Find updates about Covid-19 as it applies to our Local (CMH & SMH, Trinity & St.Luke’s)

When your professional obligations conflict with your personal obligations.

FAQ Professional Practice Q&A v.1_6

Also see ONA’s guide for members: “My right to refuse unsafe work”

Ontario Takes Extraordinary Steps to Ensure Health Care Resources are Available to Contain COVID-19

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Posted, June 11, 2020

Dear ONA member,

From day one of this pandemic, the Ontario Nurses’ Association (ONA) – along with each one of you – have been ringing alarm bells about the serious situation in long-term care (LTC).

Residents, nurses and health-care professionals must be protected from further spread of COVID-19. We need more funding, more full-time registered nurses and health-care professionals, pay for lost wages and an end to making profits in long-term care. Lives are at risk!

Together, we have the power and influence to hold this government accountable to keep its promise to fix this broken long-term care system.

That’s why I’m asking you to make the commitment to take action to protect residents and the valued nurses and health-care professionals who care for them:

• Sign-up for our Day of Action to Protect Long-Term Care on June 17, 2020. We are asking Premier Ford to protect residents, nurses and health-care professionals.
• If you are an ONA LTC member sign-up to join a Zoom Chat with your Member of Provincial Parliament and other ONA LTC members.
• Sign our petition to Phase Out For-Profits in Long-Term Care.

Make the Commitment to Protect LTC.

Sign-Up Here

As a union, the solidarity we show each other by combining our efforts to support our long-term care members makes a real difference. Help ONA keep the pressure on the government.

Make the Commitment to Protect LTC.

Thank you for taking action.

In solidarity,

Cathryn Hoy, RN
First Vice-President
Political Action & Professional Issues
Ontario Nurses’ Association (ONA)

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Posted, May 29, 2020

Dear ONA member,

As you may recall from my updates, I have been lobbying the government to include all health-care workers under the pandemic pay program. Many of you have been assisting my efforts by sending our online emailer to the Premier and Ministers. Nearly 4,000 emails have been sent.

In fact, I was speaking with the Minister of Health about pandemic pay at 3 p.m. today. We also received a briefing from the Ministry of Health.

Unfortunately, the government has made the decision that the funding provided by the federal government will only cover the list of eligible classifications that was expanded on May 27.

Please review the updated list on the government’s webpage.

Eligible employees in eligible workplaces will receive:

• $4/hour premium
• Monthly lump sum payments of $250 for four months who work over 100 hours per month
• Pandemic pay will be effective for 16 weeks, from April 24, 2020 until August 13, 2020.

Eligible workplaces clarified today:

• All hospitals in the province providing publicly-funded services, including small rural hospitals, post-acute hospitals, children’s hospitals and psychiatric hospitals
• Home and community care settings (including community-based mental health and addictions)
• Mental health and addictions (congregate)
• Public health
• EMS sector

Eligible workers clarified today:

• Personal support workers including home support workers, home help workers, community support workers, residential support workers, homemakers
• Registered nurses, registered practical nurses, nurse practitioners
• Developmental services workers
• Attendant care workers
• Auxiliary staff, including:
  • Porters
  • Cooks, food service, food preparation
  • Custodians, cleaning/maintenance and environmental services staff, sterilization and reprocessing staff
  • Housekeeping
  • Laundry
  • Security, screeners
  • Stores/supply workers, receivers, department attendants
  • Hospital ward and unit clerks
  • Client-facing reception/administrative workers; schedulers; Administrative staff working in home and community care or community-based mental health and addictions
  • Community drivers
  • Community recreational staff/activity coordinators
• Mental health and addictions workers: counsellors/therapists, case workers, case managers, intake/admissions, peer workers, residential support staff, Indigenous/cultural service workers
• Respiratory therapists in hospitals and in the home and community care sector
• Paramedics
• Public health and infection prevention and control nurses.

Funding and Eligible Periods

Government funding will flow directly to each worker’s employer for payment to staff.

Funds will flow proactively; employers do not need to apply to government.

Four designated pay periods for hours worked are eligible: from April 24 to August 13, 2020 as follows:

• April 24, 2020 to May 21, 2020
• May 22, 2020 to June 18, 2020
• June 19, 2020 to July 16, 2020
• July 17, 2020 to August 13, 2020

Payments to employers will flow after August 13.

Eligible workers receive the $4/hour in addition to regular wages for each hour worked during the eligibility period.

Pay is not part of an employee’s base salary or pensionable earnings, and does not impact benefits.

Statutory deductions will apply. Employers will be reimbursed the cost.

Lump-Sum Payment

The lump-sum payment is $250 per four-week period (as above) where an eligible worker works more than one hundred (100) hours of eligible work, to a maximum of $1,000 over the 16-week pandemic pay period.

Note the total 100 hours worked can be with multiple employers. The lump sum is paid by the worker’s primary employer. Individuals must notify their employers of their multiple workplaces to ensure all hours are reported to the primary employer for payment.

Sectors

Hospital Sector

Nurses (RN, RPN, NP), PSWs, respiratory therapists are eligible workers, along with auxiliary support workers, food service and others such as screeners.

Unfortunately, the list of eligible health-care professionals has not been expanded.

Home and Community Sector

Eligible workplaces: All publicly-funded home care, community support service organizations, assisted living in supportive housing, ABI services, family-managed care, bundled care, the SMILE program, short-term transitional care models/programs, community paramedicine, CILT/attendant care, hospices, respite programs, LHIN-provided services, approved contracted agency staff, ministry funded programs for First Nations/ABI programs; bundled care models.

The LHIN Care Coordinators are not included unless they have been redeployed to employers covered by the pandemic pay eligibility as set out above.

Eligible workers:

• Both certified and non-certified PSWs who provide personal support services are eligible. Other titles include: non-certified PSWs, home support workers, home help workers, community support workers, residential support workers; homemakers under the Homemakers and Nurses Services Act.
• Other congregate care workers instrumental in operation of the program or providing care/service in-person, including: security; screeners; schedulers; administrative staff; recreational staff/activity coordinators/other coordinators.
• Other similar positions that are low-wage and provide front-line care, interact with residents or are instrumental to the operation of the congregate program.
• Porters; food preparation/food service; custodian/maintenance; housekeeping/cleaning; drivers; laundry.

Public Health and Emergency Services Sector

Eligible workplaces:

• Public health units
• Emergency services, system wide.

Eligible workers:

Nurses in public health units that have consistent and ongoing exposure to COVID-19:

• Registered Nurses
• Registered Practical Nurses
• Nurse Practitioners
• Public Health Nurses
• Infection Prevention and Control Nurses.

Emergency Service Providers:

• Primary Care Paramedic
• Advanced Care Paramedic
• Critical Care Paramedic
• Paramedic Preceptor
• Emergency Medical Assistant.

I will continue to keep you informed of any further information we receive related to implementation.

Reprocessed, Sterilized, or Decontaminated N95 Respirators

I also wanted to assure you that the government has confirmed that reprocessed, sterilized, or decontaminated N95 respirators will not be used in any setting at the current time. If your employer is doing anything differently in your workplace, please notify your Bargaining Unit President.

Physical Distancing

With the province moving to open some parts of the economy, it is critical that nurses and health-care professionals model physical distancing and proper infection control practices at work.

We all need to be exemplary role models and practice what we preach to the public.

I will be sending out further communications as we learn more about the scope and mandate of the province’s Commission on Long-Term Care that the Premier announced will commence in July.

All the best to everyone on the front lines working tirelessly under extraordinary circumstances. I informed the Minster today that you will need some time off this summer for respite care.

Take good care of yourselves. Ontarians continue to count on each one of you.

In Solidarity,

Vicki McKenna, RN
President

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Alert – Substitution of Technical Grade Ethanol in Hand Sanitizer

It has come to our attention that, due to supply issues, some manufacturers are substituting food grade ethanol with technical grade ethanol in some hand sanitizers.

Health Canada has issued a time limited approval to use technical grade ethanol while supply shortages of the higher-grade ethanol exist. However, because it contains toxicological properties including carcinogenicity, Health Canada has required that manufacturers notify all customers that technical grade ethanol is in the product and to label the containers with the following warnings: “Do not use on broken or damaged skin. Do not use if you are pregnant or breastfeeding. Do not inhale.”

Source available here, ONA complete memo available here

Posted, May 27, 2020

Dear ONA member,

I was so heartened to learn that more than 20,000 people – including you and thousands of other ONA members – have emailed our Premier to demand that you, as nurses and health-care professionals, have direct access to proper personal protective equipment (PPE) during this uncertain time.

Your support was a success! The Ontario Nurses’ Association (ONA) was able convince the government to:

• Let nurses and health-care professionals decide that, when you need access to PPE like an N95 respirator, to have it available from your employer.
• Allow you, as nurses and health-care professionals, to use your clinical judgment to determine what protection you need to ensure your safety and that of your patients.
• Include ONA in discussions regarding the stewardship of PPE in the province.

This was a hard-fought win for you and all who are on the front lines, doing your best under challenging circumstances.

We need your support again. The government has announced a “pandemic pay premium” for some health-care workers during this pandemic. Unfortunately, this “premium” excludes many health-care professionals including lab technicians, physiotherapists, and dozens of others. This is not fair. All health-care professionals deserve to receive pandemic pay.

Please email the Premier now and tell him that all health-care workers should receive pandemic pay.

I hope you’ll support all health-care workers by sending your email today. Your advocacy will give a big boost your colleagues who are already facing a stressful and tenuous situation.

In solidarity,

Vicki McKenna, RN
President

P.S. If your email has already been sent, please accept our heartfelt thanks. Thank you for your support!

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Posted, May 12, 2020

Dear ONA member,

I had hoped that I would never have to send you the news that I am writing with today.

I am devastated to share with you the news that an ONA member working in a long-term care facility has died of COVID-19.

Brian Beattie, RN, was a well-liked, well-respected registered nurse working at Kensington Village long-term care in London.

ONA learned of the death earlier today. I have spoken with Brian’s family and the dedicated RNs who worked alongside him. Brian considered his co-workers and residents to be his “other family” and was a strong advocate for keeping staff safe during the pandemic, thereby keeping residents safe. ONA is offering its full support to his family and our members at this difficult time. Our staff are working to ensure that his family receives any and all benefits his survivors may be entitled to.

I know that this is a very difficult time for everyone, especially those of you working closely with COVID-19 patients and residents. I share in your grief.

Our deepest condolences go out to his family, his colleagues in long-term care, and our wishes that each of you stays well.

In solidarity,

Vicki

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Ontario Nurses’ Association eBULLETIN

ONA’s Latest News – May 2020 Dear ONA member, In the wee hours, I spend a great deal of time strategizing about how to improve the health and safety of each and every one of you, our members. The COVID-19 pandemic has been highly distressing, and I have felt, as each of you no doubt have, alarmed at the lack of planning, the lack of proper personal protective equipment (PPE), and the lack of clear communications and safe practices by employers. We all know that it did not have to be like this, but the reality is that your union is working on all fronts to keep you safe. We are engaged at government meetings, and holding your employers accountable to ensure your rights are upheld and that you are safe. Members do not see this behind-the-scenes work, but it has been highly effective in a number of ways. Recently, we achieved two significant wins that will further protect nurses and health-care professionals working in long-term care homes (LTCHs). First, after exhausting all other avenues, we had to take four LTCHs to the Ontario Superior Court to force them to provide access to proper PPE to workers to protect themselves and their residents. Administrators are now obligated to follow infection control practices that have been detailed in government directives, and put safety over profit. Earlier this month, an arbitrator released a grievance arbitration decision that provides clear direction to long-term care homes, which is very welcome news. ONA had been filing grievances on a number of issues, including access to PPE, training, and ensuring cohorting of COVID-19-positive and negative residents. This decision also addresses short-staffing issues and staff working while ill. I am very pleased that this shows the way forward for you, our members, working on the front lines of long-term care. ONA has also filed appeals against several hospital employers arguing that nurses should be entitled to measures to keep them safe, including access to personal protective equipment. We have been successful with settlements at Headwaters Health Care Centre and St. Mary’s General Hospital. Media coverage surrounding COVID-19 has been non-stop, and we continue to be heard in the media, time and again. From radio interviews to television spots, in-depth articles to local community mentions, ONA is in the news, and the public is on our side. We see this through the thousands of positive and supportive comments on our social media feeds, advocacy efforts from more than 20,000 people who have sent emails in support of access to proper PPE for health-care workers, mobilizing initiatives that have spurred hundreds of our members to tell their stories about COVID-19, and so much more. I am truly heartened by the outpouring of member actions that has had such a positive difference in our ongoing pursuit of protection for ourselves and our patients, residents and clients. Know that ONA is doing everything it can to support you under such challenging circumstances, and keeping you safe is our number one goal. I, like you, wish things could be addressed more quickly, but I am heartened when I think of the progress we have made, even though we have more to accomplish. On a brighter note, Nursing Week is from May 11-17. This year will be a very different celebration, yet it has never been a better time to appreciate, honour and recognize nurses. I wish you all a safe, healthy and happy Nursing Week. Be well and be safe, Vicki McKenna, RN President News You Can Use Listen to ONA’s Forward Together Podcast In the latest episode, Vicki McKenna discusses what ONA is doing for its members, and how the COVID-19 pandemic has impacted members and the way they practice. She also looks ahead to what might come next. Listen at www.ona.org/podcast. Quick Bits and Bytes on ONA.org: Nursing Week is here! We’d like you to share your stories on social media focusing on our Nursing Week theme, Our Calling: Care, Compassion, Comfort, using the hashtag, #ItsMyCalling. Be sure to tag @ontarionurses too. You can win a fantastic prize just by posting your story. You can also submit your story to our Front Lines editor at frontlines@ona.org. Want to win $100? Provide your contact information to ONA: Complete this online form, call ONA Dues and Membership Intake at 1-800-387-5580, ext. 2200, or email your information to memberchanges@ona.org. Each member who submits their contact information will be automatically entered into a random draw for a cash prize. Seventy-five random names will be pulled during the week of May 24, 2020. Visit this page for more information, including contest rules. Status of ONA Meetings and Events: Due to COVID-19, the ONA Board of Directors has had to make decisions regarding our in-person events and meetings to ensure we keep our members and staff safe. Click on this link to see the revised schedule. May 17 is the International Day Against Homophobia, Transphobia, and Biphobia (IDAHOTB): ONA is proud to recognize and support the diversity of our members and staff, and to join in the fight against discrimination based on an individual’s sexual orientation and/or gender identity. Send your message of support for proper Personal Protective Equipment (PPE) All health-care workers need proper protective equipment to do their job safely. Join the tens of thousands of nurses and health-care workers in sending a clear message to your MPP and Premier Ford at www.ona.org/ppe/ May is National Physiotherapy Month We are very proud to recognize the work of our highly skilled members by celebrating National Physiotherapy Month every May. This year, we recognize the dedication of physiotherapists who work on the front lines to meet the needs of their patients during the COVID-19 pandemic.

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Posted, May 11, 2020

Dear ONA member,

Welcome to Nursing Week! This special commemorative week starts today and runs throughout the week until Sunday, May 17.

Our theme of Our Calling: Care, Compassion, Comfort seems particularly pertinent this year, given all that you are experiencing throughout this pandemic.

I want you to know ONA stands behind each and every one of you as you cope with the stress and uncertainty of COVID-19 in your workplaces. As you work through these challenging times, you continue to provide care to your patients, residents and clients as though they were part of your own family. It is from you that we have drawn our theme. Your care, compassion and comfort all come from your heart.

And, while you may not feel like celebrating, the Board of Directors and I encourage you to take this time to recognize yourself and each other as you provide care and services to patients, residents and clients across the province.

Please join with me and ONA’s Board of Directors as we observe Nursing Week and honour the important role you all play in our health-care system.

As our province and the entire globe practice social-distancing and refrain from attending physical events, we can still share Nursing Week via social media.

Tell us what you love about nursing and why you have made it your calling by sharing your stories on social media using the hashtag, #ItsMyCalling. Every person who posts a story using the hashtag, #ItsMyCalling, will be entered to win a prize!

You can also send your stories to our Front Lines editor at frontlines@ona.org.

Feel free to post the social media shareables and display the posters in your workplaces, which can be found on our website here.

As we head into Nursing Week 2020, your Board of Directors and I wish you the very best. Know that we are in this together and that we stand behind each and every one you.

Stay safe, and have a good Nursing Week!

In solidarity,

Vicki McKenna, RN
President

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Posted, May 8, 2020

From: Brenda Pugh
Sent: Friday, May 08, 2020 10:46 AM
To: ONA
Subject: FW: 20200504_LieuTimeLOU

Good morning,

I need to clarify that the pause in the lieu time is for ALL RN not just the OR /PACU

Sorry for any confusion

Thanks to the OR/PACU for bring this issue to my attention, and we are pleased we could get settlement on this.  As you can imagine the pandemic is a new experience and we never experience anything like this. If there is any other issues that I need to be aware of please let me know

As you are aware we have grieved the delay of our approved vacation book delay till may 31 and are not in agreement with no vacation approvals for the next schedule and are trying to resolve this

The government has extend the emergency act till MAY 21 – if you have vacation booked between now and the MAy 21 please speak with your manger to see if it still approved

Any issue email

Be safe

Brenda

Brenda Pugh R.N.

ONA President CMH

Local Coordinator local 55

519-841-3855

From: Brenda Pugh
Sent: Thursday, May 07, 2020 2:16 PM
To: ONA
Subject: FW: 20200504_LieuTimeLOU

Attention OR,PACU,

Please see the attached minutes of settlement regarding your 120 days in which you can bank you lieu time

We have come to a settlement that from March17- July 15 2020 we have paused the 120 days due to covid 19.

Webmaster comment: Attachment available in Outlook

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Posted: May 8, 2020

Dear ONA member,

Across Ontario, nurses and health-care professionals in the hospital sector are being asked to go above and beyond to protect your patients. We want to thank you for all you are doing to keep our communities safe during this pandemic.

As your workplaces change and adapt to COVID-19, and the government continues to respond with updated and new directives, we need to hear from you. The Premier has said that he wants to hear from the front lines. Now it is your turn to tell us what you are experiencing.

Are there still gaps on the front lines of your workplace? Are you being put in danger or are you being protected?

Please complete this short survey to tell us about your experiences. Your answers will be kept confidential and we only ask that you provide your name and bargaining unit for internal follow-up. If you received this survey yesterday by ONA text messaging to your cell telephone and you already completed the survey, you do not need to complete it again.

During this pandemic – and beyond – we need safety for all nurses and health-care professionals. Help us by completing this poll so we can keep the pressure on government and your employers to deliver on the promises they have made to protect you and your patients.

Thank you for all you do,

Cathryn

PS – if you haven’t already, join thousands of nurses and health-care workers in sending an email message to your MPP and Premier Ford: https://www.ona.org/ppe/

Cathryn Hoy, RN
First Vice-President
Political Action & Professional Issues
Ontario Nurses’ Association (ONA)

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Posted: May 1, 2020

Dear ONA member

This communication contains an update from my call today with the Ministry of Health relating to the status of pandemic pay and some information on implementation processes.

Eligible Workplaces and Workers

The government has added a bit more clarity to the sectors covered and has added a few more classifications. In my call today with representatives of the Ministry of Health, I voiced my concern that the list of classifications does not cover a number of health-care professionals providing direct care during this pandemic. From the discussion today, it sounds like the final list of sectors and classifications is pretty much close to final, with the possible exception of some further clarification regarding auxiliary staff in hospitals beyond cleaners, cooks, and housekeeping.

The government provided some additions to the originally announced list of eligible workers: public health nurses, respiratory therapists in hospitals and in the home and community care sectors and paramedics. See below for the full list as provided by government to date.

Eligible workplaces

• All hospitals in the province, including small rural hospitals, post-acute hospitals, and others.
• Long-term care homes (including private, municipal and not-for-profit homes).
• Licenced retirement homes.
• Home and community care.

Eligible workers

• Personal support workers.
• Registered nurses.
• Registered practical nurses.
• Nurse practitioners.
• Attendant care workers.
• Auxiliary staff, including: Porters, cooks, custodians, housekeeping, laundry facilities and other key workers.
• Developmental services workers.
• Mental health and addictions workers.
• Respiratory therapists in hospitals and in the home and community care sector.
• Paramedics.
• Public health nurses.

Also included for the social services sector:

• Homes supporting people with developmental disabilities.
• Supportive housing facilities.

These workplaces cover nursing and clinical staff, and direct support workers (e.g., developmental service workers, staff in licenced children’s residential sites, in-take/outreach workers).

Please know that ONA is advocating for expansion of the above lists but the government’s policy seems to be set at this point.

The full updated listing of workplaces and workers is available at this link.

Implementation

The Ministry representatives did provide some further information on implementation but the precise details are still a work in progress.

We know that the pandemic hourly pay of $4.00 per hour will be a separate pay and they are working out how it will be administered. The Ministry said more details will be issued in the coming days next week.

Details on implementation of the lump sum payment of up to $250 per month, if working over 100 hours per month, are also not yet finalized. We expect information on this will be released within the next two weeks.

Please be assured that ONA will provide you with further information as soon as the government provides the details on implementation.

Thank you for all of your work on the front lines to keep Ontarians as healthy as possible during this pandemic.

In Solidarity,

Vicki McKenna, RN
President

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Posted: April 28, 2020

Dear ONA member

Each year on April 28, ONA acknowledges a very somber occasion that is, sadly, even more meaningful this year.

The National Day of Mourning commemorates those who have tragically been injured, made ill or killed on the job due to workplace hazards or incidents. The observance began in 1984 and was officially declared an annual day of remembrance the following year by the Canadian Labour Congress (CLC). In 1991, it became a national observance when the Workers’ Mourning Day Actpassed, marking April 28 an official Workers’ Mourning Day.

For ONA, the National Day of Mourning hits very close to home. We remember Nelia Laroza, RN, and Tecla Lin, RN, members who died after contracting SARS while tirelessly caring for infected patients. We remember Lori Dupont, RN, our member who was senselessly murdered while working at a Windsor hospital. And, we can never forget for one single moment that health-care workers continue to have some of the highest rates of injury and illness statistics in the workforce.

But this year has brought challenges we could never have imagined.

Our nurses and health-care professionals are on the front lines, battling a virus the world still doesn’t know enough about. You are selflessly and expertly caring for your patients, residents and clients under very trying conditions while needing to protect yourselves as well. We know you are fearful and exhausted. So, on April 28 – and every day – we honour and thank you too.

While ONA provincial and Local leaders and our members normally have a strong presence at National Day of Mourning events across the province, COVID-19 means they cannot proceed. But that doesn’t mean we can’t acknowledge this day in other ways. The CLC and local labour councils are reshaping plans for the National Day of Mourning. First Vice-President Cathryn Hoy, RN, will be part of a Toronto and York Region Labour Council video streaming on April 28. Learn more about these virtual events on our website at www.ona.org/dayofmourning.

Also on our website, you will find additional information and resources, including two versions of our bilingual National Day of Mourning poster. We encourage you to download and post where possible. Share our National Day of Mourning messages on social media. And, above all else, please take a moment to remember those lost, honour the living, and continue to fight to protect us all. No one should ever have to go to work fearing they will bring an illness home to their loves ones or, worse yet, not return to them at all.

I promise that ONA is here for you. We are fighting this fight with you at every step of the way through all channels available, be it at government tables, through the courts or via the media. We are ensuring your rights under your collective agreements and occupational health and safety legislation are protected. We will stop at nothing – absolutely nothing – to ensure you have the protections you need to stay safe throughout this pandemic. And, together, we will get through this.

In Solidarity,

Vicki McKenna, RN
President

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Posted: April 28, 2020

From: Brenda Pugh
Sent: Tuesday, April 28, 2020 12:48 PM
To: ONA
Subject: $4

 

As you are aware the provincial

Government announced a $4 pay increase and a $250 per month bonus for 4 months for frontline staff

As you can imagine there a lot of questions about how and when we be paid and who will qualify

ONA is meeting with the government to discuss these issues and we will send out communication ASAP

Brenda Pugh

ONA cmh pres

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Posted: April 27, 2020

Dear ONA member,

Since my communication on Friday, a number of developments have taken place over the weekend.

The government issued an amended order that allows redeployment of hospital employees into long-term care homes. Further details are in an update below. Please review the information thoroughly as many important details are contained below.

As well, on Saturday, the Premier announced a $4.00 per hour “pandemic pay premium” for health-care workers across a number of sectors. See below for the information provided by government.

Order for Redeployment of Hospital Staff to Long-Term Care Homes

We have watched with dismay the outbreak crises accelerate and unfold in our long-term care homes. While at the same time, the anticipated surge has thankfully not arrived in our acute hospitals. The hospitals are currently running at between 65-70 per cent capacity and the homes are completely overwhelmed and unacceptably understaffed.

On Friday night, ONA received advance notice from the Minister of Health that the government would be issuing a revised temporary Emergency Order, effective Saturday, April 25, 2020, permitting hospitals to redeploy staff to long-term care homes. While ONA does not believe an order is necessary, the redeployment will bring some much-needed assistance and relief to our long-term care members and the residents they have so valiantly worked to protect and provide care.

The order has the effect of making a long-term care home a site of a hospital, where the hospital volunteers to assist a long-term care home(s).  Therefore, when a hospital sends in staff to a long-term care home, they will remain staff of the hospital covered by the collective agreement of the hospital.

The Minister of Long-Term Care also issued a Directive to long-term care homes:

1. The Minister of Long-Term Care issued a Minister’s Directive effective April 24, 2020, requiring all long-term care homes in outbreak to cooperate with Ontario Health and to provide entry to staff and any resources being made available from the federal government or public hospitals. Homes must allow them to provide services in relation to infection control or resident care as required.
2. As of April 24, 2020, the Province of Ontario issued an Emergency Order enabling hospitals, including staff from Infection Prevention and Control (IPAC) teams, to support long-term care homes to provide services and resident care as required.

In addition:

Every licensee of a long-term care home in outbreak shall ensure that staff of the long-term care home take the direction of public hospital supervisory and management staff as it relates to assessments to the home’s IPAC program, clinical supervision, and nursing and personal support services, including assistance with feeding residents of the long-term care home. This includes completing all directed activities in a timely and professional manner.

Prior to the hospitals redeploying front-line staff into the long-term care homes, hospital Infection Control staff and Health and Safety specialists will go in first to ensure the workplace is safe. Hospitals will ensure that all staff redeploying, as well as all staff in the home, have the appropriate Personal Protective Equipment (PPE) in accordance with Directives and infection control best practices.

Long-term care operators must ensure staff of the long-term care home take the direction of hospital supervisory and management staff, as it relates to assessments of the home’s IPAC program, clinical supervision, and nursing and personal support services, including assistance with feeding residents of the long-term care home. This includes completing all directed activities in a timely and professional manner.

ONA has provided the Ontario Hospital Association (OHA) with some advice to assist with the redeployment to long-term care homes, including our position to ask for and utilize volunteers first.

For our LHINs members who have been volunteering to assist in long-term care homes, nothing has changed. The redeployment orders do not mention/or oblige redeployment.

As you know, we continue to reach out to government and your employers during this time to ensure your collective agreement rights (except as amended by Emergency Orders) are maintained through this unprecedented time.

We will continue to update you as more information becomes available.

Pandemic Pay Premium

On Saturday, the Premier announced a “pandemic pay premium.”

I expect the announcement should come as welcome news to ONA front-line workers. The Premier has been saying for days that compensation may be coming. All the health-care unions have been lobbying for additional compensation during this time.

To provide additional support for front-line workers fighting COVID-19, the government is providing a temporary pandemic pay premium of $4.00 per hour worked on top of their regular wages. In addition, the government will be providing monthly lump sum payments of $250 for four months to eligible front-line workers who work over 100 hours per month. The pandemic pay premium will be effective for 16 weeks, from April 24, 2020 until August 13, 2020, and the government expects it to support over 350,000 front-line workers.

The pandemic pay is to support workers on the front lines of COVID-19 and does not apply to management staff.

The backgrounder released by the government indicates the following relevant workplaces and workers eligible for the pandemic pay premium:

Health care and Long-Term Care – Eligible workplaces

• Acute hospitals
• Long-term care homes (including private, municipal and not-for-profit homes)
• Licensed retirement homes
• Home and community care.

Eligible workers

• Personal support workers
• Registered nurses
• Registered practical nurses
• Nurse practitioners
• Attendant care workers
• Auxiliary staff, including porters, cook, custodian, housekeeping, laundry facilities and other key workers
• Developmental services workers
• Mental health and addictions workers.

Social Services – Eligible workplaces

• Homes supporting people with developmental disabilities.

Eligible Workers

• Direct support workers (e.g. developmental service workers, staff in licensed children’s residential sites, in-take/outreach workers)
• Clinical staff
• Nursing staff.

I have written to the government requesting further information on the process for payment and about other details on eligibility, particularly as it relates to health professional occupations and eligible sectors not listed.

As soon as I receive a response, I will update everyone.

Telephone Town Hall on April 29

On Wednesday, April 29, ONA will hold Telephone Town Halls in two sessions: from 5:30 p.m. to 6:30 p.m. EST (for Regions 1, 2 and 5) and from 7:30 p.m. to 8:30 p.m. EST (for Regions 3 and 4).

ONA CEO Bev Mathers, First Vice-President Cathryn Hoy, ONA Board of Directors, ONA staff and I will facilitate the discussion and provide you with the most up-to-date information and directives.

Members will begin to receive a call to join the Town Hall at 5:30 p.m. EST if you are in ONA Regions 1, 2 and 5. For members who are in Regions 3 or 4, you will begin to receive a call at 7:30 p.m. EST.

You need to accept the call to connect to it. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself to the town hall. ONA will post the audio files and will update our question-and-answer document after the town hall and post them on our COVID-19 webpage.

In addition, the Town Halls will be on Facebook Audio Live. You can visit www.facebook.com/ontarionurses at 5:30 p.m. EST and 7:30 p.m. EST to listen in and hear answers to some of your questions.

I encourage you to join if you are able.

We will all keep up the fight for ONA members and the patients, residents and clients who need your care during this pandemic. Be well and be safe.

In Solidarity,

Vicki McKenna, RN
President

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Posted April 24, 2020

Dear ONA member

Today, I am writing with fantastic news for members working in long-term care homes.

Late yesterday, the Ontario Superior Court granted an injunction against four Ontario long-term care homes – Primacare Henley Place, and Rykka Anson Place Care Centre, Eatonville Care Centre and Hawthorne Place Care Centre.

In his decision on an urgent injunction brought by ONA, Mr. Justice E.M. Morgan ruled that the homes must comply with Directives from Public Health. They require that long-term care homes respect the professional and clinical judgement of nurses when deciding how to protect themselves, and therefore their residents. He also ruled that the decision as to what personal protective equipment (PPE) and other health and safety measures are required in delivering care to a resident is to be made by nurses, based on their assessment.

In its ruling, the court ordered several long-term care homes to immediately fix several serious health and safety issues that have resulted in devastating COVID-19 outbreaks.

In his decision, Mr. Justice E.M. Morgan quoted the precautionary principle – to err on the side of caution and take all measures reasonable to keep workers safe.

He wrote in his ruling that nurses are “sacrificing their personal interests to those under their care…not only for the immediate benefit of their patients, but for the benefit of society at large.” Mr. Justice Morgan also said that the private homes’ suggestion that nurses’ quest for masks, protective gear and cohorting of patients was for the nurses’ own narrow, private interest was “ironic” and “seems to sorely miss the mark.” He ruled that the individual nurses spend their working days “sacrificing their personal interests to the persons under their care.”

ONA’s media release on the ruling can be accessed here.

What does the Decision Mean?

The homes must ensure appropriate personal protective equipment (PPE). Long-term care homes are expected to follow COVID-19 Directives #3 and #5 from the Chief Medical Officer of Health.

This means the following process is to be followed:

• A point-of-care risk assessment (PCRA) must be performed by every health-care worker before every patient interaction;
• At a minimum, contact and droplet precautions must be used by workers for all interactions with suspected or confirmed COVID-19 patients. Contact and droplet precautions include access to gloves, face shields or goggles, gowns, and surgical/procedure masks; and
• Airborne precautions when aerosol generating medical procedures (AGMPs) such as suctioning, CPR or CPAP are planned or anticipated to be performed on residents with suspected or confirmed COVID-19, and based on the individual’s point-of-care risk assessment and clinical and professional judgement, which would include access to N95 masks.
• The decision confirms that N95 masks are not for AGMPs only. ONA members can use their judgement to determine risk when working with residents inside the “two metre” guidelines. Judgement can also be used for wearing face shields or goggles, gloves and gowns.
• Staff masking: Long-term care homes should ensure all staff and essential visitors wear surgical/procedure masks at all times for the duration of full shifts or visits in the long-term care home. For further clarity, this is required regardless of whether the home is in outbreak or not. During breaks, staff may remove their surgical/procedure mask but must remain two metres away from other staff to prevent staff-to-staff transmission of COVID-19.
• Staff and Resident Cohorting: Long-term care homes must use staff and resident cohorting to prevent the spread of COVID-19.

I want to congratulate our members in these homes for fighting the good fight on behalf of their residents and their colleagues.

I am optimistic that these measures may soon result in putting out the raging spread of COVID-19 in these long-term care homes.

Military to Assist Five Long-Term Care Homes

Today, the media announced that these five long-term care homes will receive assistance from the Canadian military.

• Orchard Villa, Pickering
• Altamont Care Community, Scarborough
• Eatonville Care Centre, Etobicoke
• Hawthorne Place Care Centre, North York
• Holland Christian Homes’ Grace Manor, Brampton.

We will send further information when the details are released on this military assistance.

ONA Fighting for Safety Measures at Headwaters and St. Mary’s

This week, ONA filed two appeals at the Ontario Labour Relations Board regarding the failure of Ministry of Labour (MOL) inspectors to make orders under the Occupational Health and Safety Act to protect the health and safety of workers.

We have filed an appeal at Headwaters Health Care Centre in Orangeville, where an ONA member was denied an N95 to care for a patient suspected to be COVID-19 positive in the Emergency Department. The patient arrived by ambulance and was received from two paramedics both wearing N95s. The member engaged in a work refusal, and the MOL made no orders.

At St. Mary’s General Hospital in Kitchener, there have been serious health and safety issues since March. The appeal in this case addresses lack of access to N95s and the failure to notify the Joint Health and Safety Committee of workers who have been exposed, among other issues.

In both cases, ONA is seeking interim relief to get orders in place to protect our members as soon as possible. Other health-care unions (e.g., OPSEU) are intervening in our appeals to seek similar protections for their members.

New Government Orders

Since my last communication to you, the government has issued two new orders.

The first order, issued on April 22, extends the previous orders on redeployment, expiring on April 22, to May 6.

The following emergency orders of interest extend until May 6, 2020:

• Work deployment measures for health care workers
• Work deployment for lon g-term care homes
• Streamlining requirements for long-term care homes
• Work deployment for boards of health
• Work deployment measures in retirement homes
• Service agencies providing services and supports to adults with developmental disabilities
• Temporary he alth or residential facilities
• Work deployment measures for service agencies providing violence against women residential services and crisis line services
• Limiting work to a single long-term care home
• Work deployment for district social services administration boards
• Deployment of employees of se rvice provider organizations
• Work deployment measures for municipalities
• Limiting work to a single retirement home

Work Redeployment Order for Mental Health and Addictions

This order, issued on April 22, defines a “mental health and addictions agency” as a not-for-profit entity that:

(a)        provides community mental health and addictions services, and

(b)        receives funding from the Ministry of Health or from a Local Health Integration Network.

As with other redeployment orders, mental health and addictions agencies are authorized to take, with respect to work deployment and staffing, any reasonably necessary measure to respond to, prevent and alleviate the outbreak of the coronavirus (COVID-19).

Mental health and addictions agencies are authorized to do the following:

1. Identify staffing priorities and develop, modify and implement redeployment plans, including the following:

i) Redeploying staff within different locations in, or between facilities of, a mental health and addictions agency.

ii) Changing the assignment of work, including assigning non-bargaining unit employees or contractors to perform bargaining unit work.

iii) Changing the scheduling of work or shift assignments.

iv) Deferring or cancelling vacations, absences or other leaves, regardless of whether such vacations, absences or leaves are established by statute, regulation, agreement or otherwise.

v) Employing extra part-time or temporary staff or contractors, including for the purposes of performing bargaining unit work.

vi) Using volunteers to perform work, including to perform bargaining unit work.

vii) Providing appropriate training or education as needed to staff and volunteers to achieve the purposes  of a redeployment plan.

2. Conduct any skills and experience inventories of staff to identify possible alternative roles in priority areas.

3. Require and collect information from staff, contractors or volunteers about their availability to provide services for the mental health and addictions agency.

4. Require and collect information from staff, contractors or volunteers about their likely or actual exposure to the Virus, or about any other health conditions that may affect their ability to provide services.

5. Suspend, for the duration of the emergency, any grievance process with respect to any matter referred to in this order.

A mental health and addictions agency may implement redeployment plans without complying with provisions of a collective agreement, including lay-off, seniority/service or bumping provisions.

ONA has developed principles for redeployment and your Bargaining Unit President will consult with ONA Labour Relations Officers to discuss with your employers.

Please note this order does not override all provisions of your collective agreement, only the ones noted above.

Telephone Town Hall on April 29

On Wednesday, April 29, ONA will hold Telephone Town Halls in two sessions: from 5:30 p.m. to 6:30 p.m. EST (for Regions 1, 2 and 5) and from 7:30 p.m. to 8:30 p.m. EST (for Regions 3 and 4).

ONA CEO Bev Mathers, First Vice-President Cathryn Hoy, and I will facilitate the discussion and provide you with the most up-to-date information and directives.

Members will begin to receive a call to join the Town Hall at 5:30 p.m. EST if you are in ONA Regions 1, 2 and 5. For members who are in Regions 3 or 4, you will begin to receive a call at 7:30 p.m. EST.

You need to accept the call to connect to it. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself to the town hall. ONA will post the audio files and update our question-and-answer document after the town hall and post them on our COVID-19 webpage.

In addition, the Town Halls will be on Facebook Audio Live. You can visit www.facebook.com/ontarionurses at 5:30 p.m. EST and 7:30 p.m. EST to listen in and hear answers to some of your questions.

I encourage you to join if you are able.

Thank you to everyone delivering care on the front lines in these extremely difficult and uncertain times.

In Solidarity,

Vicki McKenna, RN
President

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Dear ONA member,

In today’s communication, I will update you on information sent out by the government late yesterday and last night.

First, I want to alert you to the media today related to the ONA Court Injunctions filed on behalf of our members at a group of Rykka Homes (Eatonville Care Centre, Anson Place Care Centre and Hawthorne Place Care Centre) and Henley Place (note this is the correct name). All of these long-term care homes are experiencing severe outbreaks with many positive cases (including staff), and resident deaths.

You can see some of the media coverage today here and here.

The judge has now scheduled a hearing on Wednesday, April 22 at 10 a.m. We will provide additional updates as they become available.

Hospital Supports for Long-Term Care

On April 17, the Deputy Minister of the Ministry of Health (MOH) sent out a memo to the Chief Executive Officers of all Ontario hospitals. In it, Helen Angus said that the MOH, the Ministry of Long-Term Care (MLTC), and Ontario Health (OH) are requesting the assistance of hospitals to support Ontario’s long-term care (LTC) homes during the COVID-19 pandemic. This support would be by voluntarily identifying staffing resources for infection prevention and control (IPAC) assistance, medication administration, along with nursing and personal support worker staffing for homes facing critical staffing shortages.

The Deputy Minister indicated that no order through regulatory changes would be necessary since the staffing resources are being voluntarily identified. Hospitals will enter into agreements with LTC homes whereby staff would be seconded and maintain their employment status with the hospital.

It has come to ONA’s attention that the University Health Network (UHN) is setting up a Deployment Unit and assigning staff to this unit, on a mandatory basis, for deployment to LTC homes.

ONA has informed the Ontario Hospital Association (OHA) that the memo from the Deputy Minister clearly indicates that any deployment from a hospital to a LTC home is on a voluntary basis. It is also clear that any staff that volunteers for this redeployment to LTC homes remain employees of the hospital. The OHA agrees with ONA’s position.

Please advise your Bargaining Unit President if your hospital is telling you that it is a mandatory redeployment to LTC homes. It is not and is a violation of the original order for redeployment of staff solely within a hospital.

In addition, the Deputy Minister’s memo to hospital CEOs says that Public Health has confirmed that hospital workers who complete shifts within a LTC home can work in multiple locations.

ONA is taking the position that if hospital staff volunteer to deploy into LTC homes that they should work in only one home. Otherwise, this is in breach of the order to work in only one home. The order to work in only one home is mandatory.

Further, the Deputy Minister’s memo states that hospital workers deployed to a LTC home in an outbreak can return to their home facility and self-monitor for symptoms if asymptomatic and appropriate IPAC precautions are followed, with no breaches in PPE use. If there have been breaches in PPE or the staff is symptomatic/being tested for COVID-19, the staff must self-isolate for 14 days from last exposure (or at least 24 hours symptom-free if symptomatic).

ONA’s position is asymptomatic staff must follow the guidance from the Ministry of Health. In the case where critically required for a positive asymptomatic health-care worker to return to work, there should be a minimum of 72 hours from positive specimen collection date to ensure symptoms have not developed in that time.

Please check with your Bargaining Unit President to inquire about whether your position is critical to operations given the reduced capacity in hospitals at this time.

Redeployment Order for Municipalities

The government also issued a redeployment order for municipal employees. Note this order excludes municipal employees in municipal homes for the aged and in boards of health that are covered by other redeployment orders for their sectors.

However, this order for municipal employees does mean that they can be deployed to assist with maintenance of long-term care homes and to assist with the delivery of public health services.

Please ensure you notify your Bargaining Unit President if you experience municipal employees being deployed into your area.

HOOPP Plan Changes to Assist during COVID

ONA received the following update yesterday:

HOOPP recognizes the bravery and commitment of health-care workers as they work tirelessly to serve our communities during the COVID-19 pandemic. In an effort to do whatever we can to support them, HOOPP’s Board of Trustees held special meetings in recent days to approve measures that will provide some assistance and flexibility to members and employers during this challenging time.

On April 16, HOOPP published information regarding the following Plan changes for members and employers via the COVID-19 pages on hoopp.com.

Continued HOOPP benefits for members on new unpaid emergency leaves – HOOPP will provide any member that takes an unpaid emergency leave, or is within the first 15 weeks of an unpaid health leave, with contributory service at no cost to members or employers.

Extension for contribution payments for leaves of absence – HOOPP has extended the timeline to make pension contributions following a leave of absence. The current timeline of 6 months from the end of a leave has been extended to 12 months and applies to all leaves of absence.

Please visit the Member COVID-19 and Employer COVID-19  pages for more information.

HOOPP is carefully monitoring developments around the COVID-19 outbreak and will continue to provide updates to the Board of Trustees, Settlors, members, employers and employees regarding HOOPP’s response.

Thank you for your dedication to care for Ontarians during this pandemic. I know you will protect yourselves as well to ensure you are there to care for your patients, residents and clients.

Please continue to check our webpage of resources at www.ona.org/coronavirusfor updates and other links.

In Solidarity,

Vicki McKenna, RN
President

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Posted, April 21, 2020

From: Brenda Pugh
Sent: Tuesday, April 21, 2020 5:46 PM
To: ONA
Subject: denial of mask

Good afternoon

As you are aware we are admitting more covid 19 patient , and that you should be doing a patient contact risk assessment and  YOU should decide what type of PPE equipment you need based on your professional assessment of the risk

If you are denied a N95 mask please text me 519-841-3855

 

Brenda Pugh R.N.

ONA President CMH

Local Coordinator local 55

519-841-3855

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Posted: April 17, 2020

Dear ONA member,

I want to start today’s communication by acknowledging the vital work each of you perform on behalf of Ontarians. COVID-19 has demonstrated how important and valued your work is to all.

So far, the surge hospitals have been expecting has not occurred. However, our members are providing care to COVID-19 patients in difficult circumstances and we cannot let our guard down.

I want to acknowledge and applaud the work of our long-term care members who are working in some of the worst conditions in this pandemic, are understaffed, and are overwhelmed by the losses of their residents.

Our members working in home care are also working in difficult conditions and uncertain caseloads.

Our public health members are also pushed to the limit in managing the COVID-19 response.

I want to acknowledge that 10 to 11 per cent of all COVID-19-positive persons in Ontario are health-care workers.

To our members who are sick and to the members of other health-care unions who are also suffering, our thoughts and well wishes are with you in your recovery. Know that we are here to support and to assist you.

I want everyone to take a moment of silence to recognize the nurses and health-care professionals both globally and now in Ontario that have lost lives to COVID-19 while performing their duty of caring for their patients, residents and clients.

In this communication, I will cover recent developments related to new orders in long-term care, retirement homes and in home care. I will also highlight the Ministry of Health’s guidance on COVID-19 testing and health-care workers returning to work.

New Orders for Working in One Long-Term Care Home and in One Retirement Home

Long-term care workers and retirement home workers will no longer be allowed to work in more than one home to limit the spread of COVID-19. This direction is contained in a new order from the government released on April 14 and April 16.

This means that in long-term care homes and retirement homes, any particular employee is not allowed to work at more than one long-term care home or retirement home, operated or maintained by the health service provider.

The order for long-term care homes includes working in municipal homes for the aged and retirement homes.

These orders also mean that an employee at a long-term care home or retirement home is also not allowed to work at a retirement home or at any other facility (such as at a hospital, in home care, or in primary care, or in long-term care).

This order for long-term care homes is effective as soon as reasonably possible, and in any event no later than 5 p.m. on Friday, April 17, 2020. The order for retirement homes is effective no later than 9 a.m. on Monday, April 20, 2020.

These are the deadlines for any employee who works in long-term care or in a retirement home, to which these orders apply, who shall inform each of their employers that they are subject to one of the relevant orders. This means that members must pick one home or other facility to work in and to notify their employers of this decision.

Beginning at 12:01 a.m. on Wednesday, April 22, 2020, an employee of a long-term care home who performs work in a long-term care home operated or maintained by the long-term care provider shall not also perform work in another facility, as follows:

(a) in another long-term care home operated or maintained by the long-term care provider;

(b) as an employee of any other health service provider; or

(c) as an employee of a retirement home.

Beginning at 12:01 a.m. on Wednesday, April 22, 2020, an employee of a retirement home who performs work in a retirement home shall not perform work in another facility, as follows:

(a) in another retirement home operated by the licensee;

(b) as an employee of another licensee; or

(c) as an employee of a health service provider.

Also, beginning at 12:01 a.m. on Wednesday, April 22, 2020, a long-term care employer and retirement home employer shall ensure that any employee who performs work in a long-term care home or retirement home, it operates or maintains is not also performing work,

(a) in another long-term care home operated or maintained by the long-term care provider;

(b) as an employee of any other health service provider; or

(c) as an employee of another retirement home.

All long-term care and retirement home employers shall ensure that a copy of the order is posted in the long-term care home, or retirement home, in a conspicuous and easily accessible location. This is to ensure that all employees are aware of their obligations.

The previous orders for redeployment in long-term care homes is extended to April 23, and in retirement homes extended to April 30, and these orders can be extended.

Because of the new orders, long-term care workers and retirement home workers, who must temporarily give up a job in another care setting, are protected from losing their job as they are entitled to an unpaid emergency leave of absence.

To help long-term care and retirement home workers make up these lost wages, the government encourages employers to offer full-time hours to their part-time employees during the COVID-19 outbreak.

To help employers cover this expense, the government has provided homes the flexibility and funds to hire nurses and other front-line staff they need, when they need them.

These emergency funds are available to help homes cover the incremental costs of increasing hours for part-time staff to help those staff limit their work locations.

Members who experience any loss of income should contact their Bargaining Unit President who then can liaison with ONA staff to assist.

Finally, the government says it is working on redeploying staff from hospitals to support the long-term care workforce to respond to outbreaks, alongside intensive on-going recruitment initiatives. We have no further information on this issue at this time.

New Order for Redeployment in Home Care

For home care workers, the government issued an order on April 16 for redeployment by home care employers. This order is in effect until April 30 and can be extended.

A local health integration network (LHIN) is authorized to request that a contracted service provider organization provide health care and related social services, other than community services within the meaning of the Home Care and Community Services Act, 1994, in a setting identified by the LHIN, and the LHIN is authorized to fund those services.

A contracted service provider organization is authorized to accept a request made by a LHIN to deploy its employees to provide the requested services.

An employee of a contracted service provider organization is not required to agree to provide the requested services.

This means an employee may not accept the request from an employer to be redeployed to another setting.

LHINs and contracted service provider organizations shall comply with any order or directive issued under the Health Protection and Promotion Act as it relates to them.

This means that Directive #1 from the Chief Medical Officer of Health applies to LHINs and to home care providers, which means that a point of care risk assessment must be undertaken in each unique interaction, the precautionary principle considered, and access provided to the proper personal protective equipment (PPE) in the specific circumstance.

Court Injunctions for Members in Long-Term Care

I know we have all been very concerned about the serious issues facing our members in the long-term care sector with the dramatic number of outbreaks. Many residents and staff have contracted COVID-19.

I wanted to share the important news that ONA has filed court injunctions on behalf of our members at a group of Rykka Homes (Eatonville Care Centre, Anson Place Care Centre and Hawthorne Place Care Centre) and Henley House. All of these homes are experiencing severe outbreaks with many positive cases (including staff) and resident deaths. You may hear about these court actions in the news.

Members, Bargaining Unit Presidents, and our Labour Relations Officers tried diligently to resolve issues of health and safety in long-term care homes, arguing our members should have access to critical PPE, including N95. These homes ignored theses requests. As a result, we tried to negotiate a central rights arbitration process and then expedited arbitrations with the individual Homes to address grievances quickly. They did not agree to either option.

Because of the lack of response and urgency of the situation for our members on the front lines, ONA filed a Court Injunction asking for interim and immediate relief on behalf of members at the Rykka Homes and Henley House pending the outcome of the arbitration.

The Application asks the court to restrain the Homes from breaching Directives 1, 3, and 5, the collective agreement and the Occupational Health and Safety Act. ONA asserts the homes committed the following breaches during these outbreaks:

• failed to provide our members with appropriate access to PPE, including fitted N95 facial respirators and other appropriate PPE for the COVID-19 outbreaks.
• the Homes severely limited the ability of RNs to access N95 and repeatedly denied nurses from using the right PPE, which they determined to be necessary based on their professional and clinical judgment.
• failed to cohort patients.
• failed to cohort staff.
• failed to cohort and isolate patients readmitted to the facilities.

There are very compelling facts and stories of the challenges faced by our members described in the notices:

• locking up and denying our members N95, including in emergency situations;
• imposing limits on masks;
• nurses being told to not wear masks and to put them their in pockets so they did not look suspicious or frighten residents, resulting in staff wearing soiled masks and potential self-contamination;
• the failure to isolate patients who were readmitted from hospitals; and
• a general failure to cohort and isolate positive and negative patients.

There were many missteps.

ONA is making the following arguments:

• The employer has not addressed the concerns that have been repeatedly drawn to their attention and have resisted efforts by ONA to resolve the issues, including through grievance arbitration. ONA has nowhere else to go but the Courts to seek immediate relief – we can’t wait, lives hang in the balance.
• Without urgent intervention by the courts, there will be irreparable harm to residents and staff at the facilities, who will continue to transmit COVID-19, become infected and possibly die.
• Unless and until readily available access to basic and mandatory requirements for health and safety, including N95 respirators and related PPE is given to ONA’s members when providing care to residents with confirmed or suspected COVID-19, more ONA members will continue to become ill. The court needs to intervene to prevent this from happening.
• We are asking the courts to order that the homes follow these minimum and mandatory requirements pending the outcome of the arbitration.

The judge has now scheduled a hearing on Wednesday, April 22 at 10 a.m. We will provide additional updates as they become available.

Testing and Health-Care Worker Return to Work

Recently, we have received questions related to COVID-19 testing for health-care workers and the process to return to work.

The main problem is that the Chief Medical Officer of Health (CMOH) has not issued a clear directive on testing for health-care workers and the process to return to work.

In addition, clear guidance has not been issued in terms of health-care workers returning to work who are deemed critical to operations.

So far, we only have guidance that has been issued.

First from Chief Medical Officer of Health, dated March 19, with recommendations to all parts of the health-care system that health-care workers should not come to work if they are sick (symptomatic).

However, if deemed critical to continued operations, the recommendation is that workers undergo regular screening, use appropriate PPE for 14 days and undertake active self-monitoring, including taking your temperature twice daily to monitor for fever, and immediately self-isolate if symptoms develop and self-identify to your occupational health and safety department.

If a health worker begins to feel unwell while at work, they should immediately don a surgical mask and notify their manager and/or occupational health and safety department.

The second guidance is from the Ministry of Health, dated April 10.

This essentially says, if critical to operations, return to work and self-isolate at work.

This means maintaining isolation outside of work until 14 days after symptom onset (or until two negative swabs) but continuing to work while wearing appropriate PPE at work, and not working in multiple locations.

The most recent guidance is from the Ministry of Health, dated April 16.

This guidance clarifies that in exceptional circumstances where additional staff are critically required, an earlier return to work of a COVID-19 positive health-care worker may be considered under work self-isolation recognizing the staff may still be infectious. In the case of a positive symptomatic health-care worker, there should be a minimum of 72 hours after illness resolving, defined as resolution of fever and improvement in respiratory and other symptoms. In the case of a positive asymptomatic health-care worker, there should be a minimum of 72 hours from positive specimen collection date to ensure symptoms have not developed in that time.

This guidance, as you can imagine, is causing quite a bit of confusion and inconsistency in application across the province in various settings, and we are continuing to press the Chief Medical Officer of Health to issue a directive that if people are positive, or have any symptoms, certainly they should not be at work. However, we have continued to meet resistance. When employers say all health-care workers are deemed critical to operations, it is causing quite a bit of anxiety and uncertainty.

Please check with your Bargaining Unit President to inquire about whether your position is critical to operations given the reduced capacity in hospitals at this time.

Collective Action Makes a Difference

I wanted to take this opportunity to report to you on ONA’s Day of Action on Tuesday to place calls to the Premier about conditions in long-term care.

We took action together to demand access to PPE, full-time nursing and health-care positions and full-time hours for part-time workers, and to have the right to work in one workplace without loss of wages to prevent the risk of transmission.

Your actions as members made a difference.

The government introduced an order, explained above, to ensure you work in only one long-term care or retirement home workplace to stop the spread that puts your residents and your lives at risk.

We need to be vigilant now to make sure there is pay for any lost wages.

The government has said that there will be more positions in long-term care.

We will need to hold the government accountable to ensure you get the staffing assistance your residents need.

The solidarity you showed each other made a difference by turning your efforts to support our long-term care members at this crucial time.

I want you to see that your actions get results and the government hears your voices.

I also want to share that the Elementary Teachers Federation of Ontario sent the Day of Action information out to 11,000 of its Toronto local members to make the call to the Premier to show their support for nurses and health-care workers.

We need to continue to act together to hold employers and the government accountable to protect the safety of you and your patients, residents and clients in all health-care sectors.

In the coming weeks, we will expand our efforts to engage you in member actions in all sectors.

Working together, we are stronger.

If you missed the telephone town hall on April 15, please visit www.ona.org/coronavirus. We have posted the audio files for the telephone town hall.

We are now planning another telephone town hall for April 29. Keep a look out for further information to come.

Stay safe and be protected with proper PPE.

In Solidarity,

Vicki McKenna, RN
President

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Posted: April 12, 2020

Dear ONA member,

My communication today is intended to update you on revisions to Directive #5 that extends the Chief Medical Officer of Health’s (CMOH) directive on proper personal protective equipment (PPE) to all health-care workers and other employees. As well, the provincial emergency orders have been extended to April 23.

Most importantly, I want to send you ONA’s revised advice on PPE, and assure you that we do not endorse any practice that would put you or your patients at risk.

I hope you have heard ONA’s radio ads asking Ontarians to stand with us as we seek proper protective equipment, and that you have seen the print ads that appeared in Ontario newspapers on Saturday. ONA is doing everything possible to ensure you are properly equipped and safe. I encourage you to visit www.nursesknow.ona.org to view or listen to the ads. Your courage and perseverance inspires all of us. You can also view my video message here.

ONA’s Advice on PPE

ONA has reviewed feedback from leaders and members following our communication on April 9 and we are providing some clarity. In addition, on April 10, Directive #5 changed to include all health-care workers in hospitals and long-term care under the same directive.

ONA’s position on access to PPE is clear and remains consistent:

• When dealing with suspected or confirmed COVID-19 patients, a point-of-care risk assessment (PCRA) must be performed before every patient interaction.
• If a member determines, based on their professional and clinical judgement, that health and safety measures are or may be required in the delivery of care to the patient, then the worker shall have access to the PPE, including an N95 respirator. If the employer does not agree, there are higher levels of PPE and environmental controls that can be considered. In the end, however, the employer cannot unreasonably deny access to the appropriate PPE.

• Examples for Physical/Environmental Control Option:
• Cohort all COVID-19 positive patients together. There is no requirement to change PPE between these patients/residents.
• Utilize baby monitors or iPads to communicate and view patients from outside of the room.
• Have COVID patients/residents in private rooms with the door closed.
• Examples for Care Option:
• Limit the number of times you need to enter the patient’s or resident’s room by using extension intravenous (IV) tubing to monitor the IV or IV pumps from outside of the room.
• Consider if there is another nurse or health-care professional already wearing PPE who can enter the room to complete a task or treatment.
• Use team nursing with a team of staff only caring for COVID positive patients or non-COVID-19 patients on a single shift.
• Group treatments together to prevent the frequent donning and doffing of PPE.

These are just a few examples of strategies that can limit exposure and decrease the number of staff encounters; thus decreasing the usage of PPE.

• However, when working within two metres of suspected or confirmed COVID-19 patients, staff must have access to appropriate PPE. This will include access to: surgical/procedure masks, fit-tested NIOSH-approved N-95 respirators, or approved equivalent or better protection, gloves, face shields with side protection (or goggles), impermeable or, at least, fluid resistant gowns. There must be training on the safe utilization of all PPE, including how to safely don and doff all of these supplies and be fit-tested for an N95 mask.
• The PCRA should include the frequency and probability of routine or emergent Aerosol Generating Medical Procedures (AGMPs) being required. N95 respirators, or approved equivalent or better protection, must be used by all health-care workers in the room where AGMPs are being performed, are frequent or probable. AGMPs include but are not limited to: Intubation and related procedures (e.g., manual ventilation, open endotracheal suctioning), cardio pulmonary resuscitation during airway management, bronchoscopy, sputum induction, non-invasive ventilation (i.e., BiPAP), open respiratory/airway suctioning, high frequency oscillatory ventilation, tracheostomy care, nebulized therapy/aerosolized medication administration, high flow heated oxygen therapy devices (e.g. ARVO, optiflow) and autopsy.

N95 masks:

I want to be very clear that ONA does not endorse any practice that puts ONA members or patients at risk.

Research suggests that it may be possible to wear N95 masks for extended periods (up to eight hours); however, this is exceptionally limited and infection control protocols must be maintained. ONA would only consider extended use if there is adherence to all possible administrative and engineering controls, and first and foremost, compliance with the manufacturers’ guidance and advice.

• Masks cannot be reused and must be discarded if:
• The mask has been used for any aerosol generating procedure;
• The mask is contaminated with blood, respiratory or nasal secretions or other bodily fluids of patients; and/or,
• Following any close contact with any patient co-infected with any infectious disease requiring contact precautions.

In these very limited circumstances, N95 masks may be able to be donned more than once, if the above conditions are met. Further, there must be care to prevent hand contamination during doffing and re-donning; hand hygiene is key. If a mask is considered soiled, or cannot be safely donned, this practice should not be used.

Expired N95 masks can be worn but should be treated as equivalent protection to a surgical mask.

Future Mask Decontamination:

ONA knows that employers have directed staff to dispose of used N95 masks in biohazardous containers for potential reuse. Research is currently underway; however, ONA understands, according to the Centers for Disease Control and the National Institute for Occupational Safety and Health, that the following masks cannot be decontaminated:

• N95s used during AGMPs;
• N95s contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients;
• N95s following close contact with any patient co-infected with an infectious disease requiring contact precautions; and
• N95s that no longer retain their structural integrity.

At this time, there is very limited research on decontamination of the N95 respirator. Until there is scientific evidence supporting safe decontamination, that does not invalidate the integrity of the mask and risk members’ health and safety, ONA will not agree to their reuse.

N95 Mask Shortage and Higher Levels of Protection:

Given the shortage of masks, particularly N95s, ONA has advised employers/government to make available to our members a higher level of protection, such as powered, air-purifying respirator (PAPR). PAPRs may also require fit testing, if they have tight-fitting face pieces (rather than a hood or helmet). It has been well documented that not all respirators fit all individuals. Individual face shape and size are important to obtaining an acceptable fit factor. Other options include Surgical N95, N99, N100, R95, P95, P99, P100 and Elastomeric respirators, which we have suggested that any of these are appropriate for you to wear in the workplace, especially with AGMPs. Not only do these masks provide a higher level of protection than N95 masks, many are reusable, thus reducing the usage and preservation of N95 masks.

PPE Supply Management:

The supply of PPE is currently being managed provincially and through five regional tables. This means that the new normal for employers will only be a five to seven day supply of PPE on site, when we hope supplies will be replenished for the next five to seven days; at least until the supply chain normalizes again.

The province and Canada are working on increasing the supply chain in the coming days and weeks. In the meantime, we all need to work on ensuring every health-care worker is safe and has access to the appropriate PPE. This means where able, please conserve PPE as recommended by the manufacturers, researchers and ONA.

Directive #5 Extended to all Health-Care Workers

ONA has been working with government to develop principles regarding PPE in the hospital sector, which resulted in ONA winning amendments to Directive #5 on March 31.

ONA understood it was the government’s intention to have immediate discussions with the other health-care unions.  This finally happened over the last few days (ONA was not involved), and on April 10, Directive #5 was revised to include all health-care workers.

In the section below, we outline the changes to Directive #5 for hospitals and the revised Directive #5 for Long-Term Care and Retirement Homes.

We have devoted many hours of discussion and lobbying to get us to this point. We are disappointed with the change to the clarity in the original document regarding the care of intubated patients, yet there is a way for our members to continue as before.  We believe that this agreement represents the best solution at this time, given the supply challenges in the system, and treats all health-care workers with equity and fairness.

For hospitals, we continue to work through a legal strategy. For long-term care, we are finalizing our legal strategies to address continuing disputes arising from before as well as the implementation of this agreement.

If you have any questions or concerns, please contact us at CovidQuestions@ona.org.

Direction #5 for Hospitals within the meaning of the Public Hospitals Act and Long-Term Care Homes within the meaning of the Long-Term Care Homes Act, 2007

All public hospitals and long-term care homes must immediately implement the following precautions and procedures, as applicable to regulated health professionals, as defined under the Regulated Health Professions Act (health-care worker), employed by or in public hospitals and long-term care homes. In addition, this includes, where specified, other employees employed by or in public hospitals and long-term care homes (other employees), dealing with suspected, presumed, or confirmed COVID-19 patients or residents:

1. Public hospitals and long-term care homes, health-care workers and other employees must engage on the conservation and stewardship of personal protective equipment. Public hospitals and long-term care homes must provide all health-care workers and other employees with information on the safe utilization of all PPE, and all health-care workers and other employees must be appropriately trained to safely don and doff all PPE.

Note:  the only change is the application to long-term care homes.

2. Hospitals and long-term care homes must assess the available supply of PPE on an ongoing basis. Public hospitals and long-term care homes must explore all available avenues to obtain and maintain a sufficient supply of PPE.

Note:  the only change is the application to long-term care homes and the clarity at the end of the second sentence adding the words “of PPE”.

3. In the event that the supply of PPE reaches a point where utilization rates indicate that a shortage will occur, the government and employers, as appropriate, will be responsible for developing contingency plans, in consultation with affected labour unions, to ensure the safety of health care workers and other employees.

Note:  the changes in this section included removing a reference to a 30-day supply and a reference to ONA, instead now referring to all affected labour unions.

Note:  the only change for items 4-7 in Directive #5 is the application to long-term care homes. See this link.

8. For long-term care homes only, all staff and essential visitors must wear surgical/procedure masks at all times for the duration of full shifts or visits in the long-term care home. For further clarity, this is required regardless of whether the home is in outbreak or not. During breaks, staff may remove their surgical/procedure mask but must remain two metres away from other staff to prevent staff-to-staff transmission of COVID-19. This is to be implemented in conjunction with all other requirements contained in Directive #3 dated April 8, 2020 or as amended.

Note:  this clause only exists in long-term care homes providing an extra precaution to protect against COVID-19 spread in long-term care homes.  This provision was previously set out in Directive #3, applying to long-term care homes only.

9. All health-care workers or other employees who are within two metres of suspected, presumed or confirmed COVID-19 patients or residents shall have access to appropriate PPE. This will include access to: surgical/procedure masks, fit tested NIOSH-approved N-95 respirators or approved equivalent or better protection, gloves, face shields with side protection (or goggles) and appropriate isolation gowns.

Note:  the first change is the application to long-term care homes.  For hospitals, the change is the removal of the requirement for “impermeable or, at least, fluid resistant” and replacing with “appropriate isolation” gowns.  Members can determine the level of gown required as part of their PCRA.

10. The PCRA by the health-care worker should include the frequency and probability of routine or emergent Aerosol Generating Medical Procedures (AGMPs) being required. N95 respirators, or approved equivalent or better protection, must be used by all health- care workers in the room where AGMPs are being performed, are frequent or probable.

AGMPs include but are not limited to; Intubation and related procedures (e.g., manual ventilation, open endotracheal suctioning), cardio pulmonary resuscitation during airway management, bronchoscopy, sputum induction, non-invasive ventilation (i.e., BiPAP), open respiratory/airway suctioning, high frequency oscillatory ventilation, tracheostomy care, nebulized therapy/aerosolized medication administration, high flow heated oxygen therapy devices (e.g., ARVO, optiflow) and autopsy. Any change to this list is to be based on the Technical Brief “Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19” dated March 25, 2020, as amended from time to time, which has been prepared by Public Health Ontario.

Note:  the first change is the application to long-term care homes.

For hospitals, the change is the removal of “or with any intubated patients” and the addition of “during airway management” during CPR. The reference to the Public Health Ontario IPAC Recommendations was added to define AGMPs.  ONA’s position is unchanged, if caring for an intubated patient; a member’s PCRA should treat intubation as a risk of AGMP and should wear an N95 mask.

11. In accordance with O. Reg 68/20 made under the Retirement Homes Act, retirement homes must take all reasonable steps to follow the required precautions and procedures outlined in this Directive.

Note:  This clause ensures that Retirement Homes also follow the above #1-10.

It is important to remember that hospitals, long-term care homes and all health-care workers are also required to comply with applicable provisions of the Occupational Health and Safety Act and its Regulations.

Extension of Emergency Orders

The Ontario government has extended all emergency orders that have been put in place to date under s.7.0.2 (4) of the Emergency Management and Civil Protection Act until April 23, 2020.

The following emergency orders, covered in previous communications with respect to redeployment in ONA member workplaces, have also been extended until April 23, 2020:

• Work deployment for health service providers
• Work deployment for long-term care homes
• Streamlining requirements for long-term care homes
• Work deployment for boards of health
• Work deployment measures in retirement homes
• Service agencies providing services and supports to adults with developmental disabilities

We anticipate these emergency orders will likely be extended again after April 23.

April 15 Telephone Town Hall on COVID-19

On Wednesday, April 15, ONA will hold Telephone Town Halls in two sessions: from 4:45 p.m. to 5:45 p.m. (for Regions 1, 2 and 5) and from 7:15 p.m. to 8:15 p.m. (for Regions 3 and 4).

ONA CEO Bev Mathers and I will co-facilitate the discussion and provide you with the most up-to-date information and directives.

All members will receive a call to join the Town Hall at 4:45 p.m. if you are in ONA Regions 1, 2 and 5. For members who are in Regions 3 or 4, you will receive a call at 7:15 p.m. You need to accept the call to connect to it. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself to the town hall. ONA will develop a question-and-answer document after the town hall.

In addition, the Town Halls will be on Facebook Audio Live. You can visit www.facebook.com/ontarionurses at 4:45 p.m. and 7:15 p.m. to listen in and hear answers to some of your questions.

I encourage you to join if you are able.

I will continue to provide further updates as they become available.

ONA is working as quickly as possible on every front to ensure your safety as you continue to provide care to your patients, residents and clients.

In Solidarity,

Vicki McKenna, RN
President

P.S. If you’ve moved or changed your phone number recently, and you want to update the contact information that we have on file for you in our union’s membership list, please submit your current contact info online: https://www.ona.org/update

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Posted: April 10, 2020

Dear ONA member,

It has been just one month since the World Health Organization declared COVID-19 a worldwide pandemic. What an unbelievable month. An unprecedented time.

Public health initiatives quickly ramped up to include social distancing measures, the temporary closure of schools, and Ontario’s health-care system going into full preparation mode for a surge in COVID-19 cases.

At ONA, we continue to manage the COVID-19 pandemic as we support you – our members – on the front line, and we will provide you with important information as it becomes available. Visit www.ona.org/coronavirus often for the most recent information and government directives.

Telephone Town Halls on April 15 – COVID-19 Updates

On Wednesday, April 15, ONA will hold Telephone Town Halls in two sessions: from 4:45 p.m. to 5:45 p.m. (for Regions 1, 2 and 5) and from 7:15 p.m. to 8:15 p.m. (for Regions 3 and 4). ONA CEO Bev Mathers and I will co-facilitate the discussion and provide you with the most up-to-date information and directives.

Members will receive a call to join the Town Hall at 4:45 p.m. if you are in ONA Regions 1, 2 and 5. For members who are in Regions 3 and 4, you will receive a call at 7:15 p.m. You need to accept the call to connect to it. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself to the town hall. ONA will develop and post a question-and-answer document after the town hall.

In addition, the Town Halls will be on Facebook Audio Live. You can visit www.facebook.com/ontarionurses at 4:45 p.m. and 7:15 p.m. to listen in and hear answers to some of your questions.

I hope that you will join us.

Be well and be safe,

Vicki McKenna, RN
President

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Posted: April 9, 2020

Dear ONA member,

I am writing today to update you on recent developments in the evolving COVID-19 pandemic.

I will update you on a number of topics, including proper personal protective equipment (PPE), a new revised Directive #3 for long-term care homes, information regarding a provincial government initiative to match health-care workers with employers to bolster the health-care workforce, and issues that have arisen with respect to the use and reuse of PPE in the workplace.

In reaction to your first-hand experience on the front lines every day, the provincial government has set up a procurement table related to access and distribution of available supply of PPE.

I know you are doing everything possible to care for your patients, residents and clients. Know that ONA is supporting your efforts at every government table, through daily interviews with multiple media outlets, advocacy with multiple Ministers and their staff, obtaining expert opinions, working with our counterparts, and through advertising launching in the coming days.

Revised Directive #3 for Long-Term Care Homes

The Chief Medical Officer of Health released a revised Directive #3 for long-term care homes on April 8.

The revised Directive #3 contains the following additions:

• Ensure appropriate Personal Protective Equipment (PPE). Long-term care homes are expected to follow COVID-19 Directive #1 for Health-Care Providers and Health-Care Entities.

This means the following process is to be followed:

• A point-of-care risk assessment (PCRA) must be performed by every health-care worker before every patient interaction;
• At a minimum, contact and droplet precautions must be used by workers for all interactions with suspected, presumed or confirmed COVID-19 patients. Contact and droplet precautions includes gloves, face shields or goggles, gowns, and surgical/procedure masks; and
• Airborne precautions when aerosol generating medical procedures (AGMPs) are planned or anticipated to be performed on patients with suspected or confirmed COVID-19, based on a point-of-care risk assessment and clinical and professional judgement, which would include access to N95 masks.
• Staff masking. Long-term care homes should immediately implement that all staff and essential visitors wear surgical/procedure masks at all times for the duration of full shifts or visits in the long-term care home. For further clarity, this is required regardless of whether the home is in outbreak or not. During breaks, staff may remove their surgical/procedure mask but must remain two metres away from other staff to prevent staff-to-staff transmission of COVID-19.
• Limiting Work Locations: Wherever possible, employers should work with employees to limit the number of work locations that employees are working at, to minimize risk to patients of exposure to COVID-19.
• Staff and Resident Cohorting. Long-term care homes must use staff and resident cohorting to prevent the spread of COVID-19.

While these are improvements because they are now contained in a Directive, the guidance on working in multiple homes is still not restricted to working in one home only. We believe this direction ignores the lessons learned from SARS.

The full text of the revised Directive #3 is on ONA’s COVID-19 web page:

https://www.ona.org/news-posts/coronavirus-updates/

In addition, the Chief Medical Officer of Health released new guidance on testing.

Testing of asymptomatic new admissions or re-admissions to a long-term care home or retirement home should be performed within the first 14 days under the direction of the overseeing clinician. Patients transferred from hospital to a long-term care home should be tested prior to the transfer.

All health-care workers, caregivers and care providers, as well as first responders should be tested as soon as is feasible if they develop any symptom compatible with COVID-19, including atypical symptoms.

This is an improvement but we would like to see testing take place in a more timely way.

Province Launches Online Portal to Match Available Health-Care Workers with Employers

On April 7, the provincial government launched a new online tool to help match skilled front-line health-care workers with employers. The idea is that to help with slowing the spread of COVID-19, the Ontario government needs to be assisting with actively recruiting health-care workers to increase the front-line capacity of hospitals, long-term care homes, public health units, clinics, and assessment centres.

The new Health Workforce Matching Portal will enable health-care workers with a range of experience to join the province’s response to COVID-19. The aim is to recruit laid off, retired or non-active health-care professionals, internationally educated health-care professionals, students, and volunteers with health-care experience.

The portal matches the availability and skill-sets of front-line health-care workers to the employers in need of assistance to perform a variety of public health functions, such as case and contact management. If interested, you can visit the portal and create your profile at this link:

https://healthcloudtrialmaster-15a4d-17117fe91a8.force.com/matchingportal/s/

While ONA supports the concept of a call to action to add reinforcements to expand our capacity to fight COVID-19 across the health-care system, we do not support the notion of health-care workers working in multiple sites during a pandemic. Working part-time hours in multiple employers will not meet the exacting infection control standards we need during a pandemic that is spreading. This is a serious lesson learned during SARS. We continuously inform the government of our professional judgment on this issue. We will keep pushing for full-time hours with one employer or part-time hours and payment for any lost wages.

Update on Provincial Supply of PPE, Proper PPE, and Mask Reuse

At this time, ONA believes that every patient and/or worker in a health-care setting should be considered to be suspected to be COVID-19 positive; therefore, every health-care worker who is working directly with patients should wear a minimum of a surgical or procedure mask.

As you aware, there continues to be a critical shortage of PPE, including surgical and N95 masks. ONA negotiated a joint statement on access to PPE in hospitals and we continue to reach out to government for all other health-care sectors.

ONA’s position on access to PPE is clear and remains consistent:

When dealing with suspected or confirmed COVID-19 patients, a point-of-care risk assessment (PCRA) must be performed before every patient interaction.

If you determine, based on your professional and clinical judgement, that health and safety measures are or may be required in the delivery of care to the patient, then the worker shall have access to the PPE, including an N95 respirator; however, there may be other alternatives. You do not need an N95 mask for every patient encounter.  For example, you can use extension intravenous (IV) tubing to monitor the IV or IV pumps from outside of the room, and consider if there is another nurse or health-care professional already wearing PPE who can enter the room to complete a task or treatment. The employer cannot unreasonably deny access to the appropriate PPE.

ONA is also recommending helping with the preservation of PPE, which means that you need to work with your employer to discuss options to provide safe patient care.  This could include: cohorting all COVID-19 positive patients together, using baby monitors or iPads to communicate and view patients from outside of the room, team nursing, grouping treatments together to prevent the frequent donning and doffing of PPE, assigning particular health-care workers to only looking after COVID-19 or non-COVID-19 patients on a single shift, and so on.

However, when you are working within two metres of suspected or confirmed COVID-19 patients, you must have access to appropriate PPE. This will include access to: surgical/procedure masks, fit-tested NIOSH-approved N-95 respirators, or approved equivalent or better protection, gloves, face shields with side protection (or goggles), impermeable or, at least, fluid resistant gowns. You must be trained on the safe utilization of all PPE, including how to safely don and doff all of these supplies and be fit-tested for an N95 mask.

The PCRA should include the frequency and probability of routine or emergent Aerosol Generating Medical Procedures (AGMPs) being required. All health-care workers in the room where AGMPs are performed, which are frequent or probable, or with any intubated patients, must use N95 respirators, or approved equivalent or better protection. AGMPs include, but are not limited to: intubation and related procedures (e.g., manual ventilation, open endotracheal suctioning), cardio-pulmonary resuscitation, bronchoscopy, sputum induction, non-invasive ventilation (i.e., BiPAP), open respiratory/airway suctioning, high frequency oscillatory ventilation, tracheostomy care, nebulized therapy/aerosolized medication administration, high flow heated oxygen therapy devices (e.g.,  ARVO, optiflow), and autopsy.

N95 masks are not single-use

N95 masks can be worn for extended periods of times and can be worn multiple times, if they are not soiled.

This must be done carefully to prevent contamination of the hands during doffing and re-donning; hand hygiene is key. Research suggests that N95 face piece respirators should be donned no more than five times. If you are storing an N95 mask between uses, it should be hung in a designated storage area, or kept in a clean, breathable container, such as a paper bag.  Masks should not touch each other and be identified for a single user.  Hand hygiene is key to prevent contamination.

Expired N95 masks can be worn but should be treated as equivalent protection to a surgical mask.

ONA knows that you have been asked to dispose of used N95 masks in biohazardous containers for potential reuse. Research is currently underway; however, ONA understands according to the Centers for Disease Control and the National Institute for Occupational Safety and Health that the following masks cannot be decontaminated:

• N95s used during AGMPs;
• N95s contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients;
• N95s following close contact with any patient co-infected with an infectious disease requiring contact precautions; and
• N95s that no longer retain their structural integrity.

At this time, there is very limited research on decontamination of the N95 respirator. Until there is scientific evidence supporting safe decontamination that does not invalidate the integrity of the mask and risk members’ health and safety, ONA will not agree to their reuse.

Finally, given the shortage of masks, particularly N95s, ONA has suggested that employers/ government make available to nurses and health-care professionals a higher level of protection, such as powered, air-purifying respirator (PAPR). PAPRs may also require fit testing, if they have tight-fitting face pieces (rather than a hood or helmet). It has been well documented that all respirators do not fit all individuals. Individual face shape and size are important to obtaining an acceptable fit factor. Other options include Surgical N95, N99, N100, R95, P95, P99, P100 and Elastomeric respirators, which we have suggested that any of these are appropriate for you to wear in the workplace, especially with AGMPs. Not only do these masks provide a higher level of protection than N95 masks, many are reusable, thus reducing the usage and preservation of N95 masks.

The supply of PPE is now being managed through the provincial command table and the five regional tables. This means that the new normal for employers will only be a five to seven day supply of PPE on site, when supplies we hope will be replenished for the next five to seven days; at least until the supply chain normalizes again.

The province and Canada is working on increasing the supply chain in the coming days and weeks.  In the meantime, we all need to work on ensuring every health-care worker is safe and has access to the appropriate PPE. This means where able, please conserve PPE as recommended by the manufacturers, researchers and ONA.

April 15 Telephone Town Hall on COVID-19

On Wednesday, April 15, ONA will hold Telephone Town Halls in two sessions: from 4:45 p.m. to 5:45 p.m. (for Regions 1, 2 and 5) and from 7:15 p.m. to 8:15 p.m. (for Regions 3 and 4).

ONA CEO Bev Mathers and I will co-facilitate the discussion and provide you with the most up-to-date information and directives.

All members will receive a call to join the Town Hall at 4:45 p.m. if you are in ONA Regions 1, 2 and 5. For members who are in Regions 3 or 4, you will receive a call at 7:15 p.m. You need to accept the call to connect to it. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself to the town hall. ONA will develop a question-and-answer document after the town hall.

In addition, the Town Halls will be on Facebook Audio Live. You can visit www.facebook.com/ontarionurses at 4:45 p.m. and 7:15 p.m. to listen in and hear answers to some of your questions.

I encourage you to join if you are able.

Lack of testing for COVID-19 and WSIB Entitlement

We are aware that symptomatic ONA members who are working may not be tested for COVID-19, either due to the fact that testing is not available to everyone or due to advice from Public Health Ontario to employers about which workers should be tested in cases of exposures.

Thus, some symptomatic ONA members, despite best efforts, may not have access to COVID-19 testing.

To increase chances of the WSIB granting entitlement and quicker WSIB decision-making, symptomatic ONA members are encouraged to undergo COVID-19 testing to confirm diagnosis. If unable to do so, you should consult with your GP and document your symptoms, your inability to be tested and information on your workplace exposure. A copy of this documentation should be sent to occupational health at your employer. You also should complete a WSIB Form 6 and provide a copy to your employer, ensure your employer completes a Form 7 and request your doctor to complete a Form 8.

If you need assistance, please contact your ONA Bargaining Unit President who has access to staff support.

In Solidarity,

Vicki McKenna, RN
President

P.S. If you’ve moved or changed your phone number recently, and you want to update the contact information that we have on file for you in our union’s membership list, please submit your current contact info online: https://www.ona.org/update

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Posted: April 7, 2020

ONA Local 55 (all sites)

Common Q&A  >> Download FULL Document here

Please note these responses will be subject to change as we get MOL orders or not, litigate, the Government creates new Directives or makes changes to Legislation.

Needless to say members should be referred back to the Bargaining Unit President so that advice and direction can be sought from the servicing LRO.

Hospital not providing proper PPE

Also refer to section specific to Directive #5 (page 3).

In a recent joint statement of ONA, the Chief Medical Officer of Health, the Ministry of Health and the

Ministry of Labour, Training and Skills Development, new measures were announced that enables nurses to use the precautionary principle to prevent exposure to and transmission of COVID-19, something that ONA has been advocating for from the start.

With these new measures, a nurse can determine – based on their professional and clinical judgement – that they require access to protective equipment, such as an N95 respirator to care for a suspected, presumed or positive COVID-19 patient.

Further, the employer cannot unreasonably deny access to it. In addition, a point-of-care risk assessment will be performed before every patient interaction to ensure hospital front-line registered nurses have the specific PPE that they need.

Where a request for PPE (N95 or better) the individual under the OHSA has the right to refuse, even though this right for health care professionals may be limited. Where disputes cannot be resolved with the supervisor the JHSC needs to be involved and the MOL may need to investigate and make a recommendation.

Reusing Masks

Our position is that you have the right to determine in your professional judgment when you need to replace your N95 or surgical mask. None of the manufacturers recommend reuse of their PPE unless it is specifically designed to be reusable. Although there is no real standard on the exact length of time for using N95s, attached is a document from NIOSH re respirator reuse that may be helpful. Note the document says that “Discard N95 respirators following close contact with any patient co-infected with an infectious disease requiring contact precautions.”

Pregnant or Immunosuppressed workers

ONA is taking the position that pregnant or immunosuppressed workers should ask to be assigned to or accommodated in no risk/low risk areas. If there is no work in no risk/low risk areas, then workers could be placed on administrative leave. We say the employer should pay them and if not, then we will file grievances. They should apply for EI to mitigate their losses. It would be good to have something from your doctor which supports the request to not have to work with confirmed or suspected COVID-19 patients.

Choosing a single employer – loss of hours

We are currently in discussions with the Ontario Hospital Association. Our position is that hours should be made up at the employer that the member decides is the primary employer. This will also impact our members working in LTC/Home Care who may work for multiple employers.

Download FULL Document here

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Posted: April 3, 2020

ONA Central

Dear ONA member.

Thank you for your ongoing efforts to keep Ontarians safe during this pandemic.

This communication provides updated information about a new Order for redeployment in public health units, an extension of Orders on redeployment and other matters in hospitals and long-term care homes, and an update on proper personal protection equipment (PPE).

Extension of Orders on Redeployment

Late in the evening of March 30, the government issued a media release that extends the existing Orders for redeployment.

The Declaration of a provincial emergency is extended and in effect until April 14, 2020. Additionally, the following Orders for redeployment extend until April 13, 2020:

• Work deployment for health service providers
• Work deployment for long-term care homes
• Streamlining requirements for long-term care homes

Order for Redeployment in Public Health Units

On April 1, 2020, the Lieutenant Governor released a temporary Order under the Emergency Management and Civil Protections Act, under subsection 7.0.2 (4) of the act – Work Deployment Measures for Boards of Health.

This Order applies to every Board of Health within the meaning of the Health Protection and Promotion Act and will expire on April 15, 2020. The Order can be extended for an additional 14 days after April 15. Any further extensions beyond that extension would require legislative approval.

The Order

Under this temporary Order, Boards of Health are authorized to take, with respect to work deployment and staffing, any reasonably necessary measureto respond to, prevent and alleviate the outbreak of the coronavirus.

Measures

The Order provides this authority to Public Health Units despite any other statute, regulation, order, policy, arrangement of agreement, including a collective agreement, except as set out below. The power to act in this manner arises under the Emergency Management and Civil Protection Act Section 7.0.2(4).  Boards of Health are authorized to do the following:

• Identify staffing priorities and develop, modify and implement redeployment plans, including the following:

1. Redeploying staff within different locations in (or between) facilities of the Board of Health.
2. Changing the assignment of work, including assigning non-bargaining unit employees or contractors to perform bargaining unit work.
3. Changing the scheduling of work or shift assignments.
4. Deferring or cancelling vacations, absences or other leaves, regardless of whether such vacations, absences or leaves are established by statute, regulation, agreement or otherwise.
5. Employing extra part-time or temporary staff or contractors, including for the purposes of performing bargaining unit work.
6. Using volunteers to perform work, including to perform bargaining unit work.
7. Providing appropriate training or education as needed to staff and volunteers to achieve the purposes of a redeployment plan.

To this end, Public Health Units are expected to:

• Conduct any skills and experience inventories of staff to identify possible alternative roles in priority areas.
• Require and collect information from staff, contractors or volunteers about their availability to provide services for the Board of Health.
• Require and collect information from staff, contractors or volunteers about their likely or actual exposure to the Virus, or about any other health conditions that may affect their ability to provide services.
• Cancel or postpone services that are not related to responding to, preventing or alleviating the outbreak of the Virus or services that are not deemed to be critical by a Board of Health’s business continuity or pandemic plans.
• Suspend, for the duration of this Order, any grievance process with respect to any matter referred to in this Order.

Redeployment plans

For greater certainty, a Board of Health may implement redeployment plans without complying with provisions of a Collective Agreement, including layoff, seniority/service or bumping provisions.

Thus, the redeployment plans can be carried out without complying with provisions of a Collective Agreement, including layoff/reassignment, seniority/service or bumping provisions. To be clear, this is not a wholesale voiding of ONA Collective Agreements; however, it does void the specific sections mentioned because these sections are essentially overridden by the emergency Order.

Next Steps

All previous Emergency Orders were provided to ONA during a teleconference prior to being filed. In this case, many of you received this Order directly from your employers. ONA will be following up with government to determine why this Order was not released in the same manner.

Bargaining unit leaders have been asked to raise any concerns around the provision of PPE, self-isolation or reduction of staffing at the bargaining unit level with their Labour Relations Officer to ensure members’ voice is represented.

Some employers will be willing to discuss principles and some will not. At this time, there is nothing to compel them except good labour relations practices and a willingness to ensure there is some labour stability during this time.

This is an unprecedented time. We continue to work at various levels of government, through legal avenues and to consult with the other health-care unions to obtain clarity and to provide input into decision-making whenever possible.

ONA will continue to pursue grievances, appeals at the Labour Board, and potential Court Action as necessary to support our members and we rely on you to identify concerns to allow us to address issues immediately.

New Directive #5 and Personal Protective Equipment (PPE)

Over the past weekend, ONA engaged government in discussions relating to proper protective equipment or PPE. Throughout this week, we have continued to meet with government, expressing the need for proper PPE and the need to protect you, if there are to be nurses and health-care professionals available to look after the patient surge expected in the weeks to come.

As a result, I want to update everyone on important developments for the hospital sector, from our meetings with government.

Working together with government and hospital partners, ONA welcomes our collaboration to achieve consensus on new measures that will help to protect the front lines as we tackle this enduring pandemic and the shortage of PPE.

ONA is also committed to continuing our discussions at all government tables to adapt these measures to all health-care settings beyond hospitals.

ONA developed a joint statement with government to apply to all health-care workers. The joint statement provides clarity on a streamlined approach to ensuring health and safety standards for front-line staff in Ontario’s hospitals dealing with suspected or confirmed COVID-19 patients.

This joint statement is incorporated in the Chief Medical Officer of Health’s “Directive #5 for Hospitals within the meaning of the Public Hospitals Act.” This means it is mandatory for hospitals to follow the measures outlined in Directive #5.

The Directive #5 also says the hospitals must comply with the Occupational Health and Safety Act.

These new measures utilize the precautionary principle to ensure point-of-care risk assessments, with attention to different health and safety measures, including administrative and engineering controls and proper PPE.

Note that the language in Directive #5 was revised because it was based on a joint statement negotiated by the government only with ONA. The revision states this Directive #5 applies to hospital nurses represented by ONA. Because of the language in our joint statement with government, we believe that all nurses and health-care professionals represented by ONA in public hospitals should be treated the same. We are advocating with government on this issue as well as to extend Directive #5 to all health-care settings.

At the centre of our approach is a point-of-care risk assessment to be performed before every patient interaction. If a nurse or health-care professional determines, based on their professional and clinical judgement, that health and safety measures may be required in the delivery of care to the patient, then they shall have access to the appropriate health and safety control measures, including an N95 respirator.

Hospital employers cannot unreasonably deny access to the appropriate PPE.

All workers who are within two metres of suspected, presumed or confirmed COVID-19 patients have the right to access to appropriate PPE. This will include access to: surgical/procedure masks, fit tested NIOSH-approved N-95 respirators or approved equivalent or better protection, gloves, face shields with side protection (or goggles), impermeable or, at least, fluid resistant gowns.  It also provides for N-95 respirators for Aerosol Generating Medical Procedures (AGMP) as well as a more inclusive list of AGMPs.

I encourage everyone to take action to extend coverage of this directive to all health-care settings. Please send your message at https://www.ona.org/ppe/

Long-Term Care Homes (LTCH)

ONA has been meeting with government to ensure our members in LTCHs have the proper PPE and support needed to provide care to your residents. While I know that resident care is your focus, we need to ensure you are properly protected so you can continue to care for these residents. Every front-line nurse and health-care professional should be fit-tested for an N95 respirator, especially for AGMPs. Please call your Bargaining Unit President and/or Labour Relations Officer, if there are shortages or issues with PPE.

Home Care, Local Health Integration Networks, Clinics and Primary Care

ONA has been meeting with government to ensure all of our members have the proper PPE and support needed to provide care to patients and clients. We need to ensure you are properly protected so you can continue to care for those patients and clients. I know that for many of you, the focus of your work may have shifted to more telepractice or virtual visits; however, when you are providing direct patient/client care, you must have access to the proper PPE.  Please call your Bargaining Unit President and/or Labour Relations Officer, if there are shortages or issues with PPE.

Upcoming COVID-19 Processes – Pandemic Planning

Reusing Masks

We are aware that Ontario Health has advised employers to collect used N95 and surgical masks and to store these in biohazard bags for potential reprocessing.  Given the global shortage of PPE, there is emerging evidence that says there may be various methods of retaining, sterilizing, reprocessing and reusing PPE, including N95 respirators. Any health-care worker, who is placing an N95 into a container, for potential reuse, should be careful not to be contaminated.

At this time, there is no certainty regarding scientific evidence that supports reusing N95 masks. We have advised government that, until there is clear evidence and science on safety, ONA will not consider these options without clear scientific evidence that these masks meet the standards for safe use in health-care settings.

Health Human Resource Matching Tool

On Friday evening or Saturday, Ontario Health will be launching the Health Human Resources Matching Tool. This is an opportunity for ONA members laid off as a result of their employer being deemed to be unessential (e.g., Shouldice or Ottawa Fertility) or for members who are not getting enough hours or for retirees or student nurses to obtain work through the pandemic.

The tool allows workers to enter their available hours and skills and these will be matched with an employer whose needs best match the worker.

The tool is voluntary for workers and employers. ONA will update our website (www.ona.org/coronavirus) as soon as we have a web link to the portal.

Thank you and keep up the fight for proper PPE. ONA’s Board, staff and I will never give up the fight on your behalf. Ontario needs you on the front lines to defeat this pandemic.

In Solidarity,

Vicki McKenna, RN
President

P.S. If you’ve moved or changed your phone number recently, and you want to update the contact information that we have on file for you in our union’s membership list, please submit your current contact info online: https://www.ona.org/update

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Location: ONA Central

Posted: March 30, 2020

ONA welcomes new measures to protect front-line hospital workers

Download Media release document here

The global spread of COVID-19 shows that we are in unprecedented times.

I want to update you on important developments for the hospital sector, from our meetings with government over the weekend.

Working together with government and hospital stakeholders, ONA welcomes our collaboration to achieve consensus on new measures to protect front-line hospital workers as we tackle this enduring pandemic.

It is critical that appropriate steps are taken to protect the health and safety of health-care workers in hospitals, their patients and the public in Ontario, using the precautionary principle and preventing exposure to and transmission of COVID-19.

It is also important to ensure that appropriate health and safety measures, including administrative and engineering controls and Personal Protective Equipment (PPE) are adopted and utilized while also preserving supplies of specialized equipment for when they are needed to safely deliver patient care.

Please read this joint statement and the question and answer document (copied below), which provides clarity on much-needed measures that will ensure health and safety standards for front-line health-care workers in Ontario’s hospitals dealing with suspected, presumed, or confirmed COVID-19 patients.

At the centre of our approach is a point-of-care risk assessment (PCRA) to be performed before every patient interaction. If you determine, based on your professional and clinical judgement that health and safety measures may be required in the delivery of care to the patient, then you will have access to the appropriate health and safety control measures, including an N95 respirator. Employers will not unreasonably deny access to the appropriate PPE.

Many hours of discussion and lobbying were required to leverage these measures for our members and to get us to this point. We firmly believe that this agreement represents the best solution at this time given the supply challenges in the system.

This is a positive step for the hospital sector, but we also need to consider the other health-care sectors, including long-term care, public health, community care, home care, and more. We will continue to update our members in these sectors as developments unfold.

Telephone Town Halls

ONA will be hosting Telephone Town Halls on Wednesday, April 1 in two sessions: from 5 p.m. to 6 p.m. (for Regions 1, 2 and 5) and from 7 p.m. to 8 p.m. (for Regions 3 and 4).

You will receive a call to join the Telephone Town Hall at 5 p.m. if you are in ONA Regions 1, 2 and 5. If you are in Regions 3 or 4, you will receive a call at 7 p.m. You simply need to accept the call to connect to the Town Hall. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself. ONA will develop a question-and-answer document after the town hall and will post the audio files from the town hall to our website.

We will discuss these new measures, and more during the Town Halls. I hope you will join us.

In solidarity,

Vicki McKenna, RN
President

Download Q&A here    

COVID-19 and Health and Safety Measures, including Personal Protective Equipment: Question & Answer

Why has the union reached this agreement with the Chief Medical Officer of Health (CMOH), Ministry of Health (MOH), Ministry of Labour, Training and Skills Development (MLTSD)?

ONA has been lobbying the Government for weeks about ensuring our front-line members have access to the appropriate Personal Protective Equipment (PPE) and utilizing the precautionary principle to prevent exposure and transmission of COVID-19. On the one side, we heard the Government saying that there were no supply issues and on the other, we were hearing from you that PPE was being rationed and/or locked up by employers.

A similar agreement was achieved by UNA in Alberta with their Government last week.

Does this mean that every nurse gets a N95 mask?

No. This agreement allows nurses to conduct a point of care risk assessment (PCRA) using their professional and clinical judgement to determine the level of PPE they need to care for the patient.

We have a responsibility to ensure that we are using PPE appropriately (not excessively) to ensure that those caring for suspected, presumed or confirmed COVID-19 patients shall have access to the level of PPE they require.

What is a point of care risk assessment (PCRA)?

A sample of a PCRA Tool follows. This tool enables the care provider to determine the risks associated with caring for the patient, the activity to be carried out, and the environment. The risk level determines the level of PPE to be accessed.

COVID-19 Point of Care Risk Assessment (PCRA)

POC Risk Factors	Risk description for COVID-19	Decision
Patient	Is the patient unable to follow instructions? (e.g., infants/young children, patients not capable of self-care/hand hygiene, cognitively impaired, have poor-compliance with respiratory hygiene)	Consider the need to replace Surgical/ procedure mask with N95* respirator
	Is patient displaying or verbalizing symptoms of increasing risk? (e.g., excretions/ secretions cannot be contained – respiratory secretions, frequent cough/sneeze)
Activity	Will you be performing an activity that may induce significant respiratory secretions that cannot be contained? (e.g., cough inducing procedure)	Consider the need to replace Surgical/ procedure mask with N95* respirator
	Will AGMPs be performed, frequent or probable? Is the patient’s condition changing? (e.g. manual or high frequency oscillatory or non-invasive ventilation, open endotracheal or airway suctioning, CPR, bronchoscopy, sputum induction, tracheostomy care, nebulized therapy/aerosolized medication administration, high flow heated oxygen therapy devices and autopsy)	MUST replace surgical procedure mask with N95* Respirator
Environment	Will care be provided outside of a regular patient room and patient is not able to wear a surgical/procedure mask?( e.g., hallway, public areas, outpatient unit, non-traditional/ leased environment)	Consider the need to replace Surgical/ procedure mask with N95* respirator

 

What happens if my Manager disagrees with my assessment?

If you have determined that you need the PPE, including a N95 mask, ONA suggests you continue have a conversation with your supervisor.

What is the dispute resolution process?

The supervisor and employee should review whether there are additional health and safety measures that should be implemented.  This discussion should not just be limited to access to a N95 respirator, are there other options that might work. If there are other options, then the employer and employee should implement these first. If after this assessment the nurse determines, based on their professional and clinical judgement, that a N95 respirator is the appropriate health and safety measure, then the employer must not unreasonably deny access to this PPE.

You can also call your Bargaining Unit President at any time.

As a last resort, you can exercise your rights under the Occupational Health and Safety Act.

Under the Occupational Health and Safety Act (OHSA), you have the right to refuse unsafe work; however, as a nurse or registered health professional that right is more limited than that of industrial and community health workers.

Our advice is that if you believe your work or task will endanger your health and safety and you exercise your individual right to refuse unsafe work, you must report the issue to your supervisor.  You must then stop doing the work or task for it to be a legitimate work refusal thus triggering the actions required by your supervisor or your employer and others.

By law, the employer must investigate the refusal at this stage in the presence of you and a Joint Health and Safety Committee (JHSC) worker member or someone selected by your Union. If the employer orders you to continue to work, remind them of their obligation to investigate and to follow the process set out for the employer under the OHSA then immediately call your ONA JHSC worker rep and your Bargaining Unit President.

If the issue cannot be resolved after the investigation and you continue to have reasonable grounds to refuse the unsafe work, the Ministry of Labour must be called. If you are considering a work refusal, please talk to your ONA Bargaining Unit President to learn more about this process and to protect your regulatory college standards.

What are the possible “safety control measures” to mitigate the transmission of infection?

Safety control measure could include:

• Ensuring that all suspected, presumed and positive patients are localized in the same units (ICU and or COVID patient care units) and ensuring that the same cohort of staff are providing the care. This would ensure that those health care providers have access to the higher level of PPE and staff on other units would not need those valuable resources.
• Controlling movement of patients around the hospital e.g. patients do not leave their unit to go outside to smoke or go to Tim Hortons for a coffee.
• Plexi-glass screens in screening areas.
• Employers also need to look at other solutions to protect workers, etc.

I have not been mask fit tested for some time, is the employer required to do that now regardless of the area I work in?

Yes, the employer must ensure that all care providers are mask fit tested (within the last 2 years and after significant weight loss or weight gain).

In addition, employers must ensure that all health care providers receive training in donning, doffing and disposal of PPE.

Employers must also ensure that they have a comprehensive pandemic plan in place including freeing up hospital beds for a potential surge in the number of cases.

How do we know that employers will have a sufficient supply of PPE?

The Government is requiring all hospital CEOs to report their inventory of PPE to the Procurement Branch of the Ministry of Health. This will help to ensure that there is an adequate supply for those that need it. We have been advised that hospitals that need PPE will have access; all they have to do is place the orders through the Procurement Branch. We have been advised that a greater numbers of supplies will be flowing over the coming weeks.

This does not mean there is an endless supply, thus the focus on conservation where it is possible.  This means wearing the same mask for as long as possible unless it is wet or soiled. This may also prevent contact exposure while removing the mask.

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Posted: March 27, 2020

ONA Central

Dear ONA member,

Today, leadership of the Ontario Nurses’ Association (ONA) met with top representatives of the Ministries of Health and Labour to explore options for the supply and distribution of protective equipment.

We agreed to keep working together to ensure front-line nurses and health-care professionals have access to the proper personal protective equipment (PPE).

We will meet again tomorrow with the goal to put in place an action plan to meet the needs of our front-line heroes.

We are all working in concert to fix this pressing issue of the distribution of PPE to the front lines. Protection of health-care workers is our number one focus and priority.

Supply of PPE

Situations have come to our attention where employers are running short, or have run out of certain PPE, like face shields.

We have also heard that employers or managers are threatening members with discipline and/or reports to the College of Nurses (CNO) in situations where members request certain PPE, or refuse to work because of the lack of proper PPE.

These actions violate your Collective Agreement, the Occupational Health and Safety Act, and CNO Standards. If a nurse, in their professional opinion, believes that there is a hazard that endangers them, they have a limited right to refuse unsafe work. Please consult with your Bargaining Unit President to support you in explaining to the employer that you feel unsafe performing care with the substandard PPE. The CNO recognizes this right, and in addition, managers threatening staff is a violation of the manager’s professional standards. You are encouraged to carefully document these interactions with your manager.

Members have also told us that if they are refusing to work additional hours, they will be reported to the CNO for abandonment. The CNO has maintained a position that so long as the employer is given notice, the refusal of additional hours is not abandonment. In fact, the CNO has indicated that fatigue can be as incapacitating as drugs or alcohol.

Further information is available by following the links below:

https://www.cno.org/globalassets/docs/prac/41070_refusing.pdf

https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/ask-practice/nursing-and-fatigue/

Inappropriate Face Masks

We are aware that reusable face masks are being made with cotton fabric. These are being offered to nurses and health-care professionals. Please know that the effectiveness of these cotton face masks is unproven, and may put you further at risk. Our best advice is to respectfully decline the offer of these cotton face masks. We strongly advise you to continue to use only approved personal protective equipment.

The landscape is changing at a rapid pace, sometimes by the hour. Please keep us informed by contacting your Bargaining Unit President or by emailing us at COVIDQuestions@ona.org.

In solidarity,

Vicki McKenna, RN
President

P.S. If you’ve moved or changed your phone number recently, and you want to update the contact information that we have on file for you in our union’s membership list, please submit your current contact info online: https://www.ona.org/update

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Location: CMH

Posted: March 26, 2020

Thank you for your information re PPE. Our position at ONA remains the same: where the science is uncertain re transmission the precautionary principle prevails. We advocate for N95s for anyone caring for a possible or positive pt.

ONA has filed a grievance with the Employer related to their PPE directives. ONA Central is currently looking at a possible injunction or expedited hearing related to this. Decisions are being made as we speak.

As always, per the Occupational Health and Safety ACT, if you personally feel your health and safety is as risk, based on your individual assessment of the scenario, you have the ability to refuse work. A work refusal triggers a call to the Ministry of Labour for an investigation. If you are considering a work refusal, pls connect with us to provide support.

ONA continues to advocate on your behalf in all levels of government. We are in constant contact with HR at the hospital so need any information sent to us via email.

At present, the Hospital is following the directives from Public Health. As always, advocating and sharing your concerns with government can be effective. Call or email your MP or MPP to let them know you are concerned re appropriate PPE. Doug Ford can be called at 416-325-1941.  Let his office know your concerns.

Thanks,

Brenda, Adele and Michelle

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Posted: March 26, 2020

Dear ONA member,

Since my last communication to you on the morning of March 23, the government has made a number of announcements. This communication updates you on recent developments related to COVID-19, and actions ONA has taken.

Let me start by saying this is an unprecedented and difficult time. I want to commend you on your extraordinary perseverance and commitment to your patients, residents and clients.

ONA Actions – All Sectors

Please know that I am putting forward a strong position at all government tables about the dire need for proper Personal Protective Equipment (PPE).

I will now be participating in a small government table to streamline access to PPE, and to ensure sufficient supply is available.

I will do everything in my power to protect you and your colleagues working on the front line of this pandemic.

Let me assure you that we are also working on a legal strategy if our efforts with government continues to ignore our demands and does not take immediate action.

We have filed numerous grievances on the precautionary principle and the lack of proper PPE. You and your colleagues have sent more than 8,000 emails via our online email to the Premier, Health Minister and your local MPP demanding proper PPE now! Please continue this advocacy with government.

We will be hosting two additional Telephone Town Halls on Wednesday, April 1 in the evening from 5 p.m. to 6 p.m. (for Regions 1, 2 and 5), and from 7 p.m. to 8 p.m. (for Regions 3 and 4).

The intent of the Telephone Town Halls is to answer as many of your questions as possible.

You will receive a call to join the Telephone Town Hall at 5 p.m. if you are in ONA Regions 1, 2 and 5. If you are in Regions 3 or 4, you will receive a call at 7 p.m. You simply need to accept the call to connect to The telephone Town Hall. If you are not able to pick up the call, you will receive a voicemail with a number for you to use to connect yourself.

If you need to update your contact information, there is a now a link on ONA’s website homepage – Update Your Information – and under ONA News. The links go to this page: www.ona.org/update

In my next communication to you, we will provide more ideas for ongoing advocacy as we will not back down in the face of government inaction and this growing pandemic.

We will fight for you every step of the way, and will push back and push through.

That is what we do as nurses and health-care professionals. We care for those unable to care for themselves. We can only give that care if we protect ourselves.

Please stay safe and advocate for your rights in the moment in your workplace.

Order on Redeployment in Long-Term Care Homes

On March 23 at 8:10 p.m., I had a telephone meeting with Minister of Long-Term Care Dr. Merillee Fullerton.

The Minister advised she issued an Order under the province’s March 17 declaration of emergency.

This temporary order, for the next 14 days, gives long-term care employers the ability to cancel and postpone services to free-up space and staff, identify staffing priorities, and develop, modify and implement redeployment plans.

We have posted this Order on our website at: www.ona.org/coronavirus.

What is in the Long-Term Care Homes Redeployment Order?

Under this temporary Order, long-term care homes will be able to unilaterally respond to, prevent and alleviate an outbreak of COVID-19 by authorizing them “to take any reasonable necessary measure” with respect to “redeployment and staffing” in order to do the following:

• Redeploying staff within different locations in (or between) facilities of the long-term care homes;

This means that employers could move staff between homes and within areas of the home.

• Changing the assignment of work, including assigning non-bargaining unit employees or contractors to perform bargaining unit work;

This could mean a variety of things including changing areas, reassigning RNs so they could assign managers to cover previous bargaining unit work, bringing in agency nurses, and so on.

• Changing the scheduling of work or shift assignments;

If staff are moving between areas and locations, then schedules and shifts will change.

• Deferring or cancelling vacations, absences or other leaves, regardless of whether such vacations, absences or leaves are established by statute, regulation, agreement or otherwise;

This means that vacations and leaves can be cancelled (this could mean union leave, education leave, pre-paid leave, professional leave, personal leave and maybe pregnancy/parental leave). We have already notified employers and the government that cancelling pregnancy/parental leave is a non-starter and we have been informed it is not their intention.

• Employing extra part-time or temporary staff or contractors, including for the purpose of performing bargaining unit work;

Employers can hire part-time or temporary staff or agency staff.

• Using volunteers to perform work, including to perform bargaining work;

Long-term care homes are likely to use existing volunteers in enhanced roles.

• Providing appropriate training or education, as needed, to staff and volunteers to achieve the purposes of a redeployment plan.

Employers are to provide training to work in new areas or locations (this will likely be limited).

The Order provides this authority to long-term care homes despite any other statute, regulation, order, policy, arrangement of agreement, including a collective agreement.

The power to act in this manner arises under the Emergency Management and Civil Protection Act Section 7.0.2(4).

This Order is in place for up to fourteen (14) days, can be extended by an additional period of up to fourteen (14) days, and then the matter has to be referred to the Legislature to be extended.

The Order is subject to the Charter. It is very clear that the purpose of making an Order under this section is to promote the public good by protecting the health, safety and welfare of the people of Ontario in times of declared emergencies. We say that the people of Ontario includes ONA members!

Please note that the Occupational Health and Safety Act continues to prevail.

The Order prohibits the filing of grievances during this time, but timelines are extended until after the Order.

The Order provides a limitation from the outset around reasonable qualification to provide a service. It states an Order may be issued: “authorizing, but not requiring, any person, or any person of a class of persons, to render services of a type that that person, or a person of that class, is reasonably qualified to provide.”

Therefore, the Order states that Employers will:

• Conduct a skills and experience inventory to identify possible alternative roles staff may perform in priority areas;

Note some employers have already started this inventory.

• Require and collect information from staff and contractors about their availability to provide services;

This may include child care, elder care, care of a loved one with COVID-19 and so on.

• Require and collect information from staff and contractors about their likely or actual exposure to the Virus or about any other health conditions that may affect their ability to provide services;

This goes again to the issue of needing to be self-isolated, either after travel, or after exposure.

• Cancel or postpone services that are not related to responding to, preventing or alleviating the outbreak of the Virus;

This means long-term care homes can cancel or delay some non-essential services such as seniors’ day programs.

• Suspend, for the duration of the Order, any grievance process with respect to any matter referred to in this Order.

As I mentioned above, grievance time limits will be extended.

Thus, the redeployment plans can be carried out without complying with provisions of your collective agreement, including layoff, seniority/service or bumping provisions.

To be clear, this is not a wholesale voiding of our collective agreements; however, it does void some sections.

Chief Medical Officer of Health – Directive #3

On March 22, the Chief Medical Officer of Health also issued Directive #3 for Long-Term Care Homes.

With respect to working in more than one long-term care home, it states:

Wherever possible, employers should work with employees to limit the number of different work locations that employees are working at, to minimize risk to patients of exposure to COVID-19.

It also states:

Residents of long-term care homes should not be permitted to leave the home for short-stay absences to visit family and friends. Instead, residents who wish to go outside of the home should remain on the home’s property and maintain safe social distancing from any family and friends who visit them.

Finally, the Minister of Long-Term Care also issued long-term care regulatory changes on March 20.

Amendments have been made to Ontario Regulation 79/10 (Regulation) under the Long-Term Care Homes Act, 2007 (LTCHA) to respond to the COVID-19 pandemic.

According to the Minister, the objectives of these amendments are to:

• Protect the safety and health of LTC residents;
• Streamline LTC home operations; and
• Support LTC homes in building staffing capacity during the pandemic.

These changes have been directly communicated to the long-term care sector employers.

The amendments made to the Regulation are as follows:

1. Amending the exemptions to the 24/7 registered nurse (RN) requirement to provide staffing flexibility in cases where the pandemic prevents an RN from being present in the home.
2. Temporarily providing for flexibility in the timing of police record checks in order to get more staff working in homes sooner.
3. Prioritize the timing of specific training requirements such as Abuse, Infection Prevention and Control ensuring those requirements are completed as soon as possible.
4. Staffing Requirement Exemptions for the number of hours the Director of Nursing and Personal Care must work in their positions to allow them to focus on front-line activities.

Next Steps on Redeployment

We have developed some principles to discuss at the bargaining unit level with your Labour Relations Officer to ensure your voice is represented. Ideally, this may help with some coordination across long-term care employers when they take actions on redeployment.

Some employers will be willing to discuss principles and some will not.

At this time, there is nothing to compel them, except good labour relations practices and a willingness to ensure there is some labour stability during this time.

We can anticipate that staffing needs are likely to change quickly and thus, limitations on redeployment will be restrictive.

Regardless, we say employers shall maintain all premium payments for overtime, paid holidays, and scheduling premiums and any other premiums or entitlements under the Collective Agreement.

I know that you and your colleagues will do everything you can to assist with this pandemic, but I also know you need proper personal protective equipment (PPE), including fit-tested N95s, and training if you are deployed or reassigned to a higher-risk area than your regular assignment.

I will issue ongoing communications to keep everyone updated.

Vicki McKenna, RN
President

P.S. If you’ve moved or changed your phone number recently, and you want to update the contact information that we have on file for you in our union’s membership list, please submit your current contact info online: https://www.ona.org/update

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Posted, March 24, 2020

Hello ONA members,

This communication is the first of many to keep you updated on the actions that ONA is taking on your behalf.

First, I want to take this opportunity to thank each and every one of you for your tremendous courage and commitment to your patients.

Ontarians need every nurse and health-care professional to be screening and treating COVID-19 patients with the proper personal protective equipment (PPE) in place.

Safeguarding ONA members and our health-care workforce to provide care for Ontarians is our paramount priority.

On March 17, the Government of Ontario declared an emergency under the Emergency Management and Civil Protection Act. This is in effect until March 31 when it will be reassessed.

ONA has been part of daily teleconference briefings, and we have a seat at multiple government tables.

ONA is closely monitoring this evolving situation, and has initiated a special internal task force to respond, as quickly as we can, to the threat of the emerging coronavirus.

Below are the top five things that we believe you need to know about COVID-19 at this time.

1. Minister’s Order for Redeployment of Nurses and Health-Care Professionals

On March 21 at 9:20 p.m., the Solicitor General issued an Order under the province’s March 17, 2020 declaration of emergency. This temporary order, for 14 days, gives hospitals the ability to cancel and postpone services to free-up space and staff, identify staffing priorities, and develop, modify and implement redeployment plans.

Under this temporary Order, hospitals will be able to respond to, prevent and alleviate an outbreak of COVID-19 by carrying out measures such as:

• Redeploying staff within different locations in (or between) facilities of the hospital;
• Redeploying staff to work in COVID-19 assessment centres;
• Changing the assignment of work, including assigning non-bargaining unit employees or contractors to perform bargaining unit work;
• Changing the scheduling of work or shift assignments;
• Deferring or cancelling vacations, absences or other leaves, regardless of whether such vacations, absences or leaves are established by statute, regulation, agreement or otherwise;
• Employing extra part-time or temporary staff or contractors, including for the purpose of performing bargaining unit work;
• Using volunteers to perform work, including to perform bargaining work; and
• Providing appropriate training or education as needed to staff and volunteers to achieve the purposes of a redeployment plan.

ONA has now had a discussion with the Ontario Hospital Association (OHA) to determine if we can negotiate principles provincially. This will not happen. We have developed some principles to discuss at the bargaining unit level with your ONA Labour Relations Officer to ensure members’ voice is represented. Ideally, this may help with some coordination across hospital employers when they take actions on redeployment.

I know that you and your colleagues will do everything you can to assist with this pandemic, but I also know you need proper personal protective equipment (PPE), including N95s, and training if you are deployed or reassigned to a higher-risk area than your regular assignment.

I will continue to keep you updated as we progress with our negotiations on implementation of the government’s Order.

2. Proper Personal Protective Equipment

I have been very clear in stating ONA’s position to all levels of government: every nurse or health-care professional screening or treating a suspected or confirmed COVID-19 patient needs to have access to fit-tested N95 or better protection, as warranted.

We advised the government that all of our members – each of you – are determined to provide the very best care and services to Ontarians.

However, as we learned all too well during the 2003 SARS crisis in Ontario, we need to ensure that each of you are cared for and protected from contracting COVID-19, if you are all to remain on the front lines of this pandemic.

To date, we have seen conflicting scientific research that shows how COVID-19 is transmitted.

We agree the virus is likely spread through droplets but there is evidence that it is also borne through the air.

We do not agree the recommendations in Directive #1 from the Chief Medical Officer of Health (see ONA’s website: www.ona.org/coronavirus) provide the proper personal protective equipment when screening or treating suspected or confirmed COVID-19 patients.

For this reason, we are following the recommendations from the SARS Commission that when the science is conflicting and uncertain, every precaution has to be taken to keep health-care workers safe.

To be very clear, we are not calling for every single health-care worker to don an N95 respirator or better.

However, every nurse or health-care professional screening or treating a suspected or confirmed COVID-19 patient needs to have access to at least a fit-tested N95 or better protection.

Again and again, it’s been shown that when health-care workers are safe, patients are safe.

If a shortage of proper personal protective equipment arises, then the government and employers need to implement other options and engineering measures that can be taken to prevent transmission of COVID-19 during screening – plexiglass barriers, for example.

We cannot afford to have the very same argument in this province that we had during SARS.

We have learned the hard way – with the deaths of two registered nurses during SARS – that the precautionary principle is paramount.

We continue to call on government, employers and public health leaders to work with us to avoid the unnecessary further spread of COVID-19.

We also need to ensure clear, consistent and mandatory directives to employers across all health-care sectors and sites.

3. Self-Isolation after International Travel or Exposure to Confirmed COVID-19 Cases

It is ONA’s position that all nurses and health-care workers must self-isolate for 14 days after returning to Canada from international travel, including travel from the United States.

The recommendations released by the Chief Medical Officer of Health on March 19 are not directives to health-care employers. Therefore, employers are able to exempt staff from the requirement to self-isolate, after international travel, if designated as essential and critical to the employer’s operations.

ONA believes this is a mistake and will needlessly expose health-care workers and patients to COVID-19, even if health-care workers are not showing symptoms when they are ordered to return to work after international travel.

We also believe that the recommendations should be made mandatory and extended to self-isolation for any health-care worker who has been exposed to confirmed cases of COVID-19.

4. ONA Members who are immunosuppressed (or for family members) or Pregnant

It is ONA’s position that any ONA member who has an immunosuppressed or immunocompromised condition or pregnant should be speaking with their Bargaining Unit President for assistance to be accommodated into a low-risk or administrative area. If you face any issues of being accommodated, please also speak with your Bargaining Unit President.

5. Managing Supplies, Including PPE

While ONA’s position remains that every nurse and health-care professional must have access to fit-tested N95s or better protection if screening or treating suspected or confirmed COVID-19 patients, we also believe that there may be ways to implement administrative measures and engineering controls, such as plexiglass barriers, to conserve supplies and PPE.

We also agree that ONA members must be good stewards of available supply of PPE and other supplies, while maintaining your safety. Access to N95s must be readily available.

Summary of Our Lobby and ONA Actions to Date

At ONA, our number one priority is speaking out and protecting our members to keep them healthy and safe so they can continue to provide care on the front lines.

As a result, we have taken a number steps to provide communications to our local leaders and members to keep everyone updated on emerging issues and evolving developments.

We have developed a dedicated webpage on our main website: www.ona.org/coronavirus. This web page houses all documents issued by the Ontario government and communications from ONA.

ONA held a telephone town hall and Facebook Live event with our members at the end of January, and again on March 17. The audio files of this town hall are posted on Facebook and on our dedicated web page.

ONA Leadership has been actively raising issues at all government tables where we have a seat. ONA Leadership is in constant communication with senior government officials – from the Premier’s office to the Minister of Health to the Chief Medical Officer of Health.

ONA’s President is responding to multiple requests from provincial media throughout the day. I can tell you that I am doing extensive media interviews to get out our messages on PPE and the protection of front-line staff from exposure to COVID-19.

All media releases responding to government actions are housed on our main web page under the media room.

ONA has launched an online email campaign to advocate for proper PPE for our members.

ONA is also working with our labour allies, including holding a joint media conference to advocate for proper PPE.

The Presidents of ONA and three other health-care unions also held a teleconference directly with the Minister of Health to press for proper PPE.

In addition, ONA is working with the official opposition to raise our issues at any tables with government and with their media work.

Directions on labour relations matters have been sent to staff labour relations officers and to ONA bargaining unit presidents on almost a daily basis, including grievance language and processes for health and safety complaints.

ONA is developing a litigation strategy that may include a central rights arbitration for our hospital sector and a possible injunction to await the results stemming from the arbitration.

ONA is participating in daily teleconferences with government officials that provide an update on government priority work for that day.

Conclusion

In summary, the major issues that have arisen in addition to the supply of and access to proper PPE, include:

• The issue of droplet versus airborne precautions and proper PPE. ONA’s view is that the virus is spread by droplets but may be borne by air.
• The issue of nurses and health-care workers returning from international travel and the requirement for self-isolation for 14 days. We now have forced the government to issue guidance but it is not a mandatory directive to hospitals and other employers. It requires self-isolation and not returning to work if sick, but it allows employers to determine and to exempt essential staff critical to their operations.
• Already some hospitals have been designating all nurses and health-care workers as essential. This approach is needlessly risky and potentially spreading exposure to the virus.
• The capacity (including a shortage of swabs) to test cases showing COVID-19 symptoms and who are under investigation is being stretched, including access to a telehealth line for advice.

ONA will continue to advocate on behalf of the health and safety of our members, including up to their limited right to refuse unsafe work assignments.

Please keep yourself informed as best as possible.

As information becomes available, the ONA website is being updated as quickly as possible – it is your best resource for new information.

As a reminder, please visit: www.ona.org/coronavirus.

Stay safe and stay protected.

Thank you for your tremendous courage, and your dedication to your profession and your patients.

Vicki McKenna, RN
President
Ontario Nurses’ Association (ONA)