As long-term care registered nurses decrease, demand skyrockets

As we head into flu season and Canada grapples with a potential second wave of the COVID-19 pandemic, it got me thinking about those most vulnerable to succumbing to the tragic consequences of this virus – our country’s seniors.

Many of you may not know that my more than three-decade-long nursing career has been in the diverse clinical area of long-term care. This is where my heart and passion lie, and it is why it has been particularly troubling to watch the devastating impacts of this pandemic on seniors and long-term care facilities across Canada.

While I am thankful Saskatchewan has fared relatively well when it comes to long-term care, there are many lessons from harder-hit jurisdictions where COVID-19’s impact has been heart-breaking.

For years society has been almost complicit in the gradual erosion of our publicly funded and administered long-term care system. Care standards and physical infrastructure have been neglected, while private care is increasingly encouraged and subsidized to pick up the slack, shifting costs onto individual seniors and families, and compromising the safety of care.
Over my career, I have seen two troubling long-term care trends converge to create a perfect storm that sadly left too many seniors at risk when the pandemic hit Canadian shores.

I have watched the medical and psycho-social complexity of resident care needs explode due to our aging population. Simultaneously, I have witnessed a waning commitment to invest in our publicly funded long-term care system, resulting in a steady reduction of Registered Nurses and Registered Psychiatric Nurses in the sector. There are now fewer registered nurses working in long-term care than a decade ago, yet demand continues to skyrocket.

These two trends have placed huge pressures on the public long-term care system, and the acute care system, which is experiencing increasing rates of avoidable hospital transfers due to this lack of appropriate nursing care. The door has also been opened to a significantly less regulated private sector.

In Ontario, COVID-19 has highlighted the folly of turning a blind eye to these trends. They have the highest percentage of for-profit long-term care homes, and it is in these facilities COVID-19 fatalities and mortality rates have been highest. In fact, Canada has the highest proportion of deaths occurring in long-term care of any OECD country. Up to June 2020, long-term care residents accounted for over 80 percent of all COVID-19 deaths, compared to an OECD average of 44 percent.

We clearly need reform and that starts with elevating this issue to the public discourse. Many do not think about long-term care until their lives are touched by it. It is time we change this, and as registered nurses, we must lead the way. We will all need long-term care one day – for our loved ones, and eventually ourselves. This is life. If COVID-19 has taught us anything, it’s that we are not ready for what the future holds, pandemic or not. Our seniors deserve better today, and we all deserve better down the road.

Tracy Zambory, RN
SUN President