Staff strategy needed to improve work conditions in long-term care, employee reps say

OTTAWA — Governments must move beyond new national standards to make long-term care work a career of choice if they are to address serious workforce issues that have resulted in deadly conditions for seniors during the COVID-19 pandemic, officials at the workers on Wednesday.

Experts from the nonprofit Health Standards Organization released updated guidelines this week for providing quality long-term care, emphasizing the need to attract and retain enough workers in homes to provide adequate care for residents.

The standards, which are not currently being enforced, recommend a pay raise and opportunities for full-time employment.

“The biggest challenge for many nursing homes right now is staff retention and recruitment, especially when hospitals are facing significant staff shortages and paying much higher rates,” said Dr. Samir Sinha, chairman of the committee that developed the new standards.

But giving more money to support workers who do the bulk of the nursing isn’t the whole solution, said Miranda Ferrier, president of the Canadian Support Workers Association.

“It’s not an easy job,” she said. “You’re dealing with literally everything about a person, fluids and everything, and some people just can’t handle that.”

Prof Carole Estabrooks of the University of Alberta, who was a member of the committee, said compliance with the standards is just a starting point and will not immediately address the urgent and urgent need for more manpower.

“Until there is a coordinated health workforce strategy at the national and provincial levels that includes long-term care, it’s going to be difficult to pull ourselves out of this really deep global workforce emergency that we’re in,” Estabrooks said.

“It’s hard to do because the needs are so urgent.”

Even before COVID-19 began spreading through Canada’s long-term care homes in 2020, most homes were understaffed.

Ferrier began working in long-term care in 2006 and has never worked a fully staffed shift. There simply aren’t enough staff to maintain a basic level of care and dignity for residents, she said.

“I remember feeling devastated,” she said. “If you’re trying to spend as much time as possible with your residents, talk to your residents, engage with them — but you don’t have the time.”

When the pandemic hit, these staff shortages had deadly consequences, as the vast majority of Canadians who died from COVID-19 in early 2020 were long-term care residents.

Now workers have burned out and many have left, Ferrier said.

Personal Support Workers (PSWs) are largely unregulated in Canada, although some provinces have taken steps to change this. It’s a move Ferrier has supported in Ontario to recognize PSWs as professionals and ensure they have the necessary training.

But that could backfire in the middle of a labor crisis, Estabrooks said, as some existing workers might quit the job if they had to be regulated.

“We have to think twice before going this route,” she said. Even without regulation, more could be done to make homes better places to work and ensure workers get the same level of education across the country.

It would also be an improvement to ensure workers have full-time employment, said Bea Bruske, president of Canada’s Labor Congress.

“We still see all too often that these nurses are precarious, part-time workers,” Bruske said.

Precarious work proved dangerous for residents during the pandemic as staff traveled door-to-door to work longer hours, potentially spreading COVID-19 between residences.

If governments hold long-term care homes to the newly released standards, that would be an improvement, Bruske said, but there will also be costs.

“It’s an important step to ensure care homes have the resources to actually provide and meet this standard,” she said.

“And that can’t come from individual residents having to pay huge fees because it’s not affordable.”

This report from The Canadian Press was first published on February 1, 2023.

Laura Osman, The Canadian Press