The Current

'Seen as part of the job': Ontario nurses, PSWs report 'pervasive' abuse in long-term care facilities

A new study looks at the violence suffered by staff in Ontario's long-term care facilities, at both the hands of residents and their families. We speak to the author of the study, as well as one nurse who ended up going to the police over the abuse she says she faced.

New study looks at the violence suffered by staff in Ontario's long-term care facilities

A new poll suggests that 62 per cent of personal support workers surveyed experienced physical violence on the job at least once a week. (Lighthunter/Shutterstock)

Unhappy with the care being provided to a relative, a registered practical nurse recalls a family "bullying [and] intimidating all of the staff on our floor" at an Ontario long-term care facility.

When Sue Moore, the president of her local CUPE branch, tried to speak up on behalf of her colleagues, she says she became a target.

"It began with them calling me vile, disgusting names to everybody on my floor, then turned into yelling at me while I was at my med cart," she told The Current's Anna Maria Tremonti. "They would swear at me, and then it would become verbal threats."

Experiences like Moore's are "so pervasive ... that it's become normalized," said James Brophy, a researcher at the University of Stirling in Scotland, and co-author of the study Breaking Point: Violence Against Long-Term Care Staff.

"It's become literally seen as part of the job," he told Tremonti.

Brophy's study, published in the Journal of Environmental and Occupational Health Policy, consulted with 56 long-term care staff in seven Ontario communities between 2016 to 2018.

Sue Moore is a long-term care nurse who called the police over abuse she suffered from a patient's family members. (Submitted by Sue Moore)

Sixty-seven per cent of Ontario long-term care staff, surveyed in a telephone poll conducted concurrently, reported experiencing non-physical violence at least once per week. 

Brophy said the poll, commissioned by CUPE Ontario and the Ontario Council of Hospital Unions, was done in tandem to confirm "whether our study essentially reflected what was occurring, and it did. In fact, probably even more graphically in some sense."

The poll, which surveyed 1,223 long-term care workers in January, suggested that 51 per cent of registered nurses and 62 per cent of personal support workers experience physical violence at work at least once per week. The results are considered accurate within 2.95 percentage points 19 times out of 20.

"Is it such a horrible thing to ask to be safe in your workplace," Moore said.

"My job is to care for the residents … but I can't do that when I'm being bullied and intimidated."

James Brophy, co-author of the report, says that we're failing both staff and residents. (Jonathan Pinto/CBC)

Moore said the verbal attacks went on for months, but when she raised it with her employer, they "did not take the steps to keep me safe."

Eventually, she called the police, who came to the facility to speak with the family. Moore said she never intended to press charges and understands that it can be an emotional time for families, but "wanted somebody to clearly communicate to them that they cannot continue with this behaviour."

The Current contacted the Ontario Long-Term Care Association, which represents 70 per cent of Ontario's long-term care homes, but it did not have anyone available for interview.

'A whole cascading effect'

Jane Meadus, a staff lawyer and institutional advocate at Advocacy Centre for the Elderly, said that many facilities are short-staffed, and that feeds into abusive behaviour.

"The staff don't have time to provide the proper care, so they're just going from patient to patient to patient very quickly, they're not able to deal with the person's needs," she told Tremonti, adding that this leads to families becoming upset, too.

"There is not enough funding, and it's a whole cascading effect."

Meadus said that solving the problem will take a "huge amount of investment" in staffing, which would pay off for the residents' well-being.

"We talk a lot about beds, and so people are always building beds but they're not putting the increased staff that's required," she said.

Christine Elliott, Ontario's minister of health and long-term care, was not available for an interview, but said in a statement that "all staff providing direct care to residents must receive annual training in behaviour management, mental health … and abuse recognition and prevention."

It's a perfect environment, a cauldron for something even more serious.- James Brophy

Brophy said that neither current nor previous governments are seriously addressing the issue, and that worries him.

"The day-to-day experience is bad enough, but you know, it's a perfect environment, a cauldron for something even more serious," he said.

"If we don't address this, we're not only failing those workers ... but we're failing the residents who live there, our mothers, our fathers, our aunts, our uncles."

Click 'listen' near the top of this page to hear the full conversation.

Written by Padraig Moran. Produced by Samira Mohyeddin, Danielle Carr and John Chipman.