Nurses know what its like to work on the front-lines of health care in Ontario.
Our experience providing care for our communities is invaluable and our votes matter.
NursesVote.ONA.org is a resource to help members of the Ontario Nurses’ Association (ONA) get reliable, evidence-based information before we mark our ballots in the federal election this fall.
September 19, 2019
Dear ONA members,
You may have heard or read about HOOPP’s (Hospital of Ontario Pension Plan’s) lawsuit with the Tax Authority in Denmark in the media.
As you may know, the Danish Tax Authority is claiming that HOOPP is not entitled to tax reclaims. HOOPP’s position is that HOOPP is eligible through the Canada/Denmark tax treaty.
Please be assured that HOOPP followed the laws and processes of the Denmark/Canada tax treaty, and should be entitled to recover the dividend tax refund. The dispute is before the tax tribunal and court, and so it would not be appropriate for ONA to make any further comment.
We continue to monitor this case closely.
We have been briefed by HOOPP management and are confident that they are managing the situation appropriately.
Please be assured that HOOPP has your best interests in mind as they manage this situation. The situation has no impact on HOOPP’s ability to pay pensions.
ONA will continue to keep you informed and will provide you with any key updates as quickly as we can.
Vicki McKenna, RN
Ontario Nurses’ Association
85 Grenville Street, Suite 400
Toronto, ON M5S 3A2
Canada’s Federal Election is on Monday October 21, 2019. ONA’s Nurses’ Vote campaign is a call-to-action to protect and strengthen public health care. As nurses and health-care professionals, we have tremendous power when we raise our voices and vote.
What’s at stake and why should I vote?
This election comes at a politically uncertain moment. Recent polls show that the Conservative Party – led by Andrew Scheer – either leads or is in a statistical tie with the governing Liberal Party. Already, Scheer’s discussions of a balanced budget within two years, threats to labour and union rights, and hostility towards spending on the public sector signal a difficult political landscape should the Conservative Party be elected to form the next federal government.
Nurses remember former Conservative Prime Minister Stephen Harper’s cuts to health-care funding. In Ontario, we are increasingly alarmed by Progressive Conservative Premier Doug Ford’s reckless shot-in-the dark approach to health-care reform. The situation is already bad enough – and Ontario’s population is aging and growing. This October, we need to elect a federal government that will strengthen and protect public health care.
Isn’t health care a provincial issue?
The federal government is a major funder of public health care. It is responsible for the Canada Health Transfer, Canada’s largest major transfer payment, which provides financial support to help provinces and territories pay for health care. The federal government also enforces the guiding principles of the Canada Health Act, the legislation that governs our universally accessible, publicly funded and not-for-profit health-care system.
For these reasons, all political parties must clearly communicate their plans for a strong public health-care system. Federal health-care transfer payments must be increased to ensure that all Canadians can access a robust, properly funded and staffed health-care system. The Canada Health Act must be enforced to stop the proliferation of private, for-profit delivery of health-care services. We need to demand more from politicians vying for our votes.
What specific issues is ONA focused on this election?
Universal pharmacare: For decades, nurses have been outspoken advocates for making prescription drugs more affordable. We support a national pharmacare program that is governed by the following principles: public, single payer administration; accessibility; comprehensiveness; universality; and, portable coverage.
Violence in the workplace and staffing: We support a pan-Canadian prevention strategy to address violence against nurses and health-care workers. This includes a health human resources plan to recruit and retain RN positions, targeted funding for violence-prevention programs and infrastructure, and research funding to better track violent incidents.
Long-Term Care: We support calls for the federal government to develop national care standards for home care and long-term care to be amended into the Canada Health Act. We have long advocated for the elimination and/or phasing out of all for-profit long-term care homes. Public funding flowing to long-term care homes must ensure a minimum care standard of four hours of nursing and personal care for residents.In addition, we are on record as supporting public funding for a transition to a public home-care system in Ontario that eliminates the current competitive bidding system for contracts primarily delivered by the for-profit sector.
Social determinants of health: ONA supports upstream policy approaches that improve the health and well-being of all Canadians, including: affordable child care and supportive housing, implementing the Truth and Reconciliation Commission’s Calls to Action and tackling catastrophic climate change.
How do I get involved?
Check back here at NursesVote.ONA.org. You will find up-to-date information on events in your riding, all-candidates debates, and our phone banking schedule. We will also feature election-related materials that you can use in your workplace and with your colleagues to talk about the issues that matter to nurses and health professionals.
I need information on how to vote!
Elections Canada is your one-stop-shop for all information related to the 2019 Federal Election. Find your federal riding, voting hours and locations, registration and identification, key dates and everything in between. Visit www.elections.ca or call 1-800-463-6868 (toll free).
On-campus voting open: October 5 – 9, 2019. New for Election 2019: cast your vote at 115 campuses across Canada. You don’t need to be a student to vote on a campus.
Advance polls open: October 11 – 14, 2019. Your assigned polling station will be open from 9:00 am to 9:00 pm.
Election Day: Monday October 21, 2019. Your assigned polling station will be open from 9:30 am to 9:30 pm.
Last again – Ontario has the most dismal RN-to-population ratio in the country
June 27, 2019
TORONTO – The ratio of registered nurses per capita in Ontario remains the lowest in the country for the fourth year in a row, continuing to put the quality of care for the province’s patients at risk, says the Ontario Nurses’ Association (ONA).
A report released today by the Canadian Institute for Health Information (CIHI) on registered nurses (RNs) in Canada shows that the province of Ontario continues to be in last place in the RN-to-100,000 population ratio.
On June 1, we join with labour and social justice organizations from across Ontario to recognize Injured Workers’ Day and stand up for those who have been injured or made ill as a result of their work.
Over three thousand injured workers gathered at Queen’s Park on June 1, 1983 forcing a government committee working on major changes to Ontario’s workers’ compensation system to conduct a public hearing on the steps of the legislature. This historic day led to subsequent annual rallies— on the day known as Injured Workers’ Day – to continually advocate for the worker’s protection.
ONA Celebrates Historic Pay Equity Win; A 13-year pursuit for fairness and equity for nursing home Registered Nurses
May 1, 2019
TORONTO, May 1, 2019 – The Ontario Nurses’ Association (ONA) is celebrating a significant win following a 13-year-long battle to maintain pay equity rights for registered nurses (RNs) working in female-dominated professions.
Private Health Care Will Hurt Ontarians: Ontario Nurses’ Association Urgently Calls on Government to Consult Front-Line Providers
Posted: February 4, 2019
TORONTO, February 4, 2019 – The privatization of parts of Ontario’s health-care system has the Ontario Nurses’ Association (ONA) deeply concerned about the impact on health-care professionals and patient care.
ONA is calling for the province to maintain the publicly delivered, publicly funded system and consult now with front-line health-care providers before implementing changes to the health-care system.
“ONA represents more than 65,000 registered nurses and health-care professionals delivering care across this province,” notes ONA President Vicki McKenna, RN. “We are there at our patients’ side throughout the health-care system, delivering high-quality care to those in hospitals, long-term care, in the community, in clinics, public health units and even in industry. It is absolutely vital that before any restructuring of health care occurs, the government consult with us.”
McKenna adds that nurses know the challenges facing the province and has a wealth of knowledge and advice to offer. Nurses also know that privatizing health-care delivery will not benefit anyone but for-profit corporations.
“Experience in home-care delivery has shown us that private, for-profit delivery is detrimental to not only our clients but to taxpayers,” said McKenna. “Why would any of us, as taxpayers, want our public dollars to go to for-profit companies?”
McKenna said that ONA is monitoring potential changes to the health-care system closely and is available to share front-line nurses’ knowledge with government to improve the system.
ONA is the union representing more than 65,000 registered nurses and health-care professionals, as well as 18,000 nursing student affiliates, providing care in hospitals, long-term care facilities, public health, the community, clinics and industry.
TORONTO – Ontario Nurses’ Association (ONA) nurses and health-care professional members working in the hospital sector will learn details of their new two-year contract today.
The contract for 61,000 hospital members is the result of an arbitration award; the contract includes a wage increase of 1.4 per cent retroactive to April 1, 2018 and a 1.75-per-cent increase on April 1, 2019. The contract expires on March 31, 2020.
“These wage increases do not reflect the value of the care of our dedicated members,” said ONA President Vicki McKenna, RN. “However, they are significantly higher than the increases proposed by the employer. This contract is certainly not everything our dedicated registered nurses and health-care professionals hoped it would be. However, the award does provide for some improvement in benefits, and it clarifies that the obligation to keep workplaces free from violence includes being free from domestic violence.
“Heavy workload issues and workplace violence continue to be of deep concern to ONA members,” McKenna notes, “as they impact both the safety of their patients and their own work lives.”
In addition, there is now protection for new nursing graduates who do not pass the controversial NCLEX entry-to-practice exam. “Rather than being terminated if they have secured employment, the nursing graduates can take an unpaid leave until they achieve certification,” McKenna said.
McKenna notes that arbitrator William Kaplan did not agree to the concessions sought by the Ontario Hospital Association.
ONA is the union representing 65,000 registered nurses and health-care professionals, as well as 18,000 nursing student affiliates, providing care in hospitals, long-term care facilities, public health, the community, clinics and industry.
Posted March 7, 2018
Dear ONA Member,
Your employer has proceeded with their new ID badge initiative despite counter advice from ONA, OPSEU, SEIU Healthcare and employee representatives on the Joint Health and Safety Committee.
On February 23, 2018, Arbitrator William Marcotte, in OPSEU vs Cambridge Memorial Hospital, found the hospital’s new name tag policy to be unreasonable under the KVP test and to be in breach of s. 25(2)(h) of Ontario Health and Safety Act. In the ruling, he directed that current hospital policy and practices continue to apply to OPSEU members and he recommended that a risk assessment of the hospital’s name tag policy be conducted.
ONA’s arbitration hearing is scheduled for June; SEIU Healthcare’s arbitration hearing will be in July.
ONA asked the hospital to immediately suspend the issuance of its new employee ID badges that commenced on February 26 and is to conclude on March 9. Moreover, your union asked the hospital to reverse its decision to show both first and last names on employee ID badges. It is believed the hospital will only apply the above ruling, for now, to OPSEU members.
Please note, the hospital has not responded to your union’s inquiries at labour management meetings regarding the hospital’s commitment to accommodate the safety and privacy of employees with “special circumstances” which is consistent with CMH’s overall dismissal of employee concerns as “tenuous at best.”
In contrast, Arbitrator Marcotte found that the requirement to have first and last names on name tags is a new safety risk for employees. With full names on ID badges, stalkers and disgruntled individuals can more easily discover additional personal information through the internet and modern technology. While the likelihood of increased risk may be low, the consequences may be serious for the employee and the employee’s family.
The hospital has procedures in place concerning workplace safety risks, but they do not consider the new risk created by its name tag policy and are reactive in nature. ONA believes that any perceived benefit that may exist due to full names appearing on ID badges is overshadowed by the increased unease and vulnerability employees feel outside of the workplace.
As this matter continues to unfold, any employee who feels that an unnecessary risk to personal safety is being taken by having both their first and last name appear on their ID badge should immediately communicate their concern to their manager and a steward.
If you have any questions, or any incidents in which you want to share with ONA, do not hesitate to contact your Bargaining Unit President, Brenda Pugh at Local055@ona.org or in Brenda’s absence, Deanna King at email@example.com
Deanna King, RN
Labour Relations Officer
55 Head Street West, Suite 306
Dundas, ON L9H 3H8
Currently, some employees have the right to take up to 10 days of unpaid, job-protected leave, each calendar year due to illness, injury and other emergencies/ urgent matters. But these rules only apply to workplaces with 50 or more employees.
The legislation will require all employers to give all employees 10 personal emergency leave days per year, including two paid days if the employee has been employed for one week or longer (7 days).
Comes into effect
This will come into effect on January 1, 2018.
Posted December 6, 2017
ONA Celebrates Win for Front-Line Nurses: Government announces nurses to be covered under PTSD presumptive legislation
December 6, 2017
The Ontario Nurses’ Association (ONA) is celebrating an announcement by the provincial government that nurses will be included in Post-Traumatic Stress Disorder (PTSD) legislation.
“We are ecstatic that the government has decided to do the right thing and include front-line nurses in the presumptive legislation,” said ONA Provincial President Linda Haslam-Stroud, RN. “ONA has always known that nurses are in every way first responders and vulnerable to developing post-traumatic stress disorder. It’s a great day for nurses who work so hard to provide quality patient care.”
ONA has been “getting loud” about the omission of nurses from the legislation since it was passed in 2016. Most recently, members participated in an on-line campaign, emailing more than 1,000 letters to their MPPs, the Health Minister and Premier calling for nurses to be included.
“Nurses do suffer from PTSD due to their workplace experiences,” notes Haslam-Stroud. “The top-five triggers for PTSD in nurses are:
-Death of a child, particularly due to abuse. -Violence at work. -Treating patients that resemble family or friends. -Death or injury of patients. -Heavy patient workloads.
ONA is currently holding its Biennial Convention at the Westin Harbour Castle in Toronto, where Health Minister Eric Hoskins made the announcement to the cheers of the approximately 1,000 front-line nurses and health-care professionals. “This is a wonderful development and a great way to end my tenure as the elected Provincial President of ONA,” said Haslam-Stroud. “Our incoming President, Vicki McKenna, RN, will be working with the government to implement the legislation in a timely manner.”
ONA is the union representing 65,000 registered nurses and health-care professionals, as well as 16,000 nursing student affiliates, providing care in hospitals, long-term care facilities, public health, the community, clinics and industry.
For more information: Sheree Bond: (416) 964-8833, ext. 2430; cell: (416) 986-8240; firstname.lastname@example.org
Posted December 5, 2017
Posted July 3, 2017.
“Canada’s Nurses Speak Up!”
CFNU Calgary Convention
Local 55 Brenda Pugh (CMH) and Laurie Kudoba (SMH)
The CFNU is the national voice for nearly 200,000 nurses and student nurses across Canada. We are relentless advocates for the health and safety of our members and the patients that we care for from coast to coast. Join us as we speak up for a stronger health care system and a better workplace for all nurses.
Posted May 1, 2017.
Demand that nurses be included in PTSD legislation
Submitted by rnaopolicy on Mon, 2017-05-01 17:48
More than a year has gone by since RNAO wrote to Premier Wynne urging that Supporting Ontario’s First Responders Act (Post-traumatic Stress Disorder, 2016) be amended to include nurses. Thanks to the 6,405 people who responded to our call urging Premier Wynne to correct the shocking oversight of excluding nurses among the list of first responders, the government has committed to ensuring that nurses be included in this legislation. However, we were disappointed this wasn’t announced at RNAO’s Annual General Meeting held on April 27, 2017, nor it was announced on May 1 – First Responders Day. Clearly, we still need your urgent action to make this a reality.
Have you always wanted to get more involved in the work of our union? Or perhaps you are a new or seasoned leader and want to hone your skill set. If so, we have just the program for you!
Back by popular demand, ONA’s 2017 Leadership Conference will take place from September 18-22 at the Oakwood Resort in Grand Bend. As last year, the conference will focus on three streams: activists, novice and advanced.
The significant changes to the Plan are the following:
We have clarified that we will reimburse legal expenses for criminal charges which are
withdrawn. Previously, the Plan offered coverage only for charges dismissed, stayed or
where the member was found not guilty. (see p. 7-8)
LEAP now automatically offers up to $5000 coverage to members who have complaints
against them at the Information and Privacy Commission (see pages 8 – 9).
We now offer coverage for prosecutions under PHIPA. We will reimburse up to $100,000
if the member is found not guilty or charges are withdrawn, dismissed or stayed, similar
to our process for criminal charges (see pages 9 – 10).
Be sure to read the Plan carefully for full details of the conditions and limitations. Feel free to
contact me if you have any questions.
LEAP Team Leader
Ontario Nurses Association
tel: 416-964-8833, ext. 2383
(1-800-387-5580, dial 0 for Toronto) ext 2383)
Fax:(416) 964-8864 (1-866-964-8864)
September 07, 2016
September 7, 2016: The Hospital Award has been released by Arbitrator Christopher Albertyn.
The details of the award will be explained to Bargaining Unit Presidents from Participating and Non-participating Hospitals at a sector meeting scheduled for Tuesday, Sept. 13, 2016.
ONA Provincial Professional Practice Teleconnect
KISS – Keep it Simply Succinct
Date: Tuesday September 27, 2016 Time: 4:30 p.m. to 6 p.m.
Topic “New Look” – Keep it Simply Succinct- KISS
During this session, ONA’s Professional Practice Specialist will provide an update on the new KISS document to help nurses on the front line document and push their patient safety and workload issues forward for faster resolution.
Online format and presentation. Full description available here.
Labour Day is September 5
Since its inception, ONA has been a leader on human rights issues that affect not only our members, but all members of our society. In 2015, ONA launched a human rights and equity initiative to champion human rights causes even further and to highlight major human rights and equity observances including Labour Day.
Source: ONA central.
In a time when workers’ rights are taken for granted and even workers’ benefits have come to be expected, it’s no wonder that the origins of Labour Day are confined to the history books. What evolved into just another summer holiday began as a working class struggle and massive demonstration of solidarity in the streets of Toronto.
Source: Canada’s history
August 25, 2016: We have just been advised that the award of Christopher Albertyn for our contract will be released the week after Labour Day. Please find below the notice of the Hospital Sector meeting on Tuesday, September 13, 2016 in Toronto.
We ask that Local Coordinators connect with all their hospital Bargaining Unit Presidents ASAP. They will need to immediately arrange time off for September 13. If there are any issues, please notify their LRO who will assist.
Who can attend: Bargaining Unit Presidents from Participating Hospitals and Non-Participating Hospitals, Local Coordinators and Observers (up to 8 from each Chartered Local Association, if local budgeting allows), in accordance with Article 6.23 of the Constitution.
Hospital’s Attendance Management Program contrary to Human Rights Code
ONA has won an important decision, challenging a hospital’s Attendance Management Program (AMP) as being contrary to the Human Rights Code.
When the hospital changed its AMP, ONA filed a policy grievance challenging aspects of the new policy, including the treatment of disability-related absences and the requirement for a medical certificate after each and every absence for employees placed in the program.
The Health Information Protection Act (HIPA) has passed in the Ontario legislature.
The act introduces new measures related to privacy, accountability and transparency in the health-care system, and will amend existing legislation to protect the personal health information of patients, including:
• Making it mandatory to report privacy breaches to the Information and Privacy Commissioner and, in certain
circumstances, to relevant regulatory colleges.
• Strengthening the process to prosecute o ences under the Personal Health Information Protection Act by removing
the requirement that prosecutions must commence within six months of the alleged offence.
• Doubling the maximum fines for privacy offences from $50,000 to $100,000 for individuals, and from $250,000 to
$500,000 for organizations.
Registered nurses working at Cambridge Memorial Hospital are taking action to fight cuts to care that hurt patients.
Despite being in the minority of Ontario hospitals that are not experiencing budget deficits, Cambridge Memorial is cutting four registered nurses from its in-patient Mental Health Unit, and reducing the registered nurse complement in the emergency department.
2014–2015: Comparison of hospital deaths to the average Canadian experience
Click on a province or territory to compare to the national average and customize your view on this page.
The determination of higher or lower than average is based on a statistical assessment and the desirable direction of the indicator. Above average, which is colour-coded as green, represents the desirable direction for each indicator.
Hospital Deaths (HSMR), 2010–2011 to 2014–2015
Display up to 3 provinces or territories by selecting the boxes. Click again to unselect. You can also ADD a city to find results for its health region or ADD a hospital, using the search boxes below. At least 3 years of data must be available for trend results to appear on the graph.
Lower is better. The measure is adjusted for some of the differences in the types of patients a hospital sees. For example, more deaths would be expected in a hospital that cares for severe trauma patients than in one that focuses on maternity care. The HSMR is most useful to follow a hospital’s performance over time.
Members Bring about Significant Changes to Kingston Hospital.
Thanks to our members diligently filling out their workload forms, they are seeing significant improvements in the emergency department (ED) and Critical Care Program at Kingston General Hospital.
ONA Professional Practice staff got involved and an Independent Assessment Committee (IAC) hearing was called.
The unit will now see an increase of one RN 24/7, and an increase of five permanent full-time and six permanent part-time positions to achieve new baseline staffing. The RN float position hours returned to a 12-hour shift (it had been reduced to 10 hours). There is also an increase in security guards and coverage by 16 hours per day. Also, all entry points to the ED have been secured with card swipe entry.
Attention ER RN (CMH)
On April 20th, we will be holding an emergency meeting for the RNs of the the ER department to discuss our next steps as we are preparing for and independent assessment committee to deal with all your unsafe work forms.
Our labor officer Deana King will be there to discuss
– Process of independent assessment
– Data we need Meeting Location: Small class room by the auditorium April 20: Start 1800 hr , repeats at 1915 hr.
Your ONA Hospital Central Negotiating Team had a very difficult three weeks of bargaining during which nothing of substance was agreed to by the Ontario Hospital Association (OHA), the organization that represents the majority of hospital employers in the province.
As a result, we spent two long days at arbitration this week and have subsequently provided additional written submissions to the arbitration board.
I’ve recorded this video to give you a quick update:
As you may know, many hospitals are balancing their budgets on the backs of RNs.
It may be known as “The new model of care to improve the patient experience” or “The return to functional nursing” but in the end it often results into lowering the calibre of Nurses working in areas that require the knowledge and expertise of Registered Nures. Diluting the skill set is a recipe for disaster and it is shocking to know that certain hospital administrators go as far as experimenting with one of our most vulnarable group of patients in the Neonatal Intensive Care. These patients typically do not fall under the scope of RPN practice as defined by the College of Nurses. These patients have care needs that are not well defined, are unpredictable in terms of fluctuating health conditions that require close frequent monitoring and reassessments. Due to unpredictable, systemic or wide ranging responses that can be subtle, these tiny patients carry a very high risk of negative outcomes. Hopefully it will not require a post mortem to learn that this idea of saving money isn’t worth it.
Please sign the RNAO petition below and let our voices be heard.
Over 17,000 colleagues who have already demanded a stop to RN replacement in Ontario, can we count on you to add your voice?
Due to the inaction of the Minister of Health and Long-Term Care, RN replacement in Ontario has become critical. The latest catastrophe is the replacement of RNs – specialized in neonatal intensive care (NICU) – with RPNs at St. Joseph’s Healthcare in Hamilton.
Over 17,000 respondents have written to Minister Hoskins and asked him to stop RN replacement. Now it’s your turn. We urge you to sign the action alert to stop cost saving experimentation with vulnerable babies and ask Minister Hoskins to immediately mandate that St. Joseph’s Healthcare reverse its decision. Furthermore, we ask Minister Hoskins to issue a letter to all hospitals placing a moratorium on RN replacement with RPNs.
Arbitration Win about Article 14.01 and Changes to Scheduled Days Off
Full details Arbitrator Barry Stephens award available here
Earlier this fall, at the MICs Group of Health Services (Lady Minto Hospital), Arbitrator Barry Stephens issued an arbitration award that is significant to the sector. In this case, the arbitrator held that nurses are entitled to premium pay under the clarity note of Article 14.01(a) for working on their scheduled day off even if the employer provides 48 hours notice of the change. The arbitrator went on to say that scheduled days off are defined at the time the posted schedule is posted.
In this case, the grievors had their posted schedules changed in a manner that required them to work on days that had originally been scheduled as their days off on the initial posted schedule. In all instances, the employer gave greater than 48 hours notice of the change. The grievors claimed they were entitled to premium pay under the clarity note in Article 14.01 (a) for being required to work on their scheduled days off.
In his decision, the arbitrator noted that although the employer was permitted to make the changes in question, the parties intended for a “scheduled day off” to refer to a day on which the employee is not scheduled to work on the originally posted schedule. As such, the change constituted a violation of the scheduling language and the employees ought to be paid a premium for that violation.
This is a significant win for ONA on Article 14.01(a). As this is central language, nurses across the province should now have more predictability because their scheduled days off are clearly determined at the time the employer posts the schedule. The employer cannot change these scheduled days off without incurring the premium once the schedule is posted, regardless of how much notice is given.
Where schedules are being changed in this manner, the hospitals should be paying premium pay to our full-time employees who have the same collective agreement language. Please contact your Labour Relations Officer (LRO) for assistance enforcing this decision. Grievances may need to be filed.
Posted January 24, 2016
Being “on call” is not a real break. That was the decision reached by an arbitrator in response to the Washington State Nurses Association’s grievance, and subsequent arbitration, against MultiCare Health System, which owns the hospital.
In a groundbreaking decision, the arbitrator stated that the buddy system does not work, failing to give nurses true breaks from responsibility for their patients and from nursing’s physically and mentally demanding work:
“The requirement of a nurse on break to be ‘on call’ diminishes the purpose of a break from work. Nursing requires knowledge, experience, dedication and concentration, tempered with compassion and patience, to successfully care for patients in need. Full article here or download PDF Source: Washington State Nurses Association