Nurses hand VIHA 4,000 reasons to stop and review new patient-care model

Jo Salken of the B.C. Nurses Union helps deliver 4,000 petition names to VIHA board chairman Don Hubbard during Wednesday
Jo Salken of the B.C. Nurses Union helps deliver 4,000 petition names to VIHA board chairman Don Hubbard during Wednesday's meeting in Duncan. RNs want VIHA's Care Delivery Model Redesign stopped for an independent patient-safety review.
— image credit: Peter W. Rusland

A new patient-care model won't be stopped and reviewed, as demanded by angry nurses Wednesday in Duncan.

They handed Vancouver Island Health Authority brass boxes holding 4,000 petition names of nurses demanding the model be reviewed by independent experts to assess patient-safety risks.

"It would be irresponsible for us to do that (independent review)," Dr. Brendan Carr, VIHA's acting CEO, said of the model already implemented at various hospitals, including Cowichan.

"We're already using external people to review it."

About 50 RNs confronted VIHA board members during their meeting at the Travelodge Silver Bridge Inn.

Nurses wearing red-and-black clothing — symbolizing a bleeding health-care system, and the death of adequate care — damned VIHA's creation and implementation of the Care-Delivery Model Redesign.

That model would basically see teams of RNs, LPNs and care aides tend patient needs, particularly among the island's aging patients.

Nurses' higher level of training would provide team planning.

"One-on-one care is not how we work today," said Carr. "It's not simply about who is a team member, but what the team comprises."

But RNs  believe they'll gradually be replaced by lower-paid care aides.

Jo Salken, of the B.C. Nurses Union, indicated VIHA's motive is saving money on labour "full stop."

She explained care aides can, for example, take patients to the toilet, but RNs doing that task are trained to do assessments about bed sores, walking gear needed, balance, and more.

"What started as 'right nurse, right patient' suddenly flip-flopped to 'right health-care worker-right patient.'"

Carr signalled he got the message from those 4,000 names.

"There's a concern, we understand that, and recognize you can't exchange a nurse with a care aid."

"We need more nurses, not less," said RN Kelly Charters.

"VIHA's not listening to our concerns."

She explained their workload is squeezed by four levels of management needed to sign off on various duties.

Brenda Hill, a Cowichan District Hospital nurse, said the model lacks the promised flexibility to address the ER's chronic overcrowding crisis.

"I don't see any help for me. It's lack of will, and lack of money."

She demanded more nursing grads be hired for the island.

"We want to hire as many grads as we can," replied Carr.

"We're here because we're frightened about what's coming" said BCNU's Margo Wilton.

She explained RNs fear the model will steal precious time from working with patients.

Nurses also said the model was developed mostly in secret since 2008, despite some meetings with RNs.

"Nurses felt duped," said Salken.

But Carr explained there was nothing secretive about the model's genesis.

"This hasn't been done in private but in open, collaborative processes by discussions that involved front-line providers."

RN Lisa McLeod disagreed.

"There were seminars for nurses but not for doctors, and they didn't mention restructuring teams of nurses.

"I think patients will come to harm. VIHA's destroying the caring culture in hospitals, and the public's the last to know."

Carr was unaware if press releases about the model were issued by VIHA's communications staff. "We see this (model) as an ongoing process focused on public safety and quality of care.'



What is VIHA's Care-Delivery Model Redesign?


The CDMR was adopted at Cowichan District Hospital in 2009. It's slated for Nanaimo Regional General Hospital on Sept. 13.

Here's how VIHA's describes new care-model highlights:

*The Care Delivery Model Redesign is part of a cross-Canada approach to change how care is provided to patients in hospital and community settings.

*At VIHA, work to improve care through the new model has been underway since 2008.

*Patients, particularly those with complex needs, require a new and different approach to care, including the need for more care planning by staff, and more assistance with daily activities.

*CDMR ensures the right type of care is provided to patients at the right time by the most appropriate health-care provider – whether a registered nurse, licensed practical nurse, health-care aide, or other health-care team member.

*The new model allows care staff to work to the full scope of their education, training and skills.

*RNs will have the opportunity to work to their higher level of training, allowing more routine tasks to be done by staff with different levels of training. Nurses have experience and skills to do care planning and patient/family communication.

*For patients, CDMR means more support with daily activities, including bathing provided by health-care aides.

* There are no job losses associated with the new patient care model.

*There is a shortage of trained health-care professionals on the island and across the country. Every trained, skilled and dedicated nursing professional is needed to provide quality care.

*CDMR is already in place in many island care settings, where it has produced better outcomes for patients, and an improved work environment for staff.

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