Photo: Nova Scotia Nurses Union
他们说：“潮汐上升升起了所有船只。”但是，大流行的波浪已经提高了公众对几十年来一直在政治上浮出水面的部分淹没船的认识：收入不平等，妇女的不稳定经济状况以及我们的医疗保健系统中的弱点，仅举几例。
此外，加拿大，特别是在新斯科舍省的长期护理状况。除某些例外，Covid-19在疗养院中的破坏导致了该系统的描述，其中包括“不足”和“令人震惊”。
Now, thanks to a recent grant of $97,412 from the Nova Scotia Health Research Fund (administered by Nova Scotia Health), Dr. Janice Keefe and two investigators will interview people about working conditions in eight nursing homes across the province. The project described as “The Unsung Heroes, Long-Term Care staff’s quality of work life”is expected to report next spring — a year from now.
但是，任何一直关注该省LTC系统中问题的新闻报道（尤其是在过去的五到六年中）的人可能会因说“嗯？”而被原谅。
The cost of the latest study is chump change when you consider 46% of the entire provincial budget goes to Health. Janice Keefe, a PhD and director of the Nova Scotia Centre on Aging at Mount Saint Vincent University, is a highly qualified and recognized expert on geriatric care. In fact, the province appointed Keefe to chair the Expert Panel on Long-Term Care a few years ago. Submitted to government in December 2018,那个报告made 22 recommendations.
如果您今天坐下来阅读它（如果您跳过标题和词汇表，则只有21页），您可能很难想象可以在其尖锐的建议中添加什么建议中期和长期。
基夫还是加拿大皇家协会长期护理工作组的成员。它的 ”恢复信任”报告于2020年7月发布，他说，迫切需要“解决劳动力危机”，这是建立国家标准，这些标准将需要更多的联邦和省级资金才能充分支付人们的费用才能完成这项工作。此后，总理任命卫生部长与各省合作制定此类标准。同时，可以质疑新斯科舍省为期一年的研究可能会产生哪些新信息，这是尚未得到记录的。
“我的第一个想法是，真的吗？”新斯科舍省护士联盟主席珍妮特·哈泽尔顿说。“在长期护理院中，我们有很多证据人员配备水平不足。我们不需要再学习！”
Hazelton说，您只需要查看在家庭护理和长期护理中工作的人中的伤害率，即可看到他们是该省最高的人。Hazelton说：“这是因为没有足够的员工来完成这项工作，因此，处理大量工作量的人会更经常生病和受伤。”
2015年12月，新斯科舍省护士联盟发表了一份名为“破碎的房屋,” which included survey responses from 200 registered nurses (RNs) and licensed practical nurses (LPNs) working in long-term care facilities. Two-thirds said they had considered quitting in the past year. Staffing levels and workload emerged as the top contributors to work-life dissatisfaction. Half the nurses said their long-term care facilities regularly or often did not meet minimum staffing levels prescribed by the Homes for Special Care Act — a finding which raised serious questions about the rigour of provincial inspections and enforcement at the time.
The NSNU has been urging the provincial government since 2015 to legislate minimum staffing levels to reflect best practices elsewhere. This would involve increasing the amount of care residents receive from 3.5 hours to 4.1 hours a day — an extra 36 minutes. This change would require hiring more Continuing Care Assistants (CCAs) who clean, dress, and feed residents, and hiring more licensed nursing staff responsible for medication, wound care prevention, and treatment associated with bedsores.
到目前为止，自由党政府一直拒绝修改《特殊护理法》的房屋，以提高人员配备水平 - 即使在第一批Covid-19浪潮中有57次疗养院死亡之后，该系统中裸露了明显的弱点。顺便说一句，上述2018年专家小组通过此评论标记了过时的三年历史的问题：政府考虑此审查并投资于立法的重大现代化。”
在这项最新研究中，Keefe和她的调查人员计划采访同意参加的工作人员，其工作分类从继续护理助理（CCAS）到高级管理人员。基夫本月初对CBC新闻说：“这是一个机会提供一些证据，以证明这些人为我们作为一个社会所做的工作的价值。我认为，这将非常有用，以便能够理解围绕招聘，尤其是保留率的问题。”
不乏参考点
Keefe may want to review a three-point plan the Canadian Union of Public Employees (CUPE) submitted to the Nova Scotia government and opposition leaders. CUPE represents 5,700 CCAs and dietary workers in nursing homes and residential care facilities across the province. Point Number One in the plan was, “Address chronic staff shortages for Continuing Care Assistants by increasing their pay from $18.96 an hour. These workers are often forced to work overtime and denied vacation.”
“The solution is not the creation of another unskilled CCA assistant that is paid at a lower rate,” said Govind Rao, a researcher for CUPE’s Atlantic region. Nevertheless, the Nova Scotia government has budgeted $10.3 million this year for nursing homes to hire and train people to help CCAs with feeding and transporting residents. This was envisioned as a stop-gap ortemporary由专家小组在2018年通过专家小组衡量，以缓解一线人员配备中的“危机”。饶说，吸引更多工人的方法是像魁北克和不列颠哥伦比亚省一样增加薪水，现在两个省份的支付每小时超过20美元。
Eight publicly and privately owned nursing homes have agreed to participate in the “Unsung Heroes” study, even though last July, the Nursing Homes Association of Nova Scotia went public for the first time with a position paper called “Enough Talk.” As the paper’s title suggests, the nursing home operators requested urgent action from the province to change the way homes are funded and to come up with a plan to address chronic shortages for both front-line workers and nurse managers.
与护士工会不同，疗养院运营商不支持最少的护理数量，因为他们担心自己会失去选择的工人组合或分类以雇用和付款的灵活性。（最新的省级预算增加了640万美元，以实施专家小组建议，以雇用更多的理疗和休闲治疗师，540万美元以雇用护士从业者和医生。
N.S.疗养院协会执行董事Michele Lowe说：“这项研究得到了我们与八名成员参加的协会的支持。”“虽然您可能会问为什么需要对这种性质进行研究，但事实是，长期护理仍被资助不足，这些项目似乎是证明影响的必要条件。珍妮丝（Janice）继续为我们的部门和努力提供优质护理而努力工作的员工倡导。”
但是加里·麦克劳德（Gary MacLeod）发现，很难看到另一项研究将如何对生活和工作中的长期护理中的人们产生有意义的变化。十多年前，他成立了一个名为“老年人（ACE））的倡导者”。他观察到了自由主义者2015年的承诺，即提供长期护理策略蒸发。今年的预算包括500,000美元用于开发长期护理的“蓝图”。
当被问及他对疗养院工作条件的最新$ 94,000研究的看法时，麦克劳德（MacLeod）钝了。“当我看到珍妮丝·基夫（Janice Keefe）博士领导的另一项'研究'报告时，我感到震惊。我非常尊重Keefe博士，但这是她参与不到三年的第三项研究。” MacLeod说。
“There is no shortage of reports and studies for what is wrong with long-term care, and不— we certainly do not need more waste of taxpayer money for another study. The recent Liberal budget has no clear plan to improve the quality of care for long-term care residents, who have to endure sitting in soiled incontinence pads for long periods of time and one bath a week, all due to staffing shortages. Who needs another study to know that?”
When the Unsung Heroes study’s recommendations are released next year — perhaps after provincial or federal elections in which other hot-button issues tend to swamp weaknesses in long-term care — it may be interesting to compare its closing statement with the report from the 2018 Expert Panel on Long-Term Care:
It is our hope that the recommendations outlined here, many of which have been previously suggested in other LTC reports, will provide important first steps to improving conditions in LTC to the benefit of both residents and workers.
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谢谢！
“This is an opportunity to provide some evidence about the value of the work that these individuals are doing for us as a society,” Keefe told CBC News earlier this month.
给我休息一下。我们都知道这些不尊重和如此明确的无污的英雄的价值。
How bout we stop discussing, studying, discovering and presenting-with-fanfare and start paying them a decent wage, benefits And respect? In so doing, we will offer those they look after respect.
为什么这是一个讨论？另一个研究？不可忽视。
And no, I’m not in the profession, nor are any of my family members or friends. I’m simply a person who’s heart is actually beating.
Pardon the cynicism but this looks like another effort to stall until after the election. The Liberals will be waiting for Janice Keefe’s report on staffing LTC just as they are waiting for recommendations from their housing committee, court rulings on Owls Head etc. etc.
在我看来，“ Unfriggnbelievable”似乎是另一个行动延迟的很好描述。另一项研究是现在没有帮助居民/他们的家庭或员工士气。
Let’s not forget about the excellent and detailed study on “Staffing Standards in Nova Scotia Nursing Homes” prepared by a long-term care staffing expert from the United States on behalf of the Nova Scotia Nurses Union and published in June 2020. Don’t know why this study has not been given the attention it deserves. It outlines the evidence-based case for 4.1 MINIMUM (and note, it is a minimum) hours of direct care per resident day. Nobody seems to know that this study exists and even the NSNU does not refer to it when they talk about staffing levels. Note that in Ontario, the Ford government has adopted into law an average of 4 hours of direct care per day (although note this is only an average — presumably to provide wiggle room for care facility operators — and I don’t think it will actually take effect until 2022). Finally, its useful to remember that Gary Burrill of the NDP tabled Bill 22, the “Care and Dignity Act”, in the NS Legislature way back in September 2018 proposing that each LTC resident receive “a minimum of four hours and six minutes of personal combined nursing and support services every twenty-four hour cycle”.