Arbitrator outlines LTC safety rules 'to further peaceful labour relations'

An Ontario arbitrator has outlined the measures long-term care (LTC) homes across Ontario must take to protect the health and safety of the nurses on their staffs during the COVID-19 pandemic.

On March 11, the World Health Organization declared a pandemic as COVID-19 spread across the globe. The disease’s symptoms are often more serious in older people, resulting in a crisis in Ontario’s LTC homes. Many LTC home residents have died and staff have experienced high rates of infection due outbreaks in the homes.

The Ontario Nurses Association (ONA) filed a grievance on behalf of registered nurses working in LTC homes across the province, claiming the homes didn’t do enough at the start of the pandemic to give nurses personal protective equipment (PPE), provide proper communication, test nurses and residents, clean the homes, maintain staffing levels during the crisis, and enforce self-isolation rules for individuals with symptoms. All of these issues added up to a failure to properly protect the health and safety of nurses under the Ontario Occupational Health and Safety Act (OHSA) and the collective agreement, said the ONA.

The collective agreement requires LTC homes to “inform employees of any situation relating to their work which may endanger their health and safety, as soon as it learns of the said situation,” provide proper safety training, and ensure the proper measures under the OHSA are carried out in the workplace.

The arbitrator noted that management has the right to run operations as they see fit, as long as they comply with collective agreement and statutory obligations and protect the health and safety of employees and residents.

The arbitrator also noted that during the hearing process, the LTC homes agreed to use “their best efforts to obtain PPE,” maintain physical distancing protocols in the homes, and ensure proper safety training is provided as soon as possible.

The homes also agreed to advise staff of residents who test positive for COVID-19, advise the joint health and safety committees of the availability of PPE, and communicate any hazards it discovers to employees. Sanitization processes such as enhanced cleaning and disinfection of common areas and provision of hand hygiene agents would also be consistently followed.

The arbitrator found it was necessary to make orders to provide direction and to help resolve disputes. The orders “are not made based on any finding of fault,” said the arbitrator, but rather “in order to further peaceful labour relations and to provide for the health and safety of employees, pursuant to the collective agreements, OHSA, and [provincial] directives.”

The arbitrator ordered:

• the LTC homes to provide nurses with access to “fitted N95 respirators, equivalent or greater protection and other appropriate PPE (appropriate gowns, gloves and face shields) when assessed by a nurse at point of care to be appropriate and required.”

• nurses to perform a “point of care risk assessment” before all of their interactions with residents in a home, to determine what PPE was necessary.

• both the LTC homes and nurses to “engage in the conservation and stewardship of PPE.”

• all LTC home staff to wear N95 masks whenever medical procedures that could generate aerosols are performed.

• the LTC homes to provide “a sufficient supply of all appropriate sizes of fit-tested N95s” for nurses along with pursuing “all proper avenues to procure sufficient supply of all PPE.”

• that there be no intimidation, threatening, or coercion of nurses who exercise their right to access PPE.

• the LTC homes to “implement administrative controls such as isolating and cohorting of residents and staff.”

• the LTC homes to “make all reasonable efforts to cohort staff between suspected or confirmed COVID-19 residents and residents who have not been infected.”