The New Brunswick Nurses Union (NBNU) presents, The Forgotten Generation:
An Urgent Call for Reform in New Brunswick’s Long-Term Care Sector. 

This two-year research report should serve as a wakeup call for all New Brunswickers. Our objective with its release is not to assign blame. There is no time for that. Our most vulnerable seniors are at risk. NBNU is ready to work alongside anyone who is committed to the welfare of our seniors and who wants to be a part of rebuilding the system that cares for them.

It is our hope that, after reading this report objectively, engaging with our microsite, and watching video testimonials from some of New Brunswick’s leading academics and seniors advocates – you too, will join us in that effort.

On behalf of the 500+ unionized RNs in New Brunswick nursing homes and the thousands of vulnerable seniors they care for, I thank you for giving this report your full attention.

Paula Doucet, RN, President, New Brunswick Nurses Union

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Since 2013, employees of New Brunswick nursing homes have had more than double the number of accepted violence claims (22.5%) as have employees of prisons (9%)

[Source: WorkSafeNB]

31 New Brunswick nursing homes failed to meet the required minimum safe staffing ratios in 2019

89% of RNs surveyed say residents are not receiving regular exercise, which can lead to bed sores, urinary track infections, muscle atrophy and sharp declines in a resident’s overall health

In recent years, some New Brunswick nursing homes have gone up to 43 days without a Registered Nurse on-duty, without being written-up by the Department of Social Development

88% of RNs surveyed say the staffing levels in their homes are inadequate

Since 2013, employees of New Brunswick nursing homes (6500) have had the same number of accepted WorkSafeNB claims for violence related injuries as employees of New Brunswick hospitals (20,000)

[Source: WorkSafeNB]

Between 2017 and 2019 more than 70 non-compliance notices were given to New Brunswick nursing homes for safe staffing violations

In 2017, New Brunswick nursing homes experienced a 27% turnover in their RN workforce

The Department of Social Development maintains no (0) database or systems to analyze much of the data it collects from New Brunswick nursing homes – harming its ability to identify threats

A strong majority of RNs (63%) report that the job of toileting residents is being left undone sometimes (32%), often (22%) or always (9%)

A majority of RNs (57%) report that the job of bathing residents is being left undone sometimes (31%), often (18%) or always (8%)

Download a copy of The Forgotten Generation report and infographic for more information.

“NBNU presents concerns anchored in concrete evidence and provides rationale for the recommendations which they have proposed.

They are not simply identifying problems, but are coming to the table prepared to offer solutions for moving forward successfully; an action that is consistent with the Registered Nurse’s responsibility to advocate for population health and safety, to lead initiatives that improve health care systems, and to work to establish quality professional practice environments.

When we are made aware, we are accountable to act and NBNU leaves us all accountable with the work they have presented herein.”

Alisha Keough, RN M.SC.

Faculty of Nursing, University of New Brunswick

“The Forgotten Generation provides a shocking picture of the satiation in New Brunswick’s nursing homes, but it is not surprising. The province has over many years chosen to see long-term care as an expense that should be minimized.

As the report details, New Brunswick has been lowering hours of care and the ration of regulated staff over a number of years, resulting in poor care and staffing shortages. These decisions have been compounded by relying on casual and part-time work and low pay.

The cost-cutting decisions reflect a custodial model where the job is simply to feed and clean residents. It sees them as less than human. The residents of nursing homes are not chairs to be dusted; they are full human beings. As you read this report, I urge you to constantly ask yourself, “how would I want to live?””

Dr. Deborah Van Den Hoonaard

Professor Emerita, St. Thomas University

“The Forgotten Generation is a timely report that reveals how a confluence of factors, inattention and a lack of capacity by successive provincial governments have led to a situation where long-term care in New Brunswick is akin to being self-regulated.

The lack of or minimal inspections with little follow-up for non-compliance orders, nursing homes petitioning for a lower qualified staffing complement, and an unwillingness by Governments to enforce needed staffing levels, coupled with poor tracking data, where it exists, seriously undermines quality long-term care.

Long-term care is no longer simply a Department of Social Development issue but needs significant input and guidance from citizens and the Department of Health to meet the increasingly complex medical needs of an older clientele, unlike the situation 25 years ago. New Brunswick seniors – our family members – deserve better.”

Dr. Mario Levesque

Associate Professor, Canadian Politics and Public Policy, Mount Allison University

COMMENTARY:  Why New Brunswick Needs a Long-Term Care Inquiry

The Government of New Brunswick – acting alone – can no longer be depended on to chart a path forward for the province’s nursing home sector and the nearly 5000 seniors under its care. Our Government’s oversight of New Brunswick nursing homes is not a solution; it is – in many ways – the problem. This week, the New Brunswick Nurses Union (NBNU) released our report, The Forgotten Generation: An Urgent Call for Reform in New Brunswick’s Long-Term Care Sector. That report’s findings should concern every New Brunswicker.  We are failing our most vulnerable seniors.

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Our report is not the first to deal with seniors and nursing home care in this province – there have been others – 16 since 2004.  That New Brunswick could have arrived at this moment despite all of them is only one of the many shameful findings our report lays out. We cannot assign this broken system the task of reforming itself.  We must have an inquiry into long-term care in this province under the terms of The Inquiries Act – and there is no time to lose.

More than 500 unionized registered nurses (RNs) providing care to nursing home residents have bravely stepped forward to sound alarm bells that should shock us all into action. RNs report that residents at their homes are not being regularly toileted 63% of the time. Residents are not regularly bathed 57% of the time. Residents in nursing homes are not properly exercised 89% of the time – which can lead to muscle weakness, bed sores and rapid deteriorations in a resident’s health. As one RN quoted in our report told us, “we are neglecting our elderly – plain and simple.”

It does not end there. Footcare, medical referrals, updates to charts and outreach to families are also not being consistently done – all the result of a system that has weakened year-over-year, to a point where it scarcely resembles healthcare at all.

Nearly half the nursing homes in New Brunswick failed to meet their mandated safe staffing ratios in 2019. Inspections of nursing home infrastructure and fire safety also reveal worryingly high levels of non-compliance. With what consequence? Sadly, such issues are only the tip of the iceberg.  We can no longer assume that the Department of Social Development is catching – or is even aware of – many of the risks our most vulnerable seniors face in New Brunswick homes.  Social Development, as our report makes clear, is no longer up to the task.

The light our report shines on Social Development’s oversight record is devastating. NBNU’s analysis found serious inconsistencies in major incident reporting, safety and infrastructure inspections, safe staffing, and the issuing of non-compliance orders. Upon reading our report, Dr. Mario Levesque of Mount Allison University declared that the sector was “akin to being self-regulated.”

Years of budget and staffing cuts have taken their toll – exacerbated by constant calls from nursing homes themselves to ease back on regulations even more. Safety standards are falling, staffing levels are falling, oversight has declined – the only thing that continues to rise are the levels of illness RNs see in their residents.  Our parents and grandparents. The forgotten generation.

Our report also features interviews with half-a-dozen former ministers of social development. They paint a grim picture. Many now support moving responsibility for nursing homes to the Department of Health. All believe there is a desperate need for reform. None had a plan to accomplish it. This is why a provincial inquiry is so badly needed. Our leaders are at a loss, with little in the way of reliable data to help them. Government has run out of ideas. The inquiry we have called for must have the power to send for persons, papers and records and to examine witnesses under oath – only then can we be sure that our Government knows what is happening in our nursing homes what must be done to restore confidence. The frantic and desperate decision-making must end.

That desperation has led our leaders to begin turning the care of our most vulnerable over the private sector, with predictably worrying results. The lack of data, transparency and accountability makes it nearly impossible for New Brunswickers to know what standards of care private nursing homes are providing with our tax dollars but reports recently done in other provinces speak plainly enough. The British Columbia Seniors Advocate recently found that private nursing homes in B.C. had endangered seniors by failing to deliver hundreds of thousands of funded care hours. NBNU has asked New Brunswick’s seniors advocate to conduct a similar investigation, but that is nowhere near enough.

You will hear voices in the coming days that will point to the 16 reports done since 2004 and ask why an inquiry is necessary.  You will see politicians of all stripes point the finger at Ottawa, and demand that the Federal Government do more. I urge you, my fellow New Brunswickers, do not let your leaders deflect, do not let them spin, do not let them pass the buck. There is no time for such games, New Brunswick seniors are at risk.

Hundreds of Registered Nurses have stepped forward to speak truth on behalf of thousands of elderly residents who cannot speak-up for themselves. Now its up to all of us to step forward and do the right thing.

The New Brunswick Nurses Union (NBNU) is a labour organization of approximately 6900 Registered Nurses and Nurse Practitioners who are employed in various healthcare facilities throughout the province of New Brunswick. Together, we form a strong and unified voice.

103 Woodside Lane, Fredericton, NB E3C 0C5

Tel: (506) 453-0829 / Toll Free: 1-800-442-4914

Fax: (506) 453-0828 / 453-0834