According to a panel of experts called in by the Ontario Nurses' Association (ONA), the St. Mary's General Hospital emergency department is in need of more registered nurses (RN) to reduce staff workload.
The panel was called in to look at care, professional practice issues and the environment in the emergency department (ED), and made a total of 79 recommendations to address workload concerns.
"The panel's unanimous recommendations to improve care and the practice environment in the emergency department at St. Mary's General Hospital include many of the same measures proposed by our ONA members," notes ONA President Vicki McKenna, RN. "Our RNs have been raising concerns with this hospital for the past three years, before calling in the Independent Assessment Committee."
The IAC, which is a last resort to try to settle issues that can't be resolved between nurses and employers, made recommendations that address 11 areas of concern related to patients being held in the ED when no inpatient beds are available.
In response, the panel recommended an increase by a total of five RNs daily, as well as suggestions for "improved nursing leadership communication and support, needed education and equipment, [and] violence and safety issues in the ED," among other things.
"The panel has released a very strong report which, if implemented by St. Mary's, will lead to an improved practice environment for our members, reduced RN turnover, and improved care for patients," says McKenna. "The implementation of increased staffing, independent decision-making by the Resource Nurse, enhanced orientation and mentorship for new RNs and improved leadership and communication strategies, will create a foundation to move towards full implementation of all the recommendations. RNs are very pleased with the report and the recommendations, particularly the affirmation of the need for increased RN resources to support improved patient care and enhance positive patient outcomes. ONA looks forward to working collaboratively with St. Mary's General Hospital to implement these excellent recommendations."
The ONA represents more than 68,000 RNs and health-care professionals, as well as 18,000 nursing student affiliates, providing care in hospitals, long-term care, public health, the community, clinics and industry.
The following response was issued in request for comment from St. Mary's General Hospital.
St. Mary's General Hospital (SMGH) and the Ontario Nurses Association (ONA) have been working collaboratively to resolve concerns from nurses working in our Emergency Department. Last month, this process moved to an Independent Assessment Committee (IAC) process, which involved a panel of three nurses, including a Chair and two nominees: one selected by SMGH and the other selected by ONA.
On Friday, July 16, the IAC released its report, outlining a number of recommendations. We are pleased to have been involved in this process and we are committed to digesting the report and working with our Emergency Department and the ONA to prioritize these recommendations. We look forward to working together collaboratively to start to implement some of these recommendations.
"St. Mary's respects the recommendations given by the Independent Assessment Committee (IAC). We are committed to an environment that provides safe patient care and where all our professional staff are able to work within their scope of practice, with the resources that they need. St. Mary's has purchased equipment and increased other resources to make this possible," said Leisa Faulkner, Vice President Patient Services and Chief Nursing Executive (CNE).
"The IAC provided some fresh perspective on this issue and I am confident that the recommendations they delivered will enable us to move forward in a collaborative way with ONA and its members. St. Mary's will continue to deliver excellent, compassionate care to hundreds of thousands of patients and their families every year," said SMGH President Lee Fairclough.
Recommendations from the IAC, while not legally binding, will be taken very seriously and given priority at St. Mary's. We strive to implement all mutually agreed changes in a timely and informed way. As SMGH endeavors to implement the recommendations that make sense for us, we will be engaging staff directly on implementation.