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«UNDERSTAFFED AND UNDER PRESSURE A reality check by Ontario health care workers October, 2005 UNDERSTAFFED AND UNDER PRESSURE A reality check by ...»

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A reality check by

Ontario health care workers

October, 2005




A reality check by

Ontario health care workers

October, 2005

Table of Contents













A reality check by Ontario health care workers Home Care worker: Jeeze, I thought hospital workers were in good shape. I had no idea you guys were dealing with all this.


Nursing Home: Yeah and I thought we had it bad, but Sister, hearing you talk about home care makes my hair stand on end.

Part of a conversation from an OFL meeting May, 2005 _________________________

In May and June, 2005, the Ontario Federation of Labour, working in conjunction with affiliated health care unions, sponsored meetings in 17 Ontario cities to examine the consequences of understaffing.

On a daily basis, those charged with providing these most vital human services were telling each other, their unions, management, and the government that patients and clients were either not receiving the care they needed, or were being placed in harm's way.

This message was the same at every regional meeting: In Hamilton, Orillia, Ottawa, St. Catharines, Kingston, Kitchener, Brockville, Thunder Bay, Sudbury, Toronto (3), Timmins, Windsor, London, Owen Sound, and Peterborough, workers were beyond a limit of being able to cope.

"The stress of trying to keep up, but of not being able to, has been unbelievable,"

-1said one hospital worker. "But you see when we can't keep up or do our jobs properly, people can die or get really, really ill. I feel sick every day, and every day when I get home I have a good cry for all my patients who didn't get what they deserved, and for me too. I can't take it anymore."

This report is a collection of many of the stories heard around the province. These are the accounts of what health care workers said in meetings to each other and to the Ontario Federation of Labour.

It is also a record of first-ever meetings of health care workers from all sectors and unions. Workers from nursing homes and homes for the aged, retirement homes, hospitals, emergency services, laboratories, home care, public health units, and mental health facilities shared their stories and learned from each other.

In so doing, they came to mutual conclusions that all sectors and workplaces have been hard hit by understaffing; the problems associated with understaffing, and its consequences, are systemic and serious; if the McGuinty government continues to hide behind the Mike Harris health cuts, and does not immediately and significantly increase staffing numbers in all sectors, more Ontarians will die and thousands of others will never be able to achieve full recovery.

As a worker attending the Ottawa meeting noted, "McGuinty keeps making these announcements, less waiting time, quicker access to services, stuff like that, that make the government look good for the public. But it's not true. We're the same people that have to deliver these services 24/7 and thousands of us have been cut, with more to come.

Sure, you might get triaged in 15 minutes but you'll have to wait forever for help. It is just a horrible thing to do to the public and to us."

–  –  –

What makes this a hopeful exercise, rather than one of despair, is the fact that it can be achieved. There is actually ample funding available – now. According to health care economist Armine Yalnizyan, more than $1 billion has been dedicated to health care and is available for rebuilding.

Pharmaceutical drugs and medical equipment are two major pressures that are driving budgets through the roof. For hospitals, costs soared from 18% to a whopping 24% in just six years. These cost pressures come from the two parts of health care that are totally dominated by for-profit corporations, and they must be brought under control.

“Choose Change” was the slogan and promise upon which the Provincial Liberals were elected. The public did choose change. They were earnest in their belief that real change would happen. Regrettably, the government has opted for the continuation of the Mike Harris agenda. The terrible Tory legacies of privatization, contracting out of services, casualization of the workforce, service, and tax cuts have been retained as the underpinnings of the new system.

We don’t want Mike Harris. We want the Liberals to make a different choice, and workers across Ontario want to get on with the job of rebuilding. That is one of the reasons why so many exhausted health care workers came out to area meetings. Their accounts were shared with us to pressure the McGuinty government to come to grips with what is really taking place.

This publication and the stories contained within it represent a test of whether the government really wants to know what is happening. Long-promised whistleblower protection has never materialized; instead, Health Minister Smitherman points workers to a government 1-800 line! This does nothing to help the Port Perry nurse who spoke out

–  –  –

That is why we have not put names with these stories, and it is also why you will read many comments that implore us to “let the government know,” or “tell the government.” We will do everything possible to publicize this information. We offer our profound thanks to all of you who gave your precious time and effort to bring about positive change. We thank you all for continuing to care passionately about patients, those who depend on you, and the public health care system.

Your skill, dedication, and professionalism in the face of these cuts speak to how extraordinary you are.

In Solidarity and with great respect, Wayne Samuelson, President Irene Harris, Executive Vice-President Ethel Birkett-LaValley, Secretary-Treasurer

–  –  –

This document could not have been produced without the active support of Canadian Union of Public Employees (CUPE) Canadian Office and Professional Employees (COPE) International Association of Machinists and Aerospace Workers (IAMAW) Ontario Ontario Nurses’ Association (ONA) Ontario Public Service Employees Union (OPSEU) Service Employees International Union (SEIU) United Food and Commercial Workers (UFCW) United Steelworkers (USW) In particular, we wish to acknowledge the following people and thank them their invaluable contribution CUPE: Maureen Giuliani, Doug Allan, Gwen Hewitt, Brian McCormack COPE: Maureen O’Halloran IAM: Heather Kelly ONA: Lawrence Walter, Valerie MacDonald, Beverly Mathers OPSEU: Catherine Bowman, Barbara Linds, Rick Janson SEIU: Cathy Carroll UFCW: Harold Sutton USW: Jorge Garcia-Orgales

–  –  –

ER Emergency Department IV Intravenous MRSA Methicillin-resistant Staphylococcus Aureus MS Multiple Sclerosis OR Operating room OT Occupational therapy P3 Public-Private Partnership hospitals PSW Personal support worker RN Registered Nurse RPN Registered Practical Nurse TB Tuberculosis VRE Vancomycin-resistant Enterococci

–  –  –

Emergency medical services provided by Ontario paramedics are a vital part of our health care system. The public knows that, but provincial and municipal politicians lag far behind in their recognition of these important life-saving services.

In 1997, when the Tories downloaded land ambulance services to specified municipalities, they agreed to fund 50% of costs. Even then, provincial funding wasn’t enough. Ambulance services were struggling to maintain standards in the face of growing demand. Now, with more than 1.4 million requests per year rolling in, the “high quality” the government refers to speaks volumes about the professionalism and dedication paramedics and dispatchers who compensate daily for the serious lack of resources.

Liberal promises and lofty pronouncements have flowed but the necessary funding hasn’t.

–  –  –

For example, in London, in 2004, police were allocated $396.95 per household, fire services were $247, and ambulance ranked in at only $47.45.

In Toronto, the largest municipal Emergency Medical Service in Canada, police account for $462.09; fire at $202.02; and EMS are way down the priority list at $42.61.

“We are so understaffed you wouldn’t believe it. People in Toronto would freak out if they only knew the numbers of calls we get from the dispatcher telling us that we are the only ambulance available for the entire city. You can imagine what that does to our stress levels.” All parts of the system are stretched and that includes dispatch. For example, for the years 2001-03, dispatchers in one centre handled 6,400 calls (the standard is 4,200).

For workers, it was stressful and impossible to keep up, so difficult they had to urinate out the side door because there was not enough staff and therefore no down time.

The stress of working in dispatch, coupled with low wages, is a key reason why retaining trained and skilled people is so difficult.

It’s also hard to hold on to paramedics. “People don’t retire from this profession.

They either die, go off on sick leave, or move on to the fire or police departments,” one paramedic noted. Indeed, the career span is only five to eight years, and then, one way or another, they move on.

“Many of our problems are based on a lack of resources. It’s driving paramedics to the breaking point and leading to overall poor health care for the public. It’s gotten

–  –  –

One consequence of the lack of adequate resources is the unacceptably low staffing levels.

Here are some accounts of what is happening, and what it means for paramedics who, despite all of the obstacles, keep fighting to deliver top quality, life-saving services to the public.

If the public only knew...

Medics are now being pushed to look after multiple patients. You probably don't want to be one of those. You might be though because it has started happening all over the city. The paramedic is sent to hospital emergency to relieve crews who are in "Offload Delay”. The patients might have been triaged but they're backed up and someone has to remain with them since many of them can deteriorate or be in a serious condition. One medic had a dementia patient who was a wanderer, and an elderly person who had nausea and decreased awareness. What you don't want to see is the patient vomiting because aspiration Pneumonia in the elderly is extremely serious. Usually two medics would be able to move the patient together to prevent the patient from inhaling their vomit. The medic called the supervisor to report that she could not look after both patients – she had to focus on the patient with nausea, but he gave her a direct order to care for both patients. Sure enough, the patient started vomiting. The damage had been done to that patient. Multiple patients per medic is a dangerous way to go, but it's happening all the time now.


We had a drowning – a little three-year-old. When it’s kids, well, it’s one of the toughest things. The ambulance had just one paramedic. When you arrive on the scene with just one paramedic, it always slows everything down. No way you are going to get

-9things done as quickly as you do with a partner. For example, I can’t start CPR and an IV at the same time. If a cop hadn’t been on hand, there would have been no one to even drive that ambulance. It’s overwhelming when you’re alone and it’s certainly not good emergency health care. This isn’t our standard – ours is higher. The Ambulance Act of Ontario states every ambulance must be staffed with two qualified attendants. But instead of dealing seriously with the problems that are causing the too-low staffing, they get around the law by calling an ambulance something different. No matter what you call it, it’s wrong.


One supervisor was escorted out of hospital ER. Our policy obligates him to come to the site when his vehicles are held up to see for himself why they are not being released. They actually booted him out of Emergency because they didn’t want him to see what he saw: that there were actually beds available – they just had no one to staff them!

I’ve also been there when there were nine beds but no staff. That’s nuts! We can’t leave our patients so a whole ambulance is down and the whole system gets strained. There was a whole trauma unit closed because there was no staff.


There is a big distance between stations in rural areas and sometimes only one ambulance for coverage. So if things get busy, other ambulances have to come from 45minutes away, or even longer. When I have to do that, it means someone else has to leave their area to cover my ass and on and on. It’s a domino effect. It’s one thing for dispatch to say that an ambulance is en route, but if the ambulance is coming from way out of the area, it’s not going to do much good, is it? We need a lot more staffed units. Patients in these situations deserve the best care but we can’t give it to them right now.


One of our northern centres is staffed for only eight hours/day and on call for the remaining 16 hours. On the weekends, it’s all on-call work. They won’t look at paying people properly and it’s a fair distance to drive for one shift, so understandably no one

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