December 2014 - Frontline perspective on long term care essential

Frontline perspective on long term care essential

#skpoli #nursing #ptsafety

It is disturbing that workers at Regina’s Santa Maria care home haven’t noticed any changes since the tragic death of one of its residents, 74-year-old Margaret Warholm, in October 2013. Of equal concern is that the three care aides who were compelled to come forward felt they needed to do so anonymously for fear of repercussions.

Frontline care providers have an inside perspective of problems the public, and often government and employers know little about. In many instances, it is those at the point of care that can best identify deficits in the system – a system they live and breathe every day. Their voice should not be stifled and they should never feel fearful of standing up for the patients and residents they have dedicated their lives to caring for.

To fix the problem we have to first acknowledge there is one that needs fixing. This means listening to all stakeholder concerns, paying attention to the warning signs and then acting on these using research and best practices to guide the development of care standards. We all have a shared responsibility to make things better and safer for the patients and residents relying on the system.

In Saskatchewan, there has certainly been no shortage of warning signs. In 2014 the total number of Critical Incidents reported – 195 – was the largest since reporting began in 2005. This represents a 21.1% one-year increase over 2012-2013, and a 53.5% two-year increase over 2011-2012. This troubling downward trend, without a doubt, reflects the fears and concerns we have been hearing from both families and frontline workers.

What happened at Santa Maria is merely the tip of the iceberg. SUN members working in long term care have been raising red flags for years, often referring to the situation as dangerous. Registered Nurses (RN) and Registered Psychiatric Nurses (RPN) frequently report having to care for far too many patients or residents at a time. This number can sometimes be as alarmingly high as 30 patients or more to one RN or RPN.  

When faced with situations like this everyone suffers. Registered nurses are unable to provide the care they want and need to, and patients don’t receive the attention and quality of care they deserve. This increases the risk of critical changes in patient conditions being missed or detected too late because there simply just isn’t enough time. 

Registered nurses are being placed in a difficult position where they are frequently forced to juggle far too many patients at one time. Too often we hear from SUN members about how they are leaving shifts feeling stressed about not being able to complete everything they needed to. Being a long term care nurse myself, this is a terrible, gut-wrenching feeling I can identify with.

The trouble is this feeling is not exclusive to registered nurses. Long term care truly is a team effort. Every member of the team has a unique and vital role to play and we know everyone is feeling the same level of stress.

It’s a constant feeling of being chronically understaffed, under resourced and overworked.  These stressful, unhealthy work environments are leading to high staff turnover, loss of expertise, low staff morale, burnout, increased mistakes and ultimately declining standards of care. With so much strain on the system, care providers are finding it increasingly difficult to meet their standards of ethical and professional care. This is not fair to staff and it’s certainly not fair to patients and their families.

The time for action is now and that must start with listening to what the frontlines have to say. The demands on our long term care system are only set to increase.  In 2036, almost one quarter of Canadians are projected to be over 65. Population ageing is now one of the most important considerations in planning health services. We need to be working today to ensure we have a robust long term care system that is ready to safely meet the needs of both current and future generations. Sadly, we are already falling short.

This issue needs to become a provincial and national priority – a rallying point around which all groups, opposing or not, should galvanize to find solutions. This is not a time for political rhetoric, excuses and blame shifting; we all need to be working together and not against each other. The people of this province are looking to all of us for leadership. It’s time to take action. 

Tracy Zambory, RN

President, Saskatchewan Union of Nurses