Personal Support Worker (PSW) agencies face a crisis – especially during the summer, Christmas, and New Year’s – and this bodes ill for our aging population.
Covid-19 made it worse. But, even before the pandemic, there were issues with the agencies and PSWs. Still, in all fairness, our healthcare system here in Ontario has declined dramatically. Many individuals are suffering due to this bizarre situation, thanks to elected officials in government, and within the agencies themselves.
A report from the Ontario Health Coalition has several recommendations on how the province should deal with the serious PSW shortage. The coalition and Unifor teamed up to hold roundtable meetings across the province to document the issue and get people’s thoughts on how to fix the problem.
They’re taking the report on a cross-province tour and had stopped in Oshawa to talk about how the crisis is impacting the community, and detail the report’s recommendations.
One of the report’s recommendations is to lower the tuition for people who study to be a PSW.
The report says many long-term care homes reported staff shortages nearly every day, noting weekends are worse. The shortage is hitting rural areas even harder.
Five familiar PSW problems – which one do you face?
Personal support workers have the unique opportunity of working in a career that makes it both challenging and rewarding. With the country’s aging population making the healthcare industry increasingly complex, the need for front-line support workers is expected to increase significantly.
Various studies have indicated the demand for personal support workers is markedly higher than the supply available. Despite the high demand, studies show that many are unwilling to enter the field. While all jobs have advantages and disadvantages, it is important to be aware of the problems that are relevant in the industry if it’s a career you are considering.
This article examines five problems that personal support workers face.
Staff Shortages
Currently, there aren’t enough personal support workers or care providers in Ontario resulting in a chronic staffing shortage, specifically in long-term care facilities.
One PSW problem is meeting the demands required of them. What stakeholders commonly refer to as an assembly line culture has developed over the past decade.
According to the Ontario Council of Hospital Unions, a whopping 91 per cent of personal support workers polled reported that they felt they had too many patients that need personal care. A survey published by CBC News revealed that some respondents claimed to be responsible for as many as 40 residents in one shift.
Pervasive staff shortages can have a significant impact on the retention of employees since PSWs are more likely to quit their jobs or leave the industry altogether if they have an unrealistically high workload.
Further, prospective support workers may choose not to pursue a PSW career if they are aware of the working conditions.
Patients who rely heavily on support workers in their homes are at risk of not receiving the quality care they require.
PSWs have reported that residents/patients have expressed anger and frustration due to the lack of time support workers are allotted to assist them with daily living tasks.
The primary goal should be to raise staff levels to increase the amount of PSWs who enter or remain in the field. If there aren’t enough PSWs in a particular long-term care, home and
community care or hospital, there aren’t enough of them in the workforce.
We should implement aggressive recruitment strategies and create more PSW incentives for people to enter the field.
As of today, no government plans or initiatives geared toward attracting and retaining PSWs in Ontario have been released to the public.
Low Wages
According to a 2007 Ryerson University survey of personal support workers, 65 per cent of those polled were dissatisfied with the salary they were receiving. Further, until a new province-wide plan to increase the PSW salary was implemented three years ago, PSWs earned as little as $12 hourly with many companies opting not to cover travel expenses for those working in private homes.
However, as of April 2016, a minimum hourly wage of $16.50 to a maximum of $19 per hour was imposed by the government. Unfortunately, while the increase was beneficial, support workers are still being underpaid for the work that they perform.
As low pay was cited as one of the main PSW problems, wages presumably have a negative impact on their standard of living. Many have to choose between working in a career that they derive fulfillment from, and being able to adequately support their families. As a result, fewer people will be inclined to enter or remain in the field on a long-term basis.
With PSWs being dissatisfied with their wages and a resultant decrease in some prospective support workers choosing to enter the field, patients are less likely to obtain the services they need.
The government opted to implement policies that would raise the minimum salary of support workers. But wages need to be increased based on experience level. Unlike other fields, PSWs do not receive pay based on their level of experience, so many support workers leave the industry after an average of 20 years.
But there are currently no plans to increase the minimum wages of PSWs in Ontario.
Lack of Transparency
Lack of transparency has also been cited as a major PSW problem in the province. Currently, the government can provide only an estimate of the number of PSWs employed in Ontario since no one knows exactly who is working and where they are working.
The problem has been acknowledged by the province for several years. In 2012, a PSW registry was launched – boasting an annual budget of $2.5 million as of 2014-2015 and a 30,000 PSWs list. The initiative was hailed as an effective long-term solution.
However, systemic challenges regarding inaccurate vetting procedures resulted in the registry being shut down only three years later. Consequently, PSWs in Ontario are still working in a field that lacks transparency.
A personal support worker can feel as though they are undervalued due to working in the shadows. As a result, both the recruitment and retention of a personal support worker is at risk of being compromised.
Patient safety is paramount, and those that require the assistance of PSWs can be putting themselves at risk due to not being able to verify the background of the support workers they hire.
Possible solutions include making improvements to the previous version of the registry, and relaunching the registry once it is user-friendly, useful, and accurate.
Currently, the federal Liberal government has not revealed plans to relaunch the registry to the public.
Inadequate, Unpredictable Work Hours
According to a recent survey, over 37 per cent of PSWs polled are dissatisfied with the hours they are scheduled to work. Although shifts including evenings, weekends, and holidays are typical for most healthcare positions, support workers have cited fluctuating hours as being one of the most significant disadvantages of being employed in the field.
Also, the wage increase policy that was recently implemented resulted in PSWs being scheduled for shorter shifts – some as short as 15 minutes.
Randy Hillier, MPP for Lanark-Frontenac-Lennox & Addington, recently stated: “What can you possibly do in 15 minutes? It’s a paperwork exercise. It’s not delivering home care.”
As a result, PSWs have seen their salaries reduced by as much as $10,000 annually. Additionally, PSW work hours are becoming increasingly erratic.
In an article published by The Sun in August 2016, a PSW revealed that many workers were effectively working without being paid: “I work for free all the time. We do it because we love the clients. We need at least to pay our bills. We have to support our families.”
Problem is personal support workers cannot earn a living wage and are unable to enjoy financial and job security and stability when working in their chosen career.
Patients can be negatively impacted if fewer people are willing to work as PSWs, thereby reducing the amount of support they can receive in private home care.
Possible solutions can include stable workplace shifts/hours for PSWs through government intervention.
While the issue cannot be resolved in the context of private home care, regulations geared toward ensuring that more full-time positions are offered could be a viable solution.
The Ontario Personal Support Worker Association has received approximately 100 complaints over the past year, and The Ontario Ministry of Long-Term Care has been advised of the issue. The PSW problem has also been raised by at least one Member of Parliament, and many stakeholders have called for action.
However, there is no evidence that plans are being made to make workplace hours for PSWs more stable.
Workplace Demands
Recent polls reveal that 44 per cent of the PSWs surveyed in Ontario are not satisfied with workplace conditions in private homes, long-term care facilities, and hospitals. Over half of the support workers polled reported they had been the victim of some form of abuse with 24 per cent of the cases being classified as physical violence.
With many residents/patients suffering from cognitive impairments, PSWs are often subjected to verbal or physical abuse when performing their duties. Despite the prevalence of workplace violence, survey respondents indicated that management personnel are often unwilling to address incidents that occur, only doing so for approximately one-third of the cases reported.
Sexism has also contributed to poor workplace conditions for PSWs. Because the field has a high percentage of women, feminists have argued that the work they perform is not fully recognized due to the fact that caretaking is supposedly inherent to the female gender.
Additionally, racism has become a concern as visible minority groups comprise a large percentage of the PSW workforce in the province. Many have revealed that they are often treated unfairly by management due to racial biases.
Poor working conditions can impede one’s ability to perform tasks effectively and potentially result in psychological challenges or physical injury when not addressed. As PSWs are responsible for ensuring the safety of those they care for, it is crucial that workplace conditions are conducive to meeting that objective.
Patients who require the assistance of support workers are often vulnerable and need PSWs to be in the best mental, emotional, and physical state possible to perform their duties.
Improving workplace conditions for PSWs would require the effort of both the government and the private sector.
Developing an effective system for reporting workplace violence, providing sensitivity training for personnel in management positions, would help.
Currently, no plan to address the problem has been made available to the public.
While working as a PSW offers satisfaction and fulfillment, you have to be prepared to face numerous challenges including workplace violence, unpredictable hours, and a relatively low pay rate.
While efforts have been made recently to address some of the issues raised, such as the minimum annual salary for PSWs, other issues are likely to remain unchanged in the foreseeable future.
One might wonder if one might want a disabled relative and/or elderly relative to have to put up with the existing system that we have in place today, or are the people willing to step out and let your elected officials know things have to change because by the time you get to your golden years, will you have the care that you expect?