Concern is growing over the idea of nursing agencies in Ontario hiring out high-priced contract nurses to various long-term care homes and other public health care settings.
Sudbury's branch of the Registered Nurses Association of Ontario (RNAO) is calling on the province to either regulate or eliminate nurse staffing agencies in Ontario.
Maria Casas, the Political Action Executive Network Officer for the RNAO in Sudbury, said the idea of using nurses for hire is "contributing to the breakdown of our health care system" in Ontario.
Casas outlined her concerns in a recent letter to Premier Doug Ford, Health Minister Sylvia Jones and Long-Term Care Minister Paul Calandra.
In an interview with Sudbury.com, Casas said the contract agencies are fine when somebody needs to hire a nurse to look after a loved one in their home or someone with special needs. She said the problem is that the contract agencies are stepping into the public sector.
"They primarily are working to staff the publicly-funded system that is short staffed; so it's some of the home-care agencies, long-term care homes, and so on," she said.
Casas said while the issue has been discussed by nurses in other parts of the province, it seems to be more of an issue in Sudbury.
"This is not an RNAO central issue, necessarily. This is something that's come up locally that I'm hearing from my colleagues throughout the Sudbury district, and I represent the Sudbury chapter primarily," she said.
Casas said the agencies do provide fully-qualified nurses, but that's not the point. She said it is not an ideal situation.
"Right now everyone is reaching out, and most homes in either category (profit or not-for-profit), have delayed accessing agencies for the very reason that it's not ideal,” she said.
“It's a person coming in that does not have the same commitment as your own staff would. It does not provide for the continuity of care that you would like to have for your residents or clients.
“But it's at the point where, to my knowledge, every long-term care home is using an agency to some degree or another.”
She said the contract agencies are providing a short-term solution to a problem that requires a long-term answer.
Casas said many qualified nurses have begun working for contract agencies partly because the pay is usually higher than public sector pay, but also because there is flexibility with shifts that one usually does not find in LTC homes or hospitals.
"They get to choose when they work,” Casas explained. “And that option is not usually available in most other places. Because there are certain staffing requirements for each shift; you have to have so many nurses on duty.
"It also pays very well in some cases. So the individual nurse is getting money, and then of course, the agency is getting a fee on top of that to make their profit. So it's costing those long-term care homes a great deal of money to bring a nurse who doesn't have the same commitment," she said.
So what are the options? What should the government do to stop the high-priced contract service?
Casas said it is "a tricky situation" because the contract nursing services have been around for such a long time and they do provide "a wonderful service to the community."
Casas said one option that could be explored would be limiting the level of service to that of private care only.
"So if I have my elderly dad at home, and I want someone to come in and look after him so many hours a week, and I want care that's above and beyond what is funded for him, you know, I could contract out to bring in a worker to be with him. So that would be an option."
Casas said it is possible that some contract nurses will disagree with her position, but she said the current shortage of nurses in Ontario is a serious matter.
"I think we have to look at the big picture,” she said.
“We're dealing with a serious situation. You know, this is probably the worst shortage of nurses I've seen in my 30-plus years of practice. This didn't happen overnight. It's been slowly creeping up. We were seeing nurses leaving as far back as 2015 citing high stress levels and working conditions that were not suitable to their lifestyle. But I think we have to take action. I think we have to be strong and be bold.”
Her final comment is that quicker action is needed in getting qualified nurses from other countries officially registered and recognized in Ontario more quickly. Casas said the Ontario College or Nurses has been working hard to make it happen, but more needs to be done.
"The college really has stepped up to try and get that to happen. But I do think that the college needs more resources to continue on that path. So I want to say that there has been success, some success in that area. But there are thousands more waiting from what I understand."
Len Gillis covers mining and health care for Sudbury.com.
