The Ontario Ministry of Labour wants to extend “presumptive” post-traumatic stress disorder (PTSD) legislation to include up to 140,000 frontline nurses. If the proposal becomes law, it will cover the nurses for “stress and impairment to functioning,” including painful flashbacks, nightmares, outbursts and thoughts of suicide and guilt or sadness following a traumatic event.
“With the new proposed presumption, once a frontline nurse is diagnosed with PTSD by either a psychiatrist or a psychologist, the claims process for WSIB (Workplace Safety and Insurance Board) benefits will be expedited, and nurses will not be required to prove a causal link between PTSD and a workplace event,” said the ministry in a statement.
In April 2016, Ontario passed the Supporting Ontario’s First Responders Act, creating the “presumption” that PTSD diagnosed in first responders was work-related — so covered workers do not have to prove the link between their work and PTSD.
The act covered about 73,000 first responders in the province, including police officers, firefighters, paramedics, corrections workers and dispatchers. But nurses were not included, sparking an outcry from the group. The province aims to amend the legislation this spring, said Michael Speers, a spokesman for Labour Minister Kevin Flynn, on Friday. The amendment would cover “all frontline nurses providing direct patient care,” he said.
In separate announcements, the province also indicated it would add other occupational groups to the legislation, including probation and parole officers, bailiffs, special constables and civilian members of police services in the Violent Crime Linkage Analysis System and forensic units.
According to the Ontario Nurses’ Association, the top five triggers for PTSD in nurses are the death of a child, particularly due to abuse; violence at work; treating patients who resemble family or friends; death or injury of patients; and heavy patient workloads.
Andy Summers, regional vice-president of the association, said there is still a need for some clarification, including the definition of “frontline” nurses, and whether nurses are covered after they leave a frontline role. “Trauma takes time to become evident,” he said.
Julie Prince, a registered nurse who had worked in labour and delivery and neonatal intensive units, was diagnosed with depression and elements of PTSD in February 2015, a few months after leaving her hospital post. She is now a case manager with the Waterloo Wellington LHIN, working with adults and seniors.
Prince said she is “elated” to hear about the province’s plans to extend coverage, but wonders if it will include nurses who recognize that they have been traumatized after leaving frontline roles. Prince still has hospital-related dreams and feels anxious when she passes or enters a hospital. “It’s still there. It still lingers,” she said. Doris Grinspun, president of the Registered Nurses’ Association of Ontario, said a diagnosis of PTSD, not the nurse’s role or the site of work, is what matters.
“We also believe that administrators need to be included. During SARs, for example, they experienced great stress. We can’t leave them out. Administrators lead organizations. They are constantly in contact with patients. We want to see all nurses included.” There are also concerns about other hospital workers exposed to trauma.
Michael Hurley, president of the Ontario Council of Hospital Unions, said there are other vulnerable workers in health-care settings who also need to be covered. For example, an admitting clerk at Perth and Smiths Falls District Hospital was stabbed in the neck and arms last summer by a man who had grabbed a pair of scissors.
“It’s great to see the government extending presumption to nurses. But they’re not the only health care workers who have experiences that can lead to being traumatized in the course of their work,” he said.