Bill 163 Update and How It May Amend the Workplace Safety and Insurance Act, 1997 and the Ministry of Labour Act with Respect to Posttraumatic Stress Disorder claims made by Nurses.
Post-traumatic stress disorder (PTSD), once only thought to affect soldiers returning from war, is now recognized as a mental illness that can affect anyone. In North American, PTSD affects approximately 8% of the population. It can be caused by traumatic events that involve death, the threat of death, or witnessing either of these events. PTSD has also been related to ongoing emotional trauma. A person with PTSD may suffer symptoms such as; flashbacks, social isolation, aggression and irritation. It is this part of the illness that causes crippling emotional disabilities.
Bill 163 was influenced by a high number of First Responders committing suicide that was highlighted in the press. I was, like many nurses, friends of these victims and surprised that our colleagues were suffering so much that suicide was the only solution they felt was open to them. It was these actions that started conversations about self-reflection and debriefing sessions, although is a good start, it is not a final solution. People suffering from PTSD, as we have learned from our fallen colleagues, the signs and symptoms can be silent; therefore, more steps need to be taken towards prevention rather than reaction.
In steps to treat PTSD victims before it is too late, the government introduced Bill 163 which received first reading February 18, 2016, and received Royal Assent, April 6, 2016. Bill 163 recognized that traditional 911 responders i.e. Paramedics, Police Officers, and Firefighters were open to the risk of PTSD. Bill 163 aids victims of PTSD by allowing them to file WSIB claims which provides time and funding while the victim deals with their illness. Under section 14(2) of the Workplace Safety and Insurance Act, 1997 it lists the current people who may apply:
(2) This section applies with respect to the following workers:
1. Full-time firefighters.
2. Part-time firefighters.
3. Volunteer firefighters.
4. Fire investigators.
5. Police officers.
6. Members of an emergency response team.
7. Paramedics.
8. Emergency medical attendants.
9. Ambulance service managers.
10. Workers in a correctional institution.
11. Workers in a place of secure custody or place of secure temporary detention.
12. Workers involved in dispatch.
Quickly identified was the exclusion of Nurses from this list. As expected, there was an immediate reaction by Nurse led organizations. The RNAO stated the following:
"Ontario's RNs, NPs and nursing students are urging the provincial government to fix its mistake, and immediately add nurses to legislation that expedites access to treatment for post-traumatic stress disorder (PTSD).
Nurses witness trauma, suffering and death on a regular basis. We also suffer the highest rates of violence of any profession, and these tragic incidents continue to pile up".
However, Labour Minister Kevin Flynn, rejected a push to broadly cover nurses and other workers, such as child protection staff, probation and parole officers and provincial bailiffs, as requested by the Ontario Public Service Employees Union. Suggesting that if;
“Where a nurse is engaged in a first-responder situation, which we believe they are in corrections, we’ve extended the coverage.” (Toronto Star, April 5, 2016)
Violence and the risk of PTSD for nurses is nothing new. Statistics Canada noted the following in 2005:
“Health care providers are subject to a particularly high risk of workplace violence, and nurses are most at risk. Evidence from numerous studies indicates that on-the-job abuse can result in a variety of negative outcomes among nurses, including anger, fear, depression, anxiety, sleep disruption, increased sick leave, symptoms of post-traumatic stress disorder, and job dissatisfaction. In addition, the likelihood of intending to leave their jobs or even the nursing profession altogether is greater among nurses who have experienced abuse on the job”.
To protect our healthcare workers, both first responders and hospital workers, change has to come from the employer, as changing society is a moving target. By employers taking more of a positive step towards protecting their staff from violence and mitigating the effects of traumatic situations will reduce the effects of PTSD. Evidence shows this starts at the reporting stage. Studies conducted in the U.K. showed a reduction of incidents contributed towards employers having a structured reporting system, and more importantly a response to authority that supports employees. Simply having signs that state "Zero Tolerance" in our Emergency Rooms are not enough, it needs to come with teeth. Only then will we influence society to recognize that healthcare workers are a supporting hand, and not a frustration punching bag.
The government has now made steps to address the inclusion of nurses in the bill. As of December 6, 2017, the Ontario News Room posted the following:
“Ontario is proposing to increase first responder support to include all front-line nurses who provide direct patient care and suffer from post-traumatic stress disorder (PTSD) by expediting their access to benefits, resources and timely treatment through the implementation of a presumption that PTSD is work-related”.
This proposal has now been endorsed by Labour Minister Kevin Flynn, who has stated:
“Our government is committed to ensuring the health and safety of the millions of people who work in Ontario. PTSD is a serious and debilitating injury. With appropriate resources and timely treatment, we know it can be prevented or mitigated. It’s imperative we are ready to help those nurses who put their personal health and safety on the line while helping others.”
This needed amendment will open access to the 165,461 nurses, currently registered with the College of Nurses of Ontario. The first rule in healthcare is to ensure healthcare workers health and safety because if not, then no one is coming to help you.