Ontario authorizes workers from other provinces, outside hospitals amid ICU strain

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TORONTO — Health-care workers from other provinces and non-hospital settings could be deployed to Ontario's overburdened intensive care units as early as next week, the health minister said Thursday as the government issued emergency orders to pave the way for those transfers.

Christine Elliott said the moves are meant to get the most out of available resources as the province fights a devastating third wave of COVID-19 infections that have been pushing Ontario hospitals to their limits.

"It's one thing to create a bed space, but if you don't have the staff there, it's not really helpful, so this will allow us to continue to expand our capacity to be able to care for both COVID and non-COVID patients who require placement in intensive care," Elliott said in an interview Thursday.

Hospitals have been transferring patients between regions and ramping down non-urgent procedures in recent weeks in an effort to deal with an onslaught of COVID-19.

There were 2,350 patients hospitalized with COVID-19 on Thursday, with 806 in intensive care, according to provincial data.

The government detailed its new emergency orders in a memo to hospitals, civil servants and unions on Thursday, saying they will help with the capacity crunch but should only be used when necessary.

"Our health care system continues to face unprecedented staffing and capacity pressures as positive cases, hospitalizations and admission to intensive care units due to COVID-19, escalates," Deputy Health Minister Helen Angus wrote in the document. "There is a critical need for public hospitals to maximize their capacity in order to provide care to their communities.”

One order allows workers to provide patient care outside their regular scope of practice, consistent with duties assigned by a hospital. The other allows out-of-province health care workers to practice in an Ontario hospital without registering with regulatory colleges in the province.

Elliott said workers won’t be asked to perform tasks they aren't qualified for.

Talks have begun to redeploy specialists including plastic surgeons and cataract surgeons to work in intensive care units, assisting with emergency, life-saving surgeries, Elliott said.

She said 45 health-care workers have already volunteered to work in intensive care and the province is working with another 55 individuals about potentially making the move.

The province is also preparing to bring in intensive care teams from Newfoundland and Labrador, Elliott said. Those would include intensive care physicians, nurses and respiratory therapists who could be in the province by the weekend or early next week, likely deployed to COVID-19 hot spots.

Ontario is also in talks with Prince Edward Island and Nova Scotia about potentially sending workers.

Elliott said Ontario has also reached out to other countries to gauge their ability to send workers to help.

Some discussions have begun with the United States, the Philippines and other countries, she said, but those conversations are still ongoing as governments contend with their own needs.

"I know that there are many that want to help but they need to look at their own situation," Elliott said. "The countries that we have gone to and the groups that we've gone to are determining right now what the level of help is that they might be able to provide."

There have also been considerations about sending Ontarians who need "significant surgeries" to areas of the U.S. where Ontario has established relationships, but Elliott said the province isn't at that point.

Elliott added that the new orders also allow for changes in staff to patient ratios if needed. For example, she said, the province might expand the ratio of patients individual nurses are asked to work with, assigning more than one patient to each nurse.

Health-care workers have raised concerns about burnout and their ever-growing workload during the third wave.

The CEO of the Registered Nurses' Association of Ontario said she's concerned that expanding the ratio of patients nurses are required to work will overburden those on the front line.

"The end result of it will be we will lose more people," Doris Grinspun said. "They already require very complex care and are in dire need. It will also result in an even higher (staff) exodus."

Grinspun also expressed skepticism about the province’s efforts to recruit workers from other jurisdictions, saying they simply won’t have enough to spare.

The president of the Ontario Hospital Association said the latest emergency orders are necessary as hospitals try their best to cope.

"The human health costs of the people of Ontario from COVID-19, and those who survive after hospitalization and the hundreds of thousands of people who had access to their surgery disrupted ... the consequences are going to last for a generation."

This report by The Canadian Press was first published April 22, 2021.

Holly McKenzie-Sutter and Shawn Jeffords, The Canadian Press