The head of Nova Scotia’s largest nursing union says while she supports recently released national long-term care standards, she isn’t optimistic they’ll be implemented.
“Those are excellent standards. But like everything, they’re not going to be worth the paper they’re written on unless provincial governments put them in the legislation. We are strongly advocating for that to happen, but we’re not very optimistic because many of those recommendations are wonderful but we all know they’re expensive,” Nova Scotia Nurses’ Union (NSTU) president Janet Hazelton told the legislature’s health committee on Tuesday.
“People need to make a decision in this province. We’re either going to invest in long-term care or we’re not. And if we can live with not, then let’s live with it. Let’s tell our seniors that this is your life, this is it. But stop telling them and their families that we’re going to improve it and then not do it,” Hazelton told the committee.
Tuesday’s health committee meeting agenda was focused on delivery for 4.1 hours of care per resident in long-term care.
Paul LaFleche, deputy minister with the Department of Seniors and Long-term Care, told the committee that while he recognizes there’s more work to do, efforts to establish the 4.1 standard are “well underway.”
“Some facilities have already reached 4.1 hours of care per person, most facilities are on the cusp of implementing it, and we continue to work with other facilities to support them as they prepare to meet this goal,” LaFleche said.
“With this investment, Nova Scotia is one of the first provinces in Canada to set this standard of care. Our department is working closely with the sector to recruit and retain staff needed, making continuing care a great place to work and ensure seniors receive the best possible care.”
‘Not where we need to be’
CUPE Nova Scotia president Nan McFadgen said it’s not quite as simple as stating that Nova Scotia now has 4.1 hours of care when talking about “hands-on” care specifically.
“If you’re talking hands-on care, Nova Scotia has three (hours), which is not what CUPE has been lobbying for for over 15 years… We were happy about the announcement because at least it’s a step, and a step is better than no step at all,” McFadgen told the committee.
“However, we’re not where we need to be for caregivers and the people who receive their care in Nova Scotia. The story is not over. You’ve started the story.”
$45 million spent on long-term care travel nurses
The committee also heard that In the last 18 months, the province has spent $30 million on travel nurses (also called agency nurses) to fill in long-term care sector gaps.
In an email after Tuesday’s meeting, a Department of Health and Wellness spokesperson clarified the $30 million figure was actually an older estimate.
From the fall of 2021 to the present, $45 million was spent on travel nurses in the long-term care sector.
“The use of travel staff is a stop gap measure until we further stabilize our workforce. We closely monitor the use of travel staff and only approve when necessary,” spokesperson Khalehla Perrault said in an email.
“Recently, we had the 1,000th student sign up for a CCA (continuing care assistant) program through the free tuition and book support, and we are on track to reach the goal of 2,000 CCA students over two years.”
‘Having no solution is not a solution’
Hazelton said there are “significant” concerns about using travel nurses in long-term care.
“I’ve expressed concern about (it) because there’s a lot less supports in long-term care. So they don’t have other licensed staff to call upon, to rely on. Often some of our residents have dementia, so they may or may not know who they are,” Hazelton said.
“The travel nurses aren’t part of the community, they don’t know the residents like regular staff would.”
Hazelton said while there are many nursing recruitment incentives, more needs to be done to retain the nurses already working in the system.
“We need to make sure that our Nova Scotia nurses are wanting to stay, live, and work in this province. Having no solution is not a solution. We can’t keep spending millions and millions of dollars,” she said, referring to travel nurses.
“Can you imagine how much they spent in acute care? So if they’re spending it anyway, we have to figure out a way to spend it more appropriately within our own province.”
Travel nurses ‘absolutely’ been a necessity
Tracey Barbrick, associate deputy minister with the Department of Seniors and Long-term Care, told the committee that years of under-investment in this workforce resulted in a “significant” deficit of CCAs, LPNs (licensed practical nurses), and RNs (registered nurses) required for the long-term care system.
“Travel nurses have absolutely been a necessity while we ensure that we’ve got beds open in the nursing homes in the province so that people that are waiting at home can get into a facility when their families are exhausted from holding it up at home,” Barbick said.
“We use them as we need to keep the nursing home beds open and in operation… Travel nurses have been part of the strategy while we grow a proper workforce that meets the needs of the sector as a short-term plan. It’s not our long-term plan.”
The provincial government funds 8,052 long-term care beds throughout Nova Scotia. Barbrick said one year ago there were 500 beds closed across the system. This was due to a combination of staffing, COVID, wages, and other issues.
She described things as “moving in the right direction,” noting that today there are only seven beds closed due to staffing.
Barbrick attributed this to the CCA wage increase and the 4.1 hour standard, the announcement of which resulted in 550 new staff in the system.
“About 70% of our nursing homes have demonstrated that they’re ready to fill the positions, and we’ve actually advanced the money to move to 4.1,” Barbrick said.
“50% of them have actually achieved it. Of that 550 staff that were part of the 4.1 announcement, 400 have been hired.”
‘It’s just sad’
As the province continues meeting with Ottawa to secure more health care funding, Hazelton urged them to earmark some of those as yet undetermined federal funds for improvements to long-term care.
“We need to improve the system because we’re all going to be there… It’s just sad. And we’ve been talking about this since I’ve been president, and that wasn’t yesterday,” Hazelton said.
“So we have an opportunity. We just got a bunch of federal funds. We should use some of those federal funds to improve our long-term care, not just our acute care. The acute care, they have their problems. But long-term care, I think, is worse in some ways.”