Certainly, thank you.
Thank you, Madam Chair, and good afternoon. My name is Sheri Oliver and I'm the director of Strategic Nursing Initiatives with the Registered Practical Nurses Association and we're known as RPNAO.
As I suspect many of you already know, the RPNAO is the voluntary professional association for registered practical nurses within the province of Ontario who are registered to practise in Ontario under the Nursing Act of 1991 and the Regulated Health Professions Act of the same year. The RPNAO is also a member organization of PN Canada, the national professional organization for practical nurses. We appreciate the opportunity to be here today.
I would like to brief you about one of Ontario's practical nurses and, in doing so, perhaps correct some of the misunderstandings that we characteristically encounter.
As I've indicated, registered practical nurses are regulated health care professionals and are known as RPNs in Ontario. In other jurisdictions you will know practical nurses as LPNs or licensed practical nurses. We constitute the second largest regulated health care profession. In Ontario both RNs and RPNs share the same statutory scope of practice and study from the same body of knowledge.
While you will find both RNs and RPNs in all health care sectors, they differ primarily in the populations with which they practise. Those differences relate to the depth and breadth of education received, and I'll speak more to the availability of education in just a moment.
Since January 1, 2005, new graduates applying to register to practise as an RPN with the College of Nurses of Ontario must have a two-year diploma in nursing from a community college of applied arts and technology. Across Canada there are over 64,000 practical nurses, of which half, 29,000, are from Ontario.
Now, with that as background, I would like to recount some of the issues facing the profession that are relevant to the Standing Committee on the Status of Women. Ninety-four percent of RPNs are female. As such, we experience many of the challenges that face other female professionals in the workforce, and some are unique.
The majority of RPNs work shift work, weekends, and holidays. Having access to quality, affordable, and flexible child care is an issue consistently raised by our membership. For RPNs, having access to child care isn't a frill or a luxury; it is essential to allow them to practise and to contribute the human resources that our health care system desperately needs.
Financial security is also a major issue for many RPNs. Salaries for the RPN vary widely in Ontario. The best salaries for RPNs are available in hospitals, where a full-time RPN can earn between $42,000 and $47,000 annually, not much in today's economy, especially given the onerous responsibilities that nurses encounter on a daily basis.
Every day nurses face physically and emotionally taxing situations that are inherent to their chosen profession. For example, registered practical nurses working in the long-term care or community sectors have extremely large workloads, practise at high levels of autonomy, yet receive some of the lowest overall wages in provincial health care. But the RPNs who do have full-time employment, especially those who have full-time employment in hospitals, are relatively fortunate in our profession.
This statistic will surprise you, given all you've heard about a nursing shortage, but only 55% of RPNs in Ontario are able to find full-time work. There are about 2,000 in Ontario today, about 7% of the total profession, who are looking for full or part-time employment. Some are currently employed as unregulated health care providers or have jobs outside of health care. This is a chronic problem for our profession. l suspect you'll agree that it makes absolutely no sense during a so-called nursing shortage that much needed health care professionals are unable to find employment within the health care system.
I am sure you can also appreciate the systemic stressors that the lack of secure employment has on their own personal health, the well-being of their children, and attempts to balance personal and professional lifestyles as we encroach deeper into a sandwich generation. Our members describe the ability to find secure full-time work in their profession while controlling their overtime hours as their most important work life aspiration.
The Government of Ontario has put financial incentives in place to increase full-time employment opportunities for nurses, but the uptake of those initiatives by health care organizations has been greater for the registered nurse, and as a result, their full-time employment has improved at a much greater rate than that of the RPN. In fact, RPNs have seen little improvement in the availability of full-time employment.
Women, as a group, are less able or willing to accept a job or job advancement that will adversely affect their ability to care for their families. Accordingly, female professions must tolerate lower job security, limited career advancement opportunities, and less financial security.
You may ask yourselves how we find ourselves in this very peculiar situation of having a significant number of unemployed or under-employed RPNs in a time of a shortage of nurses. There are several factors at play.
One is a misunderstanding by hospitals and other health care delivery organizations about the competencies of RPNs. In Ontario, some hospitals have decided to implement an all-RN model, believing that this will result in higher-quality care. RPNs who were working in those hospitals were laid off or dismissed outright.
This all-RN model usually reflects studies done in the United States. l must point out, however, that licensed practical nurses in the United States are not educated to the same level as registered practical nurses in Ontario and do not have the same skill sets. Accordingly, those American studies do not reflect the knowledge, skill, and judgment that RPNs acquire.
We know that access to and availability of education has a positive impact on health care outcomes. However, for the practical nurse, educational opportunities related to collective agreements, child care opportunities, lack of employment recognition, and barriers in the educational system limit the impact these nurses can have and, in turn, are less able to manage educational opportunities available.
The second factor is that, for a number of historical reasons, RPNs are represented by multiple unions and are usually a very small component of those union memberships. It's completely understandable, therefore, that those unions rarely give RPNs' issues much priority. Registered nurses, on the other hand, have their own union that has focused exclusively on their issues.
The third factor is that RPNs are rarely found in management positions in health care organizations, most particularly hospitals. The heads of nursing are almost always registered nurses, and quite frankly and unfortunately, there's inevitably some intra-professional turf protection.
One final point I want to make, about which women in general encounter in the workplace, is one that is rarely discussed openly, and that is verbal abuse. Particularly in the high-pressure, high-stress environment of health care, verbal abuse directed at nurses and other female workers still frequently occurs. The ability to withstand verbal abuse is seen to be part of your job description as a nurse. Few nurses complain about or report verbal abuse, because doing so may be career limiting and because few health care organizations have effective reporting procedures or whistle-blowing protections in place. The same challenges exist in reporting verbal abuse to the professional regulatory bodies. So verbal abuse continues to be an unfortunate part of the job for nurses.
Madam Chair, I've almost exhausted my 10-minute allocation, so I shall stop now in order to leave as much time as possible for questions.
Thank you for your time.