A Broken System
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A Broken System

Doing more with less has an expiration date in long term care

By Rob Cleveland, CLAC Representative

I never understood our healthcare system until I began representing members who work in it—particularly long term care and retirement homes. It is deeply flawed. When I would see a story in the news about a resident being poorly treated or having died from medication complications, I always chalked it up to a poor caretaker; or, at worst, perhaps someone who should not be caring for our seniors at all.

How wrong I was! What I could not appreciate from afar were the levels to which frontline staff would go for their residents. That is not a typo—I mean “their residents” in the most congenial, familial way. Our members serve an increasingly marginalized segment of society not because they simply need a job, but out of a sense of duty and to honour their elders—from a genuine, heartfelt compassion for others, and the sheer joy of continuing to nurture and care for people within their community.

I see these loving interactions time and again, especially in the small-town and rural facilities that dot the southwestern Ontario landscape where it is even harder to find dedicated, qualified staff. I watched one of our stewards, a personal support worker (PSW) take a moment to talk with one of her residents after working several overtime shifts in many months. When they finished, I commiserated with my steward, who looked exhausted, suggesting she had taken on more than her share of the burden.

Without missing a beat, she replied, “I do it for my residents. Who is going to help them if I’m not there? Who is going to make sure they get their meals and baths? I can’t not help.”

She is the kind of person that most of us would want caring for our parent or grandparent.

So where is the disconnect? It’s in the lack of adequate government funding for long term care—and by extension, retirement homes, where we increasingly place vulnerable citizens with complex social and health needs. It’s in a lack of resources to adequately compensate work that PSWs in particular do, which is further exacerbated by the fact that there are fewer and fewer PSWs in training. Owen Sound, London, Clinton, and Brantford are but a few places where PSW programs have been curtailed or shut down, and mostly out of a lack of interest. It’s also in the lack of registered staff, particularly registered practical nurses to fill the needs of smaller, rural facilities.

Friends, it’s the Walmart-ization of healthcare—“do more with less,” they say. This scenario can continue for a time, but it’s unsustainable. Staff simply burn out. There are physical and mental health implications. In this space, as members rush from resident to resident, mistakes and oversights are made. Stress. Exhaustion. Poor judgment. Bad decisions. Miscommunication between staff members. Medication errors. Missed baths. Bed sores. Doing more with less has an expiration date. 

Most of the mistakes that occur are not out of a lapse of judgment per se, but from frontline staff trying to do too much. This is what happens when self-care takes a distant second to work. It’s not a lack of concern for their residents’ welfare—it’s that most staff care too much. They go that extra mile, they cover off a missed shift so that their colleagues don’t have to work short (two or three people doing the work of four), they come in for that second double shift in a week to ensure their residents receive adequate care.

Both the previous and current provincial governments have pledged more beds—perhaps as many as 20,000 over five years—in long term care and hospitals to help alleviate some of the pressure on the healthcare system. This is welcome news, but it’s a Band-Aid solution. We cannot even staff our current number of beds. There may be more beds available in the near future, but that means more mistakes and oversights—unless we can actually fix what we already have with more training, more resources, and more funding.

We’ve seen the signs along our highways in Ontario: “Fatigue kills. Take a break.” One of those signs is needed at Queen’s Park as a stark reminder of what they’re asking of our members in healthcare.

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