Nurses union draws up plan to revive overloaded home care program

A Manitoba Nurses Union study that found home care is collapsing after years of policy changes, underfunding and poor planning, includes a plan to resuscitate it.

In the last decade, the number of clients has increased by 41 per cent, while total nursing hours grew by two per cent, says the report that was written based on freedom of information data, interviews and firsthand accounts from nurses and clients.

“The nurses are morally distressed over that fact that they’re not able to get the care they want to get,” union president Darlene Jackson said. “But it’s the clients and the families who are suffering. They are the ones that are bearing the brunt of this with missed visits, late visits.”

The report was compiled after employers ignored solutions proposed by home care nurses.

“This is basically solutions for the government to pick up and run with,” she said about the report.

The document calls on the province to reinstate specialized nursing programs such as the rapid response teams that were launched in 2017 to identify patients at risk of frequent readmission. That program ended during the COVID-19 pandemic.

It wants the province to establish standards and public reporting for wait times and missed visits, provide respite and mental health supports for caregivers, invest in technology and modern scheduling tools and ensure that all care providers work within regulated scopes of practice.

The document highlights the fallout from the rollout of the Winnipeg Regional Health Authority’s centralized scheduling system earlier this year. Thousands of appointments were unassigned and there was widespread confusion among staff and clients.

Nurses were ignored after they called for a smaller pilot project to test the program before its widescale implementation last spring.

Scheduling had previously been done in more than a dozen locations by three separate entities. Nurses had worked closely with dedicated scheduling clerks and formed teams familiar with clients’ needs and geography. That setup was replaced by a centralized office. In April, nurses went public with concerns about the impact the new system was having on their clients’ health and well-being.

In September, Health Minister Uzoma Asagwara acknowledged it wasn’t working as it is was supposed to, apologized and said it would be withdrawn. Thirty-two scheduling clerks were hired ahead of the return to the previous system.

Home care nurses are still waiting for the scheduling changes to be rolled back.

“I met with nurses and nursing resource co-ordinators this morning and nothing’s changed,” Jackson said Friday. “Everything is exactly the same. The nursing co-ordinators have very little input into client care.”

Asagwara, who was not available for an interview, responded to the union report with a statement.

“We’ve worked with front-line staff to improve scheduling predictability and reduce cancelled visits,” the statement said.

From July to September, cancellations were reduced by 43 per cent. “We continue to staff up home care, with training for more health-care aides underway now and actively hiring more nurses,” the statement said.

Jackson said the push to expand home care in the 1990s aimed to reduce the need for acute care beds by helping the growing number of aging Manitobans to stay in their homes. It was a great idea, but the resources and funding required didn’t keep pace, she said.

Progressive Conservative health critic Kathleen Cook called the union report “a call to action.”

She said her Roblin constituency office, in west Winnipeg and Headingley, has been “overwhelmed” with messages from home care clients and families about missed appointments and inconsistent care.

carol.sanders@freepress.mb.ca

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