and solidarity to ensuring quality care."

The recent report from the RNAO, "Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN", brazenly misstates the evidence accumulating around appropriate nurse skill-mix and role utilization and radically calls for all-registered nurse (RN) care delivery within 5 years in all large community hospitals. The RNAO proposal does not address the fate of almost 18,000 registered practical nurses (RPNs) currently working in public hospitals, or why after decades of providing nursing care, these RPNs should be replaced.

"We are surprised that RNAO would advocate for changes to the health workforce skill mix, favouring budget imperatives rather than evidence, but then fail to offer any evidence relevant to Ontario that 'an all-RN nursing workforce' in the hospital sector would be any viable or practical option," said Katha Fortier, Ontario Regional Director and an RPN herself. "But the RNAO report doesn't stop there - it calls for a doubling in the number of RNs in long-term care, but also to reduce by almost 30 per cent the hours of personal care and support provided by the Personal Support Worker (PSW)."

"For someone to suggest that only one category of nurse - the RN - can provide all the care required in acute care, teaching hospitals or large general hospitals, or should double in the current staff mix in long-term care at the expense of the direct hands-on personal support and care received by residents is simply cavalier and irresponsible," said Fortier. "When that suggestion flows from the RNAO, it reveals nothing more than blatant self-promotion and self-interest at its worst, and regrettably negatively reflects on all registered nurses, even though the majority are not members of RNAO." 

More than ever, all nurses need to work collaboratively and promote an environment of collegiality with all nurses showing consideration and respect for each other. That is an ethical obligation set out in a practice standard set by the College of Nurses of Ontario (CNO). That same regulatory body - representing both RNs and RPNs has also published "A Critical Review and Analysis of the Literature on Staff Mix Models" that concludes evidence in the literature of the 'evaluation of staff mix models in relation to outcomes is practically non-existent'.

"Solidarity is the key concept that this RN professional association apparently now finds so alien - our goal should be to optimize the contribution of RNs/RPNs/PSWs and all other health care providers as an inter-professional, collaborative and collegial team operating to provide high-quality patient care within and across the health care system," said Dias. "Our health care delivery models should be based on principles of collaboration and partnership and allow for optimal teamwork, respect, and knowledge sharing." 

"It's time to mind the integrity and credibility gap when it comes to staff mix and roles in the health system transformation unfolding in Ontario," said Fortier.

Unifor is Canada's largest union in the private sector, representing more than 310,000 workers.

SOURCE Unifor