RNs Are Trained for the Unpredictable, and They Are Leaving

In the quiet corridors of Parkwood Institute, where the work of mental health care unfolds in conversations and careful observations, a change has arrived that speaks not of clinical need but of budgets. St. Joseph’s Health Care London has announced it is removing 85 registered nurse positions from its mental health programs, a decision the hospital frames as a realignment of care delivery and which nurses describe as a profound loss for patients.

The layoffs will eliminate 83 full-time and 31 part-time RN roles, with the hospital planning to add approximately the same number of registered practical nurse, personal support worker, occupational therapy assistant, and social service worker positions in their place . The cuts include registered nurses who work on the COAST team, a program that partners nurses with police officers during street patrols to help people in mental health or addiction crisis. St. Joseph’s will pull out of the COAST program effective January 15 .

The hospital says the changes follow a model of care review and that “this change is not about reducing care.” In a statement, St. Joseph’s said it is “realigning how care is delivered and ensuring patients receive care that matches their mental health, recovery and whole person needs, while making the best use of our resources” . The cuts are part of an austerity plan as the hospital faces a $4.7 million budget deficit, its first-ever, and works toward a balanced budget within three years .

An RN at Parkwood, speaking anonymously to CBC News, said the decision will “immediately and detrimentally affect patient care.” “RNs are trained to deal with patients who have unpredictable outcomes, RPNs are not,” the nurse said, adding that the cuts will eliminate about two-thirds of the RN positions at Parkwood . The loss of the COAST program, the nurse said, comes “in the middle of a homelessness crisis” .

Ontario Nurses’ Association president Erin Ariss condemned the cuts, saying RNs provide the highest level of care. “When you assign the work to other workers, you will not receive the same level of care as an RN,” she said. Ariss placed much of the blame on the provincial government, noting that Ontario is the only province where RN positions are being eliminated .

Health Minister Sylvia Jones has directed hospitals in deficit—the majority in Ontario—to set three-year plans to eliminate their red ink. A spokesperson said the province boosted hospital funding by four percent this year and that the changes at St. Joseph’s “will not impact patient access to care or services” . For the nurses at Parkwood and the patients they serve, the debate over what those changes mean in practice is only beginning.

AI Image Disclaimer: Visual content accompanying this article is generated by artificial intelligence for illustrative purposes only.

Sources: CBC News, The Canadian Press, Toronto Star, Ontario Nurses’ Association