'Licences are on the line' as nurses work to help Ontario hospitals fight COVID-19: union rep

Nurses are worried they may end up losing their licences for doing work outside their scope of practice as Ontario hospitals try to manage an influx of patients during the COVID-19 pandemic.

Staff say working beyond ability could cost them jobs or affect patients, refusing leads to bullying

Nurses in Niagara say new provincial orders are putting them on professionally shaky ground by having them work in settings they're not used to. SEIU Healthcare says nurses across Ontario are dealing with the same issue. (Hamilton Health Sciences)

Some Ontario nurses say they're worried they may end up losing their licences for taking on extra work as hospitals try to manage an influx of patients during the COVID-19 pandemic.

The province recently issued an order to allow health-care professionals, like nurses working in hospitals, to provide care outside their typical scope of practice provided it's to help fight the pandemic.

However, the College of Nurses of Ontario (CNO) also says nurses are required to work within their knowledge, skill and judgment — which puts the onus on individual nurses to decide if they can or can't do a procedure, says Rafal Fratczak, a registered practical nurse (RPN) and chief steward for RPNs who belong to the SEIU Healthcare chapter at Greater Niagara General.

Nurses who might not be ready to take on what is being asked of them may say yes to avoid disappointing their colleagues, said Fratczak.

If a nurse does take that risk, someone could complain to the CNO. Fratczak said that means "licences are on the line."

"It creates a lot of fear, confusion and a huge amount of stress," he said in an interview.

WATCH: Nurses facing pressure as hospitals fight COVID-19, could affect patients

Ontario nurses feeling stress and pressure from provincial orders in hospitals

2 years ago
Duration 2:23
Nurses say Ontario orders to work beyond their scope of practice are causing stress and confusion.

Jackie Walker, SEIU Healthcare's nursing division president and an RPN, said it could impact the care people receive.

"It could put patients at risk if nurses don't say no, if nurses don't assess their knowledge, skill and judgment and [don't refuse] the work being assigned with them," she said.

But Walker said declining work isn't that simple.

"There are unofficial consequences to saying no, " she said.

"RPNs have shared with me that they have been ostracized and bullied on the unit for not having a specific knowledge, skill and judgment that maybe their counterparts want them to have."

Fratczak said the pressure has caused some nurses to go on sick leave and retire early.

It's a sign of a severely strained health-care system during a third wave of COVID-19 cases, many of which are variants of concern.

Questions about nursing licences are also popping up in Hamilton.

Dr. Cheryl Williams, the chief nursing executive at St. Joseph's Healthcare Hamilton, answered a question about nursing licences during a town hall meeting on April 26. She said the care is always being done in the context of the pandemic.

"As we're asking you to do things differently, like working in a team-based model of care and any other changes we're making, we're making sure we have all that documented and it's really clear so the expectations and the support is there for you," she said.

"We are expecting our colleges would recognize, acknowledge, support and put any complaints that someone may make toward anybody's licence during the midst of the pandemic in the context and environment in which care is being provided, including the expectations that have been asked of you from the province and the organization that is directing your work."

CNO says no complaints submitted so far

The CNO issued a letter due to the "high degree of uncertainty and stress" nurses have been feeling.

"During these challenging times, we are working hard to get you the support you need," Anne Coghlan, executive director and chief executive officer, said in a letter.

Anne Coghlan, executive director and CEO of the College of Nurses of Ontario, says in a letter that the CNO is working to get nurses the help they need.

In an email response on Tuesday afternoon, CNO said hospitals are supposed to provide staff with the training to meet their needs.

It also said CNO is guiding nurses to work with their employers to maintain "safe nursing practice" wherever they're working.

So far, the college hasn't received any complaints about nurses working outside the scope of their practice.


Bobby Hristova is a journalist with CBC Hamilton. He reports on all issues, but has a knack for stories that hold people accountable, stories that focus on social issues and investigative journalism. He previously worked for the National Post and CityNews in Toronto. You can contact him at bobby.hristova@cbc.ca.