The Ottawa Citizen reported the shortage of nursing staff is affecting the quality of care in Canada’s nursing homes. “A study by SafeCare BC found 60 per cent of long-term residential care homes that participated in the survey have a worker shortage, and it is particularly acute on Vancouver Island, with 78 per cent of care homes reporting a shortage.”
“We know it’s having a negative impact on workers, so there’s no doubt the shortage of workers is having a negative impact on the quality of care (for seniors in nursing homes),” said SafeCare BC spokesperson David Hurford.
The positions employers are finding the most difficult to fill are care aides and health care assistants, with 66 per cent of nursing homes reporting a need, followed by licensed practical nurses and registered nurses, both at 47 per cent, and food service workers and dietitians at 16 per cent.
The U.S. Court of Appeals for the Fourth Circuit ruled in Palmetto v NLRB that registered nurses (RNs) and licensed practical nurses (LPNs) at a nursing home in South Carolina were not supervisors and could therefore lawfully unionize. The Fourth Circuit focused entirely on whether the nurses used independent judgment.
The NLRB found that “a judgment is not independent if it is dictated or controlled by detailed instructions, whether set forth in company policies or rules, the verbal instructions of a higher authority, or in the provisions of a collective bargaining agreement.” The Fourth Circuit held that the RNs and LPNs lacked such independent judgment. The court held that, at most, the evidence established that the nurses “exercise not independent, but heavily constrained, judgment.”
The RNs and LPNs assessed patients, administered medications, and performed general patient care duties. The CNAs assisted residents with activities of daily living, such as helping them bathe, repositioning them in bed, and aiding them in using the restroom. The nursing home’s handbook described the nurses as the CNAs’ “first line of authority,” and placed the RNs and LPNs above the CNAs on its organizational chart.
The court ultimately concluded, “In every case, the nurses’ responsibility seems to amount to the same thing: making sure the CNAs follow the written instructions. This suggests that the Nurses serve merely as conduits for these instructions.”