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Premier Doug Ford says the province will speed the accreditation of foreign-trained nurses to help address Ontario’s growing health-care staffing crisis , which has taken a deeper hold at two key Toronto hospitals this week.
“We’re in need of more nurses, as many as we can get,” Ford said Wednesday in his first public comments on the predicament.
The acknowledgment came as Toronto General Hospital issued a critical care bed alert and the Hospital for Sick Children posted an urgent practice alert, warning some staff could be diverted to support the pediatric intensive care unit.
“We are at capacity in the Toronto General ICUs,” spokesperson Gillian Howard said in an email, citing the COVID-19 pandemic, surgery levels, patient requirements, a staffing shortage and “the vacations that people need.”
With temporary closures of emergency rooms mounting, mainly in smaller hospitals across the province as COVID-19 continues, the premier was on the defensive at an auto industry announcement in Stratford where he faced questions on the deteriorating situation in the pandemic-ravaged health-care system.
“We’re going to continue coming up with ideas and working with the College of Nurses to get the internationally trained nurses through … in a much faster, rapid process,” he told reporters.
“The minister of health is putting a directive to the College of Nurses asking them to speed up the process.”
No details on the pending directive were available but the regulatory college said June 21 that it had accredited 3,967 internationally trained nurses, an increase of 132 per cent from the same period last year.
Hospital nurses have been quitting or retiring at higher rates than usual, burned out by heavy patient loads and stress during more than two years of COVID.
Although emergency rooms were closed in 20 smaller hospitals across the province over the long weekend — forcing sick people to travel longer distances for treatment — Ford maintained “Ontarians continue to have access to the care they need, when they need it.”
“Nine out of 10 high-urgency patients are finishing their emergency visit within targeted times. And surgeries are happening at nearly 90 per cent of pre-pandemic rates,” he added.
“That’s welcome news. But it doesn’t change the fact that our hospitals and emergency departments are feeling increased pressures right now.”
Those pressures come despite the addition of 3,100 hospital beds during the pandemic and the hiring of 10,500 health-care workers.
New Democrat MPP France Gélinas, her party’s health critic, said the government’s response after weeks of silence is “not impressive” given challenges in the hospital system were well known before the pandemic.
“All of this has been building for a long time,” she added, noting nurses have been vocal in their opposition to Ford’s 2019 public sector wage restraint legislation known as Bill 124, which limited them to maximum increases of one per cent annually.
“Our premier is oblivious to all that.”
Ford said Ontario is not alone, because other jurisdictions across Canada and around the world are facing the same health-care challenges — a shortage of doctors, nurses, personal support workers and other staff.
He called on the federal government to boost health-care funding to the provinces and boasted Ontario’s $5,000 retention bonus for nurses who worked throughout the pandemic is equivalent to an average raise of 7.6 per cent, although it is an add-on payment and not reflected in their base pay.
Ford said Bill 124, widely blamed for an exodus of hospital nurses, will no longer apply as new collective agreements are negotiated.
“The hospitals will negotiate fairly with the nurses,” he added. “I appreciate the front-line health-care workers that work their backs off, day in and day out. They’re exhausted. I get it.”
Opposition parties have repeatedly pushed the government to repeal Bill 124 to stem the high attrition rate that has contributed to ER closures and the closure of the intensive care unit at the Bowmanville campus of the Lakeridge Health system last week.
Patients from the ICU in Bowmanville have been transferred to Lakeridge campuses in Ajax-Pickering and Oshawa for now.
Cathryn Hoy, a registered nurse and president of the Ontario Nurses’ Association, also called on Ford to repeal Bill 124, pointing out hospital beds are “worthless” without enough staff to care for the patients in them.
Hospitals need to be more transparent with the public, she said, because ER closures are difficult to track and “people in the community don’t know how bad the problem is.”
At Toronto General, the critical care bed alert was issued for three intensive care units — cardiovascular, cardiac and medical-surgical — which are either at capacity and/or have limited human resources to safely keep all beds open.
There are almost 60 beds across the three ICUs (30 for medical-surgical, 15 for cardiovascular and 12 for cardiac), which support the high volume of cardiac, cardiovascular, cancer and transplant surgeries at the hospital.
The urgent practice alert at SickKids impacts the critical care response team and went into effect Tuesday. Members of the team may now be pulled from their regular roles to support the pediatric intensive care unit.
The team “can be contacted by health-care providers across the hospital in the event a patient is identified as having early warning signs of requiring ICU-level care,” spokesperson Jessamine Luck wrote in an email. “Select members of the team may occasionally support direct patient care in the pediatric intensive care unit (PICU) on a case-by-case basis.”
Like other hospitals in the province, SickKids is experiencing staff shortages, while also seeing sicker patients in ICUs, she added
“We do not anticipate any direct impacts to patients. In the event critical care response team staff are supporting direct patient care in the PICU, critical care response time for consult requests may increase slightly, which is why staff were alerted to the situation,” Luck said.
UHN’s Howard said that under the critical care bed alerts staff “actively triage patients that require specialized ICU care” and work with the provincial CritiCall service to which all hospitals report data on their critical care beds.
“CritiCall will, as usual — in consultation with the ambulance services — ensure that a patient in an emergency situation will be transported to a hospital that has ICU capacity.”
Other hospitals, in the province, including Kingston General and St. Joseph’s Healthcare Hamilton, have closed beds. Perth’s emergency department closed in July after a COVID outbreak among staff; it has since reopened.
As well, the number of hospital staff off work due to COVID has nearly doubled since May, to about 4,800 during the week of July 16 to 22.
Meanwhile, Adalsteinn Brown, a co-chair of the volunteer science table advising the government, has resigned to concentrate on his day job as dean of the Dalla Lana School of Public Health at the University of Toronto. His replacement is Dr. Allen Upton, chief of the division of infectious diseases at SickKids.
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