Surge Capacity and Casualization

BMC Geriatrics

Background Over the successive waves of the COVID-19 pandemic, front-line care workers (FLCWs) —in this case, at long-term care facilities (LTCFs)— have been the backbone of the fight. The COVID-19 pandemic has disproportionately affected LTCFs in terms of the number of cases, deaths, and other morbidities, requiring managers to make rapid and profound shifts. The purpose of this study is to describe the effects of the pandemic on LTCF services offered and LTCFs staff dedicated to linguistic minorities in three Canadian provinces. Methods This qualitative descriptive study involved eleven managers and fourteen FLCWs, from six LTCFs of three Canadian provinces (New-Brunswick, Manitoba and Quebec). A qualitative content analysis was performed to identify key themes describing the effects of the COVID-19 pandemic on the services offered and the management of LTCFs staff. Results Based on participants’ experiences, we identified three main categories of themes. These macro-themes are as...

Australian Journal of Advanced Nursing, 2020

2004

Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 10, No. 2, February 2004 255 RESEARCH SARS TRANSMISSION Figure. Onset of symptoms for severe acute respiratory syndrome by number of shifts worked (dashed lines represent 95% confidence limits).

FACETS

Nurses represent the highest proportion of healthcare workers globally and have played a vital role during the COVID-19 pandemic. The pandemic has shed light on multiple vulnerabilities that have impacted the nursing workforce including critical levels of staffing shortages in Canada. A review sponsored by the Royal Society of Canada investigated the impact of the pandemic on the nursing workforce in Canada to inform planning and implementation of sustainable nursing workforce strategies. The review methods included a trend analysis of peer-reviewed articles, a jurisdictional scan of policies and strategies, analyses of published surveys and interviews of nurses in Canada, and a targeted case study from Nova Scotia and Saskatchewan. Findings from the review have identified longstanding and COVID-specific impacts, gaps, and opportunities to strengthen the nursing workforce. These findings were integrated with expert perspectives from national nursing leaders involved in guiding the r...

Philosophical Transactions of the Royal Society B: Biological Sciences, 2004

The outbreak of severe acute respiratory syndrome (SARS) in the first half of 2003 in Canada was unprecedented in several respects. Understanding the psychological impact of the outbreak on healthcare workers, especially those in hospitals, is important in planning for future outbreaks of emerging infectious diseases. This review draws upon qualitative and quantitative studies of the SARS outbreak in Toronto to outline the factors that contributed to healthcare workers' experiencing the outbreak as a psychological trauma. Overall, it is estimated that a high degree of distress was experienced by 29–35% of hospital workers. Three categories of contributory factors were identified. Relevant contextual factors were being a nurse, having contact with SARS patients and having children. Contributing attitudinal factors and processes were experiencing job stress, perceiving stigmatization, coping by avoiding crowds and colleagues, and feeling scrutinized. Pre–existing trait factors als...

Emerging Infectious Diseases, 2006

Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known. From 13 to 26 months after the SARS outbreak, 769 HCWs at 9 Toronto hospitals that treated SARS patients and 4 Hamilton hospitals that did not treat SARS patients completed a survey of several adverse outcomes. Toronto HCWs reported significantly higher levels of burnout (p = 0.019), psychological distress (p<0.001), and posttraumatic stress (p<0.001). Toronto workers were more likely to have reduced patient contact and work hours and to report behavioral consequences of stress. Variance in adverse outcomes was explained by a protective effect of the perceived adequacy of training and support and by a provocative effect of maladaptive coping style and other individual factors. The results reinforce the value of effective staff support and training in preparation for future outbreaks.

The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières, 2006

The purpose of this study was to enhance our understanding of the influence of the SARS crisis on the work and personal lives of community nurses.A total of 941 community nurses employed in a range of health-care settings in the province of Ontario, Canada, provided qualitative information about their perceptions of the impact of SARS in their workplace and in their personal lives. Themes and subthemes from the data were organized into 2 categories: The Experience (operational, organizational, and personal narratives), and Learning from the Experience (opportunities for personal learning, professional and policy development, and insight into policy and administrative implications). The findings are discussed within a framework of the learning opportunity presented by the crisis at the local, national, and international levels. The roles of effective communication, emergency response coordination, and education are considered with respect to policy development and administrative resp...

New Solutions: A Journal of Environmental and Occupational Health Policy, 2020

Healthcare workers (HCWs) in Ontario, Canada have faced unprecedented risks during the COVID-19 pandemic. They have been infected at an elevated rate compared to the general public. HCWs have argued for better protections with minimal success. A worldwide shortage of N95s and comparable respirators appears to have influenced guidelines for protection, which stand at odds with increasing scientific evidence. In-depth interviews were conducted with ten frontline HCWs about their concerns. They reported that the risk of contracting COVID-19 and infecting family members has created intense anxiety. This, in conjunction with understaffing and an increased workload, has resulted in exhaustion and burnout. HCWs feel abandoned by their governments, which failed to prepare for an inevitable epidemic, despite recommendations. The knowledge that they are at increased risk of infection due to lack of protection has resulted in anger, frustration, fear, and a sense of violation that may have lon...

Nursing Ethics, 2007

Key words: infectious disease outbreak; leaving the job; SARS Taiwan was affected by an outbreak of severe acute respiratory syndrome (SARS) in early 2003. A questionnaire survey was conducted to determine (1) the perceptions of risk of SARS infection in nurses; (2) the proportion of nurses considering leaving their job; and (3) work as well as non-work factors related to nurses' consideration of leaving their job because of the SARS outbreak. Nearly three quarters (71.9%) of the participants believed they were 'at great risk of exposure to SARS', 49.9% felt 'an increase in workload', and 32.4% thought that people avoided them because of their job; 7.6% of the nurses not only considered that they should not care for SARS patients but were looking for another job or considering resignation. The main predictors of nurses' consideration of leaving their job were shorter tenure, increased work stress, perceived risk of fatality from SARS, and affected social relationships. The findings are important in view of potential impending threats of pandemics such as avian influenza.

Canadian Medical Association Journal, 2007

I n spring 2003 the largest outbreak of severe acute respira- tory syndrome (SARS) outside Asia occurred in Toronto, Ont., including 257 probable cases and 43 deaths. 1 Transmission of SARS was largely confined to hospitals through contact with infected patients. To limit the spread of SARS, a provincial health emergency was declared, with widespread restrictions on the nonurgent use of hospital-based services at all 32 hospitals in the Greater Toronto Area. Ambulatory and inpatient medical and surgical activity was restricted to urgent cases, and respiratory isolation rooms were expanded. In addition, visitor access was severely restricted, and the use of personal protective equipment by staff in high-risk areas was mandated. Three community hospitals were closed for a few weeks to several months. A centralized system was created to screen all requests for inter-hospital patient transfers. 2 These restrictions lacked measures to mitigate the impact on potentially vulnerable patients, such as those with chronic diseases, elderly patients and low-income patients. Our objectives were to determine the extent to which these restrictions reduced the use of elective hospital-based services. We also sought to determine whether these restrictions disrupted urgent services or affected vulnerable patient groups and whether there were spillover effects into other sectors of the health care system or areas of the province that were not targeted by the restrictions. The results of our study may assist health care planners in designing large health care systems with better adaptability during epidemics, when restrictions may be needed to limit nosocomial spread or to increase hospital capacity. The study population comprised all Ontario residents with a valid health insurance number who resided in the Greater Toronto Area (hereafter referred to as Toronto), London or Ottawa from March 2000 to April 2004. All of the hospitals that were subject to SARS restrictions were located in Toronto. Ottawa and London were chosen as regions for comparison because they are large urban centres with multiple hospital sites and tertiary care hospitals that form organizationally complex, self-contained health care systems and because they are sufficiently distant from Toronto to make