Why are frontline staff displaced?
We continue to receive thoughtful and thought-provoking questions — thank you. Answers to five of your questions can be read below. For earlier answers, refer to our October 31 article and previously published submissions to VCH News-Vancouver.
If you have a question you’d still like to ask, email us.
Today’s answered questions
Q. Why cut frontline staff if the focus is on client-centered care?
A. We’re doing our best not to impact frontline staff. However, some frontline staff will be impacted as bumping provisions allow senior staff to displace less senior staff, some of whom may be employed in frontline services. Also, frontline staff will be impacted where we are changing our services in order to reinvest in different services based on our changing client needs. Wherever possible, though, we are doing our best not to decrease the numbers of staff providing direct patient care.
Q. You mention adjusting services to service the changing needs of clients. How have to come to understand what these needs are? Have you surveyed client demographics in the community? If so how will you account for a variance in need based on unique determinants of health (for instance: DTES vs SOUTH Vancouver.
A. GREAT questions. It’s a complex task to determine the needs of each of our communities based on the populations we serve. We’ve been lucky to partner with many folks who can help us to answer exactly the questions you posed. This includes information we receive from UBC researchers, and the outcomes of research projects such as Chez Soi, which was recently undertaken by the Mental Health Commission of Canada. The City of Vancouver is also a great source of data, as is BC Housing. But, most importantly, VCH staff – both frontline and management – are also well versed in community demographics and have been a great source of information upon which we have based our decisions.
Q. Leadership and management positions tend to be opened to clinicians with nursing backgrounds even when the position does not require direct nursing knowledge. Will there be more opportunities for non-nursing clinicians given the current budget climate? Given the budget constraints, is the direction to hire more LPNs as opposed to RNs in different areas of care?
A. Our current budget climate does not influence how we determine qualifications for leadership positions. To ensure we hire the right people for the right jobs, qualifications are tied to what the job requires, not the job’s salary. In Vancouver, many leadership positions at the manager and director levels do not require nursing backgrounds. Across Vancouver Acute and Community, we’re proud to count social workers, art therapists, speech language therapists, physiotherapists and occupational therapists among our leaders.
Regarding the hiring of LPNs, we have no plans to significantly shift our nursing mix within Vancouver at this time. Having said that, we adjust staffing models regularly – regardless of budget constraints – to ensure our staffing mix is an appropriate match for a care team/unit’s population. As acuity or client needs change on units or within programs we must ensure we have the right mix of staff for the right mix of patients to provide safe quality care. For more on collaborative practice, refer to our earlier answer to a similar question.
Also, watch for an announcement in January on new management competencies, and information sessions for employees about the new competencies, too.
Q. How do we reconcile the output of funding for programs and managers who are trying to balance budgets, but the income generated through the ministry does not come to that program?
A. Provincial funding to health authorities has increased, but funding increases can’t keep pace with the rate our costs are rising. Our expenses are increasing due to a number of factors, including a growing and aging population, rising demand and acuity, and rising labour costs (staff and physicians). In addition, we need to invest in our future by replacing outdated information systems.
B.C.’s health budget already consumes about 40% of our province’s entire budget — a finite budget that must fund education, protect our environment and provide other essential services, too. That’s why the provincial government has made a commitment to a balanced budget, and the Ministry of Health has in turn directed all health authorities to do the same.
For more on our funding and how our budget works, refer to our earlier answer to a similar question.
We hope we’ve answered your question, but if we’re not quite hitting the mark or you still have questions about funding, perhaps you could provide us a bit more detail in your question. With more information to go on, we’ll try again.