Collaborative contributions of ETHP nurses highlighted at RNAO’s annual Take Your MPP to Work Day during Nursing Week

ETHP members participated in a virtual Take Your MPP to Work Day organized by the Registered Nurses’ Association of Ontario (RNAO) on May 14.

Every year, the Registered Nurses’ Association of Ontario (RNAO) celebrates Take Your MPP to Work Day during Nursing Week (May 10 to 16). This year’s event included East Toronto Health Partners (ETHP) and showcased how the collective power and action of nurses has contributed significantly to ETHP’s community response to COVID-19 in East Toronto.

Ontario New Democratic Party (NDP) Leader of the Official Opposition Andrea Horwath and MPPs Peter Tabuns and Rima Berns-McGowan joined the virtual event alongside nurses and ETHP members to learn more about our collaborative initiatives throughout the pandemic as one of the first RNAO Best Practice Spotlight Organization Ontario Health Teams (BPSO OHT).

“Nurses have held Ontario’s health care system together. The gratitude I have for all of you is immense,” said Andrea Horwath, addressing the panel of nurses attending the event.

The event was moderated by Kathryn Nichol, president and CEO at VHA Home Health HealthCare (VHA) and Mikki Layton, interim chief nursing executive at Michael Garron Hospital (MGH).

“We are pleased to have the opportunity to highlight the very important work nurses are doing in our community to care for patients during COVID-19. I would like to thank all of the nurses across the ETHP partnership who are tending to patients in hospitals, providing vaccines in the community, helping people stay safely at home and so much more,” said Kathryn in her opening remarks.

The panel included nurses involved in four ETHP projects across the region, including:

MGH/VHA Partnership at Atrium at Kew Beach, represented by VHA’s Oliva Mabborang and MGH’s Michele Pow

In response to the changing needs of patients and families amidst the COVID-19 pandemic and to increase hospital capacity, MGH and VHA collaborated to create a new space for patients who were in MGH’s Alternate Level of Care (ALC) unit. This new unit opened at the Atrium at Kew Beach Retirement home in East Toronto and provides onsite nursing, personal care and rehab therapy services, prioritizing patients’ functional, cognition and emotional needs.

The unit launched in April 2020 with just over 20 patients and has since expanded to care for 46 patients who receive 24/7 care. Through the program, MGH and VHA have also successfully transitioned patients home with additional supports and into long-term care, retirement home communities and supportive housing, further addressing the needs of patients and families through integrated care in East Toronto.

“Our main goal is to reactivate patients and improve their functional mobility. When a client is only able to sit, we work with our team to enable them, with little steps, to be able to walk again,” said Oliva. “If patients are truly bedbound, we give them comfort, make sure they are kept clean and avoid pressure injuries. Working together with our team of nurses, personal support workers, and rehab service providers, we create great outcomes for our patients and families.”

COVID-19 Case Management Program Nurses, represented by South Riverdale Community Health Centre’s (SRCHC) Bernadette Lettner, Lucille Vuong and Danielle Kenyon

Nurses in ETHP’s COVID-19 Case Management Program work collaboratively with hospital and community partners to support individuals who need to self-isolate, but are challenged to do so given the impacts of the social determinants of health.

One of the biggest barriers for clients is related to the lack of paid sick days. In this program, RNs check in with clients every two to three days, or as needed, for the duration of isolation and sometimes beyond. Key supports include advice on isolation requirements and information about COVID-19, symptom management, community referrals and informal mental health counselling.

Ongoing case management is provided by allied health professions/partner agencies for issues related to the social determinants of health, such as immigration, mental health, child custody, grief and loss and housing. Registered nurses (RNs) are seeing high numbers of individuals who are not linked to primary care, and as we move to COVID recovery, additional support is required to further expand RNs to work to full scope and nurse practitioners (NPs) working in primary care.

“With the COVID-19 Case Management Program team, some of the early challenges were that when isolation or quarantine is required, we very quickly end up dismantling the social structures that support people in their communities,” said Bernadette. “In order to get resources such as medication, food, and financial assistance to individuals so they can safely and appropriately self- isolate, those resources need to be in place at the time of diagnoses.”

Opioid Response and Withdrawal Management NPs, represented by MGH’s Rosie Yoon and SRCHC’s Hemant Gohil

The opioid crisis is one of Ontario’s most deadly public health crises and these deaths are preventable. The losses have had devastating impacts on families and communities and have been largely met by silence. Within five days in early May, there were 13 fatal suspected opioid-related overdose calls. Additives in street drugs create a toxic drug supply. Together with pandemic isolation, these are the leading factors contributing to fatal overdoses.

NPs working in our safer supply program aim to increase access to prescription opioids to find alternatives to the unregulated drug supplies. RNs working in Consumption Treatment Services are part of an interdisciplinary team that provides wraparound support to clients and intervenes and administers naloxone or attempts resuscitation.

“Addiction services across the province were widely underfunded well before the pandemic, but the pandemic has highlighted more of the cracks,” said Rosie. “I want to acknowledge that this has been a very difficult time and there has been grief and loss in our communities. Our community partners have helped us through this by rising to the challenge and working in the community to help save lives.”

Leadership of NPs and nurses in system design and East Toronto Family Practice Network (EasT-FPN), represented by Health Access Thorncliffe Park’s (HATP) Rita Wong, East End Community Health Centre’s (East End CHC) Filip Kotynia and South East Toronto Family Health Team’s (SETFHT) Kerry-Anne Ross

NPs and nurses at partner organizations across ETHP, including HATP, East End CHC and SETFHT, are playing a critical role in developing programs and delivering care to support the people of East Toronto. Their roles involve working collaboratively within interdisciplinary teams to support vulnerable clients with wraparound supports, developing and supporting pandemic response initiatives and participating in EasT-FPN, a network of more than 300 family physicians in East Toronto.

“Thank you for bringing us into the realities that you are facing every day as you are helping Ontarians and people in East Toronto through the ravages of COVID, but also many other systemic challenges that we know need to solved,” noted Andrea Horwath near the close of the event.

“My RNAO colleagues and I feel so proud of all of the work the East Toronto Health Partners BPSO OHT is doing,” said Doris Grinspun, CEO at RNAO.

She added that nurses not only provide medical expertise to patients, but also have taken on the additional responsibility of providing companionship and emotional support while families have been unable to visit patients in hospitals and other care settings. “The ways they have worked together has been so admirable throughout this incredibly challenging time.”