The Manitoba Nurses Union is renewing calls for the province to legislate minimum staffing at personal care homes.
An MNU report released on Thursday sounds the alarm about nursing shortages, patients with increasingly more complex and chronic needs, and what the union says is the inadequate funding of long-term care.
Although the union has published several similar reports in the past, president Sandi Mowat said this one originated last fall after long-term-care nurses began raising concerns about not having enough time to spend with their patients. Those concerns escalated last month when the Manitoba government announced funding for long-term care services in 2018-2019 at $644.3 million, a drop of $2.3 million from the previous year.
"Where are they cutting that $2.3 million from?" Mowat wondered.
"Our biggest concern is that we’re hearing these rumours that they’re looking at nursing care hours and that’s a huge concern, because we believe they should actually be higher."
In a statement, Health Minister Kelvin Goertzen’s press secretary said the change in funding is "largely attributable to the annual adjustment to residential charges, which are based on the income of the resident and adjusted each year based on changes in residents’ incomes. This adjustment is not unusual."
He also noted there’s no plan to change patient care levels. Per the provincial guideline, staff must be able to give 3.6 hours of paid care to each resident per day, which is lower than the expert-recommended 4.1 hours cited in the report. As it stands, Mowat said, some nurses report spending even less than 3.6 hours directly with patients.
"Because they’re guidelines, some of the long-term care facilities don’t actually follow them," she said. "They don’t replace sick calls, they don’t replace vacancies, vacation time, etc."
The union’s report is based on a review of literature as well as surveys of staff and focus groups with staff in Brandon and Winnipeg. According to the survey, conducted by Viewpoints Research in January 2017, only a quarter of long-term care nurses believe the care their facility is providing is "excellent." That’s the same as in a 2006 survey.
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Of the more than 500 long-term-care nurses surveyed, 64 per cent believed there had been "very few to no improvements" in their facility when it came to care quality and 56 per cent said they didn’t think staffing levels were adequate. Further to that, the report says nurses spoke of a "perceived reluctance from the employer to address chronic nursing shortages."
The union is laying out six recommendations for the government, including amending staffing guidelines and legislating them so they are stronger. This is not the first time MNU has asked for such legislation, nor is it the only union to do so. The Canadian Union for Public Employees (CUPE) Manitoba made a similar recommendation in 2015. MNU also wants the government to do a full review of current and future personal care home beds and implement a health human resource strategy by April 1, 2019. The union wants each personal care home to report resident data to the province so that information can be publicly shared on an annual basis.
Mowat hopes the government is paying attention.
"We want them to take a really serious look at what we’re recommending," she said, "we want to make sure that they’re not looking at decreasing the time that the nurses are spending with patients."
The Manitoba Nurses Union's recommendations for long-term care
For the government of Manitoba to amend existing staffing guidelines to ensure every licensed personal care home provides a minimum of 4.1 direct care hours per resident per day.For the government of Manitoba to amend the Personal Care Homes Standards Regulation to legislate staffing guidelines.For the government of Manitoba to support and provide sufficient funding to ensure personal care homes employ the appropriate number of nurses, health care aides and other care providers to meet the minimum staffing threshold of 4.1 direct care hours per patient per day.That the government of Manitoba, with input from relevant health care stakeholders, develop and implement a provincial health human resource strategy by April 1, 2019. This strategy should acknowledge existing gaps with respect to Manitoba's health human workforce and include a specific focus on the human resource supply for Manitoba's long-term care sector.To ensure all PCHs in Manitoba report resident data to Manitoba Health, Seniors and Active Living, who in turn will publicly release the data on an annual basis.For the government of Manitoba to conduct a provincial review that examines the current and future supply of PCH beds in all geographic regions of Manitoba.