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A time for change in Ontario’s Long-Term Care system

by RPN

The Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System began its public hearings on June 5 in the Elgin County Courthouse in St. Thomas, Ontario. The Inquiry’s mandate is to inquire into the circumstances that allowed Elizabeth Wettlaufer, a former Registered Nurse, to commit eight murders, four attempted murders, and two aggravated assaults while working in Ontario’s long-term care homes. The public hearings will enable the victims of Ms. Wettlaufer’s crimes, the families of the victims, and representatives of advocacy organizations granted participation in the proceedings to investigate how these crimes were committed.

As the professional association for Ontario’s Registered Practical Nurses, RPNAO has been granted standing to participate in these public hearings. RPNAO has also been invited to take part in the second part of the Inquiry, which will enable the Inquiry’s Commissioner, Justice Eileen Gillese, and Commission legal counsel to meet with participants to discuss the broader systemic problems that may have contributed to the commission of the crimes, and to make recommendations aimed at preventing similar crimes from occurring in the future. This work will begin this fall, after the public hearings have been completed, and the Commission will deliver its final report in July, 2019.

Since the Inquiry began, Commission counsel has reviewed 41,000 documents and interviewed experts and witnesses with information pertinent to its work. It also prepared four overview reports about various aspects of the case. They focused on the facilities and agencies where Ms. Wettlaufer worked, the College of Nurses of Ontario, the Office of the Chief Coroner of Ontario, and the Ministry of Health and Long-Term Care. The Commission also prepared three foundational documents that outlined a timeline of the major events, including the dates of each offence; the agreed statement of facts entered into evidence during the criminal proceedings against Ms. Wettlaufer; and a list of the relevant legislation, regulation, and procedures that shape the long-term care system. As a participant in these proceedings, RPNAO was given an opportunity to review and comment on these reports before their admission into evidence at the public hearings.

The public can now access the various overview reports and foundational documents on the Inquiry’s website. As well, on days when the Inquiry is in session, the public can access a live webcast of the proceedings. These webcasts are recorded for later viewing. Transcripts of the proceedings, exhibits, and other important documents are also accessible on the Inquiry’s website.

These are important and complicated issues, and RPNAO will be heavily engaged throughout the summer and fall to contribute our perspective about what went wrong in our long-term care system that may have enabled Ms. Wettlaufer’s crimes. We want to offer recommendations that will help improve our long-term care system in a way that makes it easier to identify criminal wrongdoing without impugning nurses who are doing their jobs under often difficult circumstances. We believe to accomplish this goal it is imperative that nurses, employers, government, advocacy organizations, and long-term care residents work together to:

(a) Strengthen professional practice environments in Long-Term Care and Home Care Facilities including providing access to specific Professional Practice Human Resources;

(b) Promote a culture of safety in Long-Term Care and Home Care Facilities in an effort to increase the voluntary disclosure of Medication Errors;

(c) Increase protections for Long-Term Care and Home Care Facilities to increase the transparency in reporting between said facilities, CNO, other facilities and the general public; and,

(d) Amend the present regulations to permit Long-Term Care and Home Care Facilities to employ the best available regulated nursing professional, regardless of designation.

We believe that the work of the Inquiry is of the utmost importance to our long-term care residents, and we want Ontario’s Registered Practical Nurses, who are experts in caring for our older adults, to work with us to engage in the Inquiry process. We therefore encourage you all to access the documents and webcasts on the Inquiry’s website, and please connect with us to let us know your thoughts and ideas about these proceedings.

Together we know we can make a difference for our patients.

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