As of today, 25 nursing homes across the province are not admitting new residents because they do not have enough staff to provide care. That number fluctuates daily but it’s roughly one in five homes at this time.
Prior to Omicron, there were already about 600 vacancies for continuing care assistants (CCAs) who provide most of the hands-on care as well as shortages of licensed practical nurses (LPNs) and registered nurses (RNs). The Department of Health has sent 19 RNs to temporarily assist some of these homes.
Over the past two weeks, half a dozen long-term care homes have reported outbreaks in which staff have either tested positive or were unable to come to work because they had to self-isolate.
“Omicron has had a crippling effect on staffing in long-term care,” said Janet Hazelton, the president of the Nova Scotia Nurses Union, which represents the majority of nurses working in these homes. She blames that on the minimum staffing levels in the Homes for Special Care Act that have remained unchanged for 20 years, despite the increasingly complex needs of frail elderly residents.
“The minimum levels are too minimum. If we had decent staffing levels we might be able to weather this storm,” Hazelton told the legislature’s Health Committee examining the impact of COVID on staffing in long-term care yesterday. “But we don’t and we can’t,”
The Progressive Conservative government of Tim Houston has committed to hire 600 nurses and 1400 CCAs to improve staffing in long-term care homes. The big unknown is how long that will take.
There is $2.7 million allocated to hire nurse practitioners.
Additionally, $57 million was announced early in December to hire CCA recruiters and to expand a paid, on-the-job training program through private colleges that will graduate CCAs after only 10 months; that’s in response to plunging enrolments for CCA programs at community colleges. Some of the $57 million also empowers nursing homes to offer child care and transportation allowances to attract new workers,or cover the tuition for existing workers willing to take additional courses to upgrade their skills.
All of those incentives are welcome but will take time. One witness told the committee the fastest way to prevent more people from leaving the field because they are short-staffed and overworked is simple: increase the pay and hire more people.
“COVID is the straw that broke their backs but they have been struggling for a long time,” said Nan McFadgen, an LPN and the president of the Canadian Union of Public Employees, which represents 4,700 employees at nursing homes.
“If you work as a continuing care assistant in Halifax earning $18 an hour, you are living in poverty,” said McFadgen. “It drives me bananas that nobody — the previous government or this government — is willing to legislate 4.1 hours of daily care and pay you a wage where you can afford to buy groceries and send your kids to hockey or dance lessons. Why is it we don’t want that for care workers in Nova Scotia, who are predominantly women? And they aren’t going to come here from out west or Ontario. We need to grow our own people by offering a living wage.”
This will be the year workers in long-term care find out if government puts its money where its mouth is. There are currently 23 groups of workers negotiating at the bargaining table and another 157 collective agreements that have expired.
As for whether the Houston government will follow through on a promise to change legislation that would mean hiring hundreds of additional people to provide elderly residents with 4.1 instead of 2.4 hours of daily care, Deputy Minister for Seniors Paul LaFleche said “the intention is to hopefully bring legislation forward this spring.” LaFleche suggested that timeframe could stretch into the fall if there aren’t enough people available to fill the jobs.
Growing wait list
Staffing shortages are also contributing to a growing wait list of people waiting for admission to a nursing home from either a hospital or their home.
Acting Senior Executive Director of Continuing Care Kim Silver said there are currently 1,800 people on the wait list, with 350 people in hospital who are at the front of that line. (Silver is pinch-hitting for Tracy Barbrick who was seconded to set up the province’s mass vaccination clinics.)
Silver said the government’s response to longer wait times experienced by families caring for loved ones at home is to step-up the amount of home care delivered by private agencies as well as the provincial home care program.
LaFleche assured the committee “we do have a sense of urgency when it comes to resolving staffing shortages and the government has set out an aggressive agenda. We aren’t going to fix a 30-year problem after only four months, especially during COVID. But we’ve started. We have taken the first step and are going to take a second and third. Eventually we are going to get new facilities with single rooms and 4.1 hours of care that will benefit the sector, a better career for CCAs, and I will be back hopefully a year from now with a good story to tell you.”
Meanwhile, a seniors advocacy group called ACE — Advocates for the Care of the Elderly — has written a letter to Seniors Minister Barbara Adams and Chief Medical Officer of Health Dr. Strang. The letter expresses concerns that some nursing homes are arbitrarily using Omicron as a reason to limit visitors, reduce visiting hours, and keep residents confined to their rooms for long periods of time.
ACE doesn’t name names but requests more provincial oversight to prevent nursing homes from acting unilaterally and imposing restrictions that undermine the emotional well being of their residents.
“A fully vaccinated Long-Term Care seniors population deserves a uniform set of policy/directions regarding access to their fully vaccinated family members and to the community in which they have lived,” reads the letter written by Gary MacLeod, chair of ACE. “Instead, during the Omicron outbreak, some facilities with outbreaks have imposed Lockdowns of up to two months in length, in some cases confining and isolating seniors to their rooms. The result is seniors have suffered with feelings of grief and loss and abandonment.”
For staff and residents in long-term care, COVID continues to push people to the breaking point.