By Candace Chartier, CEO, Ontario Long Term Care Association

Ontario’s long-term care homes need current legislation to be changed to allow more flexibility in the type of staff they hire. Homes know their residents best, and which health care providers will provide what their population needs.

In Ontario, the Long-Term Care Homes Act requires that a registered nurse (RN) be in the home 24/7. This can be a real challenge for homes, particularly those in rural areas and small communities, where the supply of registered nurses is limited to begin with.

More than one in 10 Ontario long-term care homes recently surveyed by the Association indicated that finding 24/7 registered nurses is one of their top human resource challenges. Homes that are unable to meet this requirement, even temporarily, face serious repercussions for not complying with the Act.

Half of the province’s current supply of registered nurses will be of retirement age over the next five years. As long-term care is already facing RN shortages in some regions, we believe the legislation needs to change to allow homes to use registered practical nurses (RPNs) to provide 24/7 coverage, based on each home’s assessment of their needs. Right now, we have a “one size fits all” approach, and that’s not necessary or practical.

Registered practical nurses have the knowledge and skills required for providing care. Although RNs and RPNs have differing levels of education, many of the tasks they do in long-term care are the same. Registered nurses may still be required 24/7 in some homes based on the medical complexity of the residents and other factors, but in many long-term care homes, registered practical nurses may be best suited (or equally suited) to meet the needs of the home’s residents.

There is no shortage of registered practical nurses in the province, and there would be many RPNs eager for this leadership opportunity. Long-term care is already a major employer of RPNs, employing nearly 40% of the province’s supply. Registered practical nurses are highly valued for what they bring to long-term care, and it’s an attractive environment for them because there are often more opportunities to work at their full scope of practice and to take on leadership roles than in other health care settings.

Ontario has a new Progressive Conservative government which has committed to adding 30,000 new long-term care beds over the next 10 years. These new beds and new homes will need significantly more staff, and we’re asking the province to recognize the pressures we’re already under, and to fast-track changes so that we can grow a strong workforce for the future.


This article by the Ontario Long Term Care Association appeared in the Association’s magazine, Long Term Care Today, Fall/Winter 2018 and is shared with their permission.

Category: Special FeatureDate: Tuesday, February 5, 2019