ona front lines magazine, july 2014

IN THIS ISSUE . . .E4From ONA President

Linda Haslam-Stroud, RN

E5From ONA First Vice-President

Vicki McKenna, RN

Vol. 14 • No. 3JULY 2014

arbitrator has issued an award for our 58,000 members in the hospital sector that provides wage increases above what the Ontario Hospital Association (OHA) had

tabled during negotiations and rejects all its concessions.As the current hospital central collective agreement expired on March 31, 2014, ONA’s

Hospital Central Negotiating Team (HCNT) began bargaining with the OHA in November 2013. Although the team’s goal was to reach a settlement at the bargaining table and we had a mediator’s assistance available, the OHC walked away from talks, prompting a hear-ing before the William Kaplan Board of Arbitration on March 15-16. At that hearing, the OHA argued for a number of draconian concessions that would limit our ability to provide quality, safe patient care.

The arbitration award, issued on April 30, 2014, provides wage increases of 1.4 per cent in each year of a two-year contract. The arbitrator rejected all

The Members’ Publication of the Ontario Nurses’ Association

continues on page 3

AN

ONA President Linda Haslam-Stroud holds up a copy of the highlights of the arbitrated award

for our hospital members while addressing hospital Bargaining Unit Presidents and Local

Coordinators at a special sector meeting in downtown Toronto on May 2, 2014.INDEXUp Front ......................................................... 3Member News ............................................. 6Nursing Week Spread ..............................12ONA News ...................................................14Queen’s Park Update ...............................16Pensions .......................................................17CLC News .....................................................18OH&S .............................................................19Human Rights and Equity .....................20Student Affiliation ....................................21Awards and Decisions .............................22LEAP ..............................................................24

ONTARIO NURSES’ ASSOCIATION85 Grenville St., Ste. 400Toronto ON M5S 3A2

ONA Members Help

Stave off Hudak Win!

PGS. 10-11

Details of Hospital Arbitration Award Inside!

Arbitrator Rejects OHA Concessions in Hospital Award

(June 20, 2014 / 14:13:41)

86856-1 ona_frontlines jul2014 v13_p01.pdf .1

JULY 20142 www.ona.org


President, VM #2254 Communications & Government

Relations / Student Liaison

Vicki McKenna, RN

First VP, VM #2314Political Action & Professional Issues

Pam Mancuso, RN

VP Region 1, VM #7710Human Rights & Equity

Anne Clark, RN

VP Region 2, VM #7758Labour Relations

Andy Summers, RN

VP Region 3, VM #7754Occupational Health & Safety

Dianne Leclair, RN

VP Region 4, VM #7752Local Finance

Karen Bertrand, RN

VP Region 5, VM #7702Education

Michael Balagus

Chief Executive Officer / Chief Administrative Officer

How to contact your 2014 ONA Board of Directors

Call ONA toll-free at 1-800-387-5580 (press 0)

or (416) 964-8833 in Toronto and follow the

operator’s prompts to access board members’

voice-mail. Voice-mail numbers (VM) for Board

members in the Toronto office are listed below.

ONA Provincial Office

85 Grenville St., Ste. 400

Toronto ON M5S 3A2

Tel: (416) 964-8833

Toll free: 1-800-387-5580

Fax: (416) 964-8864

E-mail: [email protected]

ONA is the union representing 60,000 registered nurses and allied

health professionals and more than 14,000 nursing student affiliates

providing care in hospitals, long-term care facilities, public health, the

community, clinics and industry.

www.ona.org

Design: Artifact graphic design (artifactworks.ca)

Printed by union labour: Thistle Printing Limited

Copyright © 2014 Ontario Nurses’ Association

All rights reserved. No part of this publication may be reproduced

or transmitted in any form or by any means, including electronic,

mechanical, photocopy, recording, or by any information storage or

retrieval system, without permission in writing from the publisher

(ONA members are excepted).

Editor: Ruth Featherstone

Features Editor: Melanie Levenson

Send submissions to:

Communications and Government Relations

Intake at [email protected].

Contributors: Sheree Bond, Nicole Butt,

Katherine Russo, Tricia Sadoway, Lawrence

Walter, LEAP Team

EHamilton 2 King St., W., 2nd Floor Rear Dundas, ON L9H 6Z1 Tel: (905) 628-0850 Fax: (905) 628-2557EKingston 4 Cataraqui St., Ste. 201 Kingston, ON K7K 1Z7 Tel: (613) 545-1110 Fax: (613) 531-9043ELondon 1069 Wellington Rd. South,

Ste. 109 London, ON N6E 2H6 Tel: (519) 438-2153 Fax: (519) 433-2050

EOrillia 210 Memorial Ave., Unit 126A Orillia, ON L3V 7V1 Tel: (705) 327-0404 Fax: (705) 327-0511EOttawa 1400 Clyde Ave., Ste. 211 Nepean, ON K2G 3J2 Tel: (613) 226-3733 Fax: (613) 723-0947ESudbury 40 Larch Street, Unit 203 Sudbury, ON P5E 5M7 Tel: (705) 560-2610 Fax: (705) 560-1411

EThunder Bay #300, Woodgate Centre,

1139 Alloy Dr. Thunder Bay, ON P7B 6M8 Tel: (807) 344-9115 Fax: (807) 344-8850ETimmins Canadian Mental Health

Association Building 330 Second Ave, Ste. 203 Timmins, ON P4N 8A4 Tel: (705) 264-2294 Fax: (705) 268-4355EWindsor 3155 Howard Ave., Ste. 220 Windsor, ON N8X 3Y9

Tel: (519) 966-6350 Fax: (519) 972-0814

ONA Regional Offices

The Members’ Publication of the Ontario Nurses’ Association

Vol. 14 • No. 3JULY 2014

ISSN: 0834-9088

www.Facebook.com/OntarioNurses

www.Twitter.com/OntarioNurses

www.youtube.com/OntarioNurses

Front Lines can be accessed

on our website at

www.ona.org/frontlines

(June 20, 2014 / 14:13:41)


UP Front

JULY 2014 3www.ona.org

continues from cover

Arbitrator Rejects OHA Concessions in Hospital Awardof the OHA’s concessions, including a three-per-cent cut to the start rate for new RN graduates. We have no doubt that would have resulted in new RNs considering their options to practice in other jurisdictions, rather than be the lowest-paid RNs in all of English-speaking Canada.

However, ONA is extremely disap-pointed that the award fails to provide any benefit or premium improvements, which have always been important features of any round of negotiations.

“Our RNs already sacrificed wages with a two-year wage freeze in the last contract,” said ONA President Linda Haslam-Stroud.

“We had every expectation of moving back to more appropriate compensation that reflects the value of RNs to health care and would have been more in line with in-creases given to other professional essential service workers and our Canadian nursing counterparts. But clearly, hospitals saw this contract as an opportunity to balance bud-

ONA hospital leaders and staff study an overhead slide as ONA President Linda Haslam-

Stroud and members of ONA’s Hospital Central Negotiating Team detail Arbitrator William

Kaplan’s award for our 58,000 hospital members at a special sector meeting in Toronto.

APRIL BOARD HIGHLIGHTS

The following are key highlights from the April Board of Directors meeting, held April 8 -11, 2014 at the ONA provincial office:

cesses and strengthen the ability of candidates to communicate

with members.

A ONA will provide a one-time contribution for the 2014 fiscal year

of $10,000 to support the Canadian Museum for Human Rights

(CMHR), which opens September 20, 2014 in Winnipeg. The CMHR

will showcase human rights from many perspectives and explore

themes and issues that touch all our lives.

You will find a copy of the Board Highlights on our website (www.

ona.org) under “ONA News.” The subsequent Board meeting was held

in London on June 2-5, 2014, and highlights will appear in the

September issue of Front Lines.

A ONA is working on a strategy to deal with influenza before the next

outbreak. We have joined forces with infectious disease specialists

to formulate proposals, taking into account freedom of choice to

receive the flu immunization, which we hope can be used as prov-

ince-wide directives. We will engage the government in discussions

to see where we can move forward. Stay tuned!

A We are very concerned about the recent outbreak of measles in

Hamilton and Brampton and the communications that came from

the public health office about the threat, especially to our mem-

bers. We will be discussing the outbreak further with Chief Medical

Officer Dr. Arlene King.

A The Board accepted in principle recommended changes to the Pro-

vincial Election Guidelines, which will modernize our election pro-

gets on the backs of registered nurses rather than respecting those very nurses.”

During a special sector meeting on May 2, 2014 in downtown Toronto, Haslam-Stroud and members of the HCNT provided hospital Bargaining Unit Presidents and Lo-cal Coordinators with details of the award. As the award is final and binding, no ratifi-cation vote is necessary.

“I would like to thank the HCNT for all their hard work on your behalf,” added

Haslam-Stroud. “Despite all the roadblocks we encountered at virtually every turn, they remained steadfast and determined to achieve your bargaining objectives.”

Highlights of the arbitration award are inserted into this issue of Front Lines. The fi-nal version of the new hospital central agree-ment is also available on our website (www.ona.org under the Quick Links box). If you have any questions about the award, please speak to your Bargaining Unit President.

(June 23, 2014 / 14:25:14)

86856-1 ona_frontlines jul2014 v13_p03rev.pdf .1


From ONA President

Chronique de la présidente, AIIO


Work has Just Begun

W ith a provincial election called for early June and the Tim Hudak-led Conservatives threatening to further privatize our health care system, dismantle our pen-

sions and impose a wage freeze, negatively impacting our ability to provide safe quality care, ONA members were politically ac-tive like never before. And I can’t thank you enough!

Throughout our pre-election campaign, you proved that not only are you staunch patient advocates, but true political activ-ists – and for some, it was for the very first time. Many of you went out of your comfort zones to participate, from delivering our campaign leaflets to residents of your community and talk-ing to them about what’s at stake to asking questions at all-can-didates meetings. You did everything we asked of you and then some, and your passion to fight for a publicly funded, adminis-tered and delivered health care system and enough RN positions has been nothing short of inspiring. This is so important, as our patients/clients/residents look to us to be their voice. And I think with this campaign, we did just that.

In fact, I have received many emails from the public, along with many of you, expressing appreciation to ONA for taking

such a strong stand. True, there have been a few detractors along the way, some telling me I have “an agenda” – anytime you take a stand there are sure to be – but I make absolutely no apolo-gies for upholding our patients’ rights to quality care. That is my agenda! It is the agenda of all of us.

With a Liberal majority government elected, the PCs losing nine seats and Hudak announcing his resignation as party leader, we clearly made a difference! But this is not the time to rest on our laurels. We must continue to be a strong union to ensure that the Wynne government and our employers support quality patient care going forward. In that sense, our work has really just begun.

For starters, with bargaining underway for members in several sectors, we will be holding firm to ensure they receive contracts that reflect their worth. And if this election campaign is anything to go by, I know I can continue to count on you to work alongside us!

We must continue to be a strong union.

Le travail ne fait que commencer

Avec le déclenchement des élections provinciales au début du mois de juin et la menace du chef du Parti conservateur Tim Hudak de privatiser encore plus notre système de santé, d’amputer nos

régimes de retraite et d’imposer un gel salarial, ce qui aurait fatalement nui à notre capacité de dispenser des soins de qualité en toute sécurité, les membres de l’AIIO se sont démenés comme jamais auparavant dans l’arène politique, et je ne pourrai jamais vous en remercier assez!

Durant la campagne pré-électorale, non seulement vous vous êtes érigés en farouches défenseurs des patients, mais vous avez aussi agi en véritables activistes politiques – et pour certains, il s’agissait d’un baptême du feu. Beaucoup ont quitté leur zone de confort pour pren-dre part à ce mouvement, que ce soit en distribuant des feuillets aux résidants de leur collectivité et en leur expliquant les enjeux de la cam-pagne, ou en multipliant les questions lors des rencontres avec les can-didats et en effectuant des appels de sollicitation. Vous avez accompli tout ce qu’on attendait de vous et plus encore, et la passion avec laquelle vous avez défendu un système de soins de santé dont les services sont financés, administrés et fournis publiquement, est une véritable source d’inspiration. Rien ne saurait être plus important, car nos patients/cli-ents/résidents comptent sur nous pour se faire entendre. C’est exacte-ment ce que nous avons fait durant cette campagne.

De fait, j’ai reçu de nombreux courriels de la population et de bon nombre d’entre vous, remerciant l’AIIO d’avoir pris si fermement posi-tion. Certes s’y mêlaient ceux de quelques détracteurs soutenant que j’ai « un plan » en tête – c’est invariablement le cas quand on prend position – mais jamais je ne présenterai d’excuses pour avoir défendu le droit de nos patients à recevoir des soins de qualité. Tel est mon plan! Et ce plan, nous le partageons tous.

Avec un gouvernement libéral majoritaire, la perte de neuf sièges pour les Conservateurs et la démission de M. Hudak à la tête du parti, nous avons nettement fait la différence! Toutefois, le moment de nous féliciter et de nous reposer sur nos lauriers n’est pas venu. Notre syn-dicat doit garder sa vigueur et nous devons veiller à ce que le gouver-nement Wynne, tout comme nos employeurs, appuie dorénavant des soins de qualité pour les patients. Dans cette optique, le travail ne fait vraiment que commencer.

(June 20, 2014 / 14:13:43)



From ONA First Vice-President

Chronique de la première vice-présidente, AIIO

Vicki McKenna, RN

Improving Workloads by Working with your Employers

You have heard me say time and time again that workload is the number one issue of our members. With Ontario experiencing a devastating nursing shortage and RN positions being elimi-

nated virtually on a weekly basis, it’s no wonder. You are run off your feet, desperately trying to provide quality safe patient care under very trying conditions – and sometimes it’s just too much to bear.

I want to assure you that your union is making a huge difference. You will have read in issues of Front Lines, including this one, that we are experiencing a great deal of success with Independent Assess-ment Committee (IAC) hearings – a last step in the process to address our members’ key workload concerns. But I am also pleased to see that more and more, we are reaching pre-IAC settlements with your employers that are significantly changing your work environments.

If you flip a couple pages, you’ll see that we’ve had one such settlement at Cambridge Memorial Hospital that clarifies proper RN staffing and support for after-hours surgical procedures and the importance of education and training. And a subsequent settlement in the labour and delivery unit of Sault Area

Hospital means one additional RN must be scheduled when there is one c-section or two inductions scheduled.

How did these settlements come to be? Certainly not by nurses sitting back and accepting impossible situations! By bringing your concerns forward to your union, we are able to meet with your em-ployers and come up with meaningful and viable solutions. As we have been successful in making these settlements binding, with timelines for implementation and sustainability built into them, they are not simply words on paper. They are real measures the em-ployer must act on. Employers know how serious IACs are and most don’t want to head there.

So the next time you are faced with a workload form, remember all the positive changes that can come about, not just to your own working lives, but to the care our patients/clients/residents are able to receive as a result of nurses speaking out. And please fill it out!

These settlements aren’t simply words on paper.

Coopérer avec l’employeur en vue d’alléger la charge de travail

Je l’ai répété à maintes reprises : la charge de travail est le princi-pal problème auquel nos membres sont confrontés. Ce n’est pas surprenant quand on sait que l’Ontario se débat avec une pé-

nurie catastrophique d’infirmières et d’infirmiers, et que des postes sont supprimés pratiquement chaque semaine. Vous n’arrêtez pas de courir, vous débattant pour prodiguer des soins de qualité aux pa-tients dans des conditions extrêmement ardues – au point que, par-fois, cela devient insoutenable.

Je tiens à vous assurer que votre syndicat contribue grande-ment à changer les choses. Comme vous l’avez lu dans les numéros précédents du bulletin Front Lines, y compris celui-ci, les audiences du comité d’évaluation indépendant remportent un franc succès et cette étape est la dernière du processus visant à trouver une solu-tion aux principales difficultés qu’éprouvent nos membres en ce qui concerne la charge de travail. Cependant, je suis également ravie de constater que de plus en plus de règlements amiables sont conclus avec l’employeur avant la mise en place d’un tel comité, et que ces règlements changent de façon appréciable vos conditions de travail.

Parcourez quelques articles et vous constaterez qu’un tel règle-ment a été conclu à l’Hôpital Memorial de Cambridge, précisant le nombre approprié d’infirmières et d’infirmiers autorisés et de per-sonnel de soutien dans le cadre d’interventions chirurgicales en de-hors des heures normales, ainsi que l’importance de l’éducation et de la formation. Par ailleurs, un règlement subséquent à l’unité de tra-vail et d’accouchement de l’Hôpital de la région du Sault indique qu’à l’avenir, une infirmière ou un infirmier autorisé de plus sera néces-saire quand une césarienne ou deux inductions sont prévues.

Comment ces règlements ont-ils vu le jour? Surement pas en restant les bras croisés et en acceptant des conditions intolérables! En faisant part de vos préoccupations au syndicat, vous lui donnez la possibilité de rencontrer votre employeur et de trouver avec lui une solution efficace et viable. Puisque nous avons réussi à faire re-specter ces règlements et à les faire appliquer dans des délais pré-cis en y intégrant un facteur de durabilité, ils ne sont pas unique-ment théoriques. Ils contraignent l’employeur à mettre en œuvre des mesures concrètes. Les employeurs sont conscients de la portée des comités d’évaluation indépendants et la plupart d’entre eux préfèrent éviter cette étape.

(June 20, 2014 / 14:13:43)


ONA Members Across Ontario


In this continuing Front Lines series, a member who wishes to remain anonymous, relays how her

ONA Labour Relations Officer (LRO) and ONA leader helped in her road to addiction recovery and

how thankful she is to them both.

I am a registered nurse, currently working in

a hospital. Last year, I was a victim of harass-

ment by my management team. I felt really

awful, tired and constantly attacked. It was

difficult coming to work. My coping skills

seemed to be decreasing and it was very

dangerous for me because I was in recovery

from addiction.

I do not know what would have hap-

pened without my ONA Labour Relations Of-

ficer (LRO). The first time I spoke to her, my

mood and hope increased. Her approach was

very professional and concrete. At the same

time, she’s a very warm person, who may in-

stantly change your point of view in hopeless

situations.

My LRO prepared the whole complaint

for me because I would not be able to do this

better on my own. I was astonished by her

knowledge and the way she presented every

single case during meetings with HR. At this

time, she was like my professional represen-

tative and guardian angel. My LRO helped

me not only go through this difficult process,

but during my recovery, which at this point

was very fragile. She also told management

they cannot treat people in the manner they

did.

At some point, I dropped the idea of a

grievance [because of a family emergency],

and I can’t imagine how many problems I

would have had with compassionate care

benefits if it were not for my LRO’s actions.

Thanks to her, my relationship with the man-

agement team is much better. She is like the

best lawyer in court! My relationship with

others in my unit is also great. I can do my

work without any stress, and I feel empow-

ered by my LRO, knowing that if anything like

this occurs again, I am not alone.

I could write many words, but nothing

would describe my gratitude towards my

LRO. I am very proud to have somebody like

her in our union.

I would also like to add many thanks to

my Bargaining Unit President, who was a tre-

mendous support. Whenever the three of us

approached any interviews, I felt like I had

two great people with me.

Want to share a brief story about what your

union means to you? Drop Front Lines editor

Ruth Featherstone an email at [email protected]

and you may be featured in this section in an

upcoming issue!

denberg (Pleasant Meadow Manor, Local 3), Sandra Kravets (Brouil-

lette Manor, Local 8), First Vice-President Vicki McKenna. Keep

abreast of the latest in nursing homes central bargaining by logging

onto www.ona.org/bargaining.

Nursing Homes Team Gets to Work!In what is a very active bargaining year for ONA, members of the re-

cently-elected 2014 Nursing Homes Central Negotiating Team take a

few minutes from their week-long orientation session at ONA’s pro-

vincial office in Toronto this past April to show you who they are. As

the current nursing homes collective agreement expires on June 30,

2014, the team has been busy reviewing your bargaining objectives

and commencing negotiations for a renewed contract. Pictured are

(back row, left to right) Judy Wright (Versa Care Thunder Bay, Local

14), (then) South District Services Team Manager Bev Mathers, (then)

Manager, Contract Administration and Bargaining Process Valerie

MacDonald, Director Dan Anderson (Chief Negotiator), East District

Services Team Manager Kappil Uppal, Labour Relations Officer (LRO)

Matthew Stout, Carolyn Turner (Southlake Residential, Local 124),

Director of Labour Relations – Contract Administration Marie Kelly,

LRO Stacey Papernick, Labour Relations Assistant Vicki Kotevich.

Front row (left to right) ONA President Linda Haslam-Stroud, Jean

Kuehl (Forest Heights Long-Term Care, Local 15), Chair Shelley Van-

(June 20, 2014 / 14:13:44)



Support from the community was high, as

the Independent Assessment Committee

(IAC) looking into the concerns of registered

nurses at Nipigon District Memorial Hospital

recommended that additional RN hours be

added to care for patients in the acute care

unit, emergency department (ED) and chron-

ic care unit, and that an RN be added to act as

a transport nurse.

The RNs in this rural hospital north of

Thunder Bay called for an IAC earlier this year

over concerns they are unable to meet their

professional standards because RN staffing

isn’t sufficient to cover patient care needs

or the fluctuations in the acuity/complex-

ity of patients. Despite the RNs consistently

providing completed workload forms, the

employer did not staff the hospital with an

appropriate number of RNs.

“For the first time, ONA met with the

town council, who wanted to support the

RNs and make sure the hospital didn’t lose

its ED,” said Professional Practice Specialist

Rozanna Haynes. “We also had the support of

a number of Band councils in the area. There

was a great amount of community support,

with business owners writing letters. And

every physician in the hospital sent letters,

saying don’t decrease our RN staffing. I’ve

never seen that before.”

Following a three-day IAC hearing in ear-

ly March, the IAC found there was an insuffi-

cient complement of RNs in the ED, chronic

care and acute care units to provide proper

patient care. The panel issued 25 recommen-

dations, including increasing RN staffing in

the ED on weekends, not eliminating a cur-

rent full-time RN position, developing a nurs-

ing human resources plan to build nursing

capacity, better monitoring of the number

and type of patient transfers and staff escort

required, easing some non-nursing duties

performed by nurses, and addressing RNs’

low morale and burnout.

“This IAC sets a precedent, especially in

the north,” Haynes noted. “It proves that even

with the smallest of units, members can use

the IAC to their benefit. They were a dedicat-

ed group.”

“The expert panel found merit in the RNs’

concerns and made recommendations that

will improve the safety and quality of the

care they are able to provide,” added ONA

President Linda Haslam-Stroud. “Our nurses

are pleased to work collaboratively with the

employer to achieve just that. A small group

of nurses who felt powerless now feel power-

ful and that they can make a difference.”

Add Additional RN Hours, Nipigon IAC Recommends

Members from Nipigon District Memorial Hospital had a little something extra to celebrate

this Nursing Week, as they gather in the hospital’s Rotary Room on May 13, 2014 to review –

and display! – their successful IAC. Pictured are (left to right) Professional Practice Specialist

Rozanna Hayes, Jen Hart, Bargaining Unit President Diana LeBar, Mary Ann Malley, Brittany

Clowes, Lynn Imhoff, Bonnie Broughton, Emma Honsberger.

Welcomes New MembersONA has held successful certification votes at the following:

Rapids Family Health Team, Sarnia: approximately 35 RNs, nurse practi-tioners, RPNs, receptionists and several allied health professionals.

PeopleCare Oakcrossing, London: 13 RNs.Chartwell Waterford Long-Term Care: 24 RNs.

We know you join us in warmly welcoming these new members to our union!

(June 20, 2014 / 14:13:44)




ONA Members Remember Fallen RNs, WorkersONA members across the province have remembered the nurses, al-

lied health professionals and thousands of other workers who have

lost their lives or suffered injury or illness on the job during moving

Day of Mourning events on April 28, 2014.

At Larry Sefton Park in downtown Toronto, Region 3 Vice-President

Andy Summers and several ONA members, including Benoit Guibord,

Ingrid Atyeo and Cyndra McGoldrick (top right photo), and staff joined

the Toronto and York District Labour Council, other unions, communi-

ty groups and politicians in a somber ceremony that included speak-

ers from various organizations.

In Windsor, a beautiful ceremony began at St. Augustine’s Church

Hall where participants shared stories in a show of solidarity and a

commitment to improve workplace health and safety, followed by a

procession to the Injured Workers’ Monument. Members from Local 8,

including Veronika Pulley and Barb St. Pierre, carried the ONA flag and

laid flowers in remembrance of their fellow ONA member Lori Dupont

and other fallen workers during the subsequent ceremony in Coven-

try Gardens (middle photo).

Local 19’s Robin Smith proudly held the ONA flag and joined ap-

proximately 200 others in wearing an armband reading, “Mourn for

the dead, fight for the living” at Sarnia’s Day of Mourning event at Flag

Court in Centennial Park (bottom right photo).

The statistics behind this day are sobering. The Canadian Centre

for Occupational Health & Safety reports that in 2012, 977 workplace

deaths were recorded in the country – an increase from 919 the previ-

ous year. This represents more than 2.7 deaths every single day. In the

20-year period from 1993 to 2012, 18,039 people lost their lives due to

work-related causes (an average of 902 deaths per year).

For ONA, Day of Mourning is a particularly

significant day to pause, remember and honour

registered nurses who have died because of

their job, including Tecla Linn and Nelia Laroza,

who passed away after caring for SARS patients

in 2003, and Dupont, who was murdered while

working at Windsor’s Hotel-Dieu Grace Hospital

in 2005.

“On Day of Mourning we stand in solidar-

ity with workers around the world and share

with each other a collective sense of loss,” said

ONA President Linda Haslam-Stroud. “Nurses

are among the most injured and ill of all pro-

fessionals because of the high occupational

health and safety hazards we encounter daily

while caring for our patients. In fact, combined with heavy workloads

and the risk of workplace violence as patients and their families grow

frustrated with wait times, nursing can be a very dangerous profes-

sion indeed.”

(June 20, 2014 / 14:13:45)



PRC Settlement Results in Positive Changes for Endo NursesONA has achieved a significant Professional

Practice Complaint (PRC) settlement at Cam-

bridge Memorial Hospital that will ensure

nurses are able to provide safe patient care

on the Endoscopy Unit.

Since late 2007, the Endo Unit has had its

own dedicated staff on weekday day shifts.

Prior to that, the Operating Room (OR) staff ro-

tated through Endo for all elective and emer-

gent cases. In early 2012, the employer cut

regular Endo hours and required the OR stand-

by team of one RN and one RPN to provide

coverage for after-hours Endo procedures,

meaning the RN was responsible for monitor-

ing sedated patients and circulating, while the

RPN was in the scrub role. This was a direct

contravention of Operating Room Nurses As-

sociation of Canada standards, which state an

RN must remain with a sedated patient at all

times and have no other responsibilities, and

that an additional RN is needed to perform

the circulating role. The OR nurses had not

rotated through Endo for five years and felt

they did not have the knowledge, skills and

judgment to provide after-hours standby cov-

erage. In addition, all hires into the OR since

2007 had not received orientation or training

to the Endo department or procedures.

Despite a flurry of workload forms from

the nurses, management seemed hesitant to

find a resolution until we discussed our con-

cerns with the CEO and apprised him of the

seriousness of the situation. If unresolved, we

would likely end up at an Independent Assess-

ment Committee (IAC) hearing. Our discus-

sion seemed to assist, and suddenly the Chief

Nurse Executive began to attend meetings to

discuss the issues. After a series of meetings

between ONA and the employer, the Minutes

of Settlement were signed earlier this year.

Resolutions of the settlement, which will

be reviewed in three months for completion

and 12 months for effectiveness and sustain-

ability, resulted in substantial improvements,

including:

• ONA RNs will be permanent members of

the hospital’s Endo Utilization Committee.

• Anesthesia coverage will be provided for

all off-hour Endo procedures or a second

RN will be present to monitor the patient.

• All OR RNs will receive training/refresher

training in Endo procedures, which will be

included in training for future hires.

• OR RNs will rotate through Endo as part of

their regular rotation during regular Endo

hours.

• Appropriate new policies and guidelines

will be developed.

“This settlement is crucial because it clarifies

proper RN staffing and support for after-hours

surgical procedures and the importance of

ongoing education and training in the main-

tenance of nursing knowledge, skills and

judgment,” said ONA President Linda Haslam-

Stroud. “It also proves that ONA is making

meaningful changes to your working lives –

and all without the use of an IAC. We look for-

ward to working with the employer on imple-

menting these very positive changes.”

ONA 40th Anniversary Winners! One of our longest-standing partners, Johnson Insurance, the provider of our members’ benefits plan, was pleased

to celebrate our 40th anniversary milestone in 2013 by rewarding 40 members with $500 pre-paid credit cards.

During the six months the contest ran, Johnson received many entries, and is delighted to provide the follow-

ing members with the opportunity to reward themselves:

Seth Appa, Oshawa

Monica Asare, Brampton

Philomina Asimonye, North York

Judy Bacalso, Oshawa

Morgan Batson, Kingston

Lana Bialy, Hamilton

Millicent Brown, North York

Steven Cairns, Bracebridge

Jennifer Carino, Thunder Bay

Liane Carmel, Ottawa

Julie Carthew, Barrie

Lindsay Cooper, Kemptville

Danielle Kwarciak, London

Qionghua Lu, Scarborough

Nicola Lyons, Burlington

Madeleine Marn, Toronto

Andrea Meghie, Ajax

Sajida Moledina, Toronto

Hyla Okorofsky, Thornhill

Natalie Patterson, Toronto

Renee Cucuz, Paris

Kulwinder Dhillon, Woodbridge

Marie Ewalefo, Hamilton

Melissa Ferguson, Brantford

Eleana Finnerty, Whitby

Patricia Garside, Sault Ste. Marie

Renee Hill, Carleton Place

Rachael Holmes, Windsor

Linda Kearney, London

Monique Keville, Sault Ste. Marie

Iryna Kotlyar, Thornhill

Abhilash Kottackal, St. Thomas

Anne-Louise Pigeon, Ottawa

Cindy Rozo, North Bay

Margaret Ryan, Essex

Nichole Sawatzky, Sault Ste. Marie

Amanda Shamblaw, Kingston

Jessica Smith, Peterborough

Allyson Turner, Moffat

Carol Veale-Morello, Woodbridge

Congratulations to all of the winners! We hope you enjoy your rewards.

(June 20, 2014 / 14:13:45)




We did it!ONA Members Help Stave off Hudak

“I have never been so proud to be an ONA member.”

– Local 19 Coordinator Emily Webb

Our hard work has paid off!

Thanks to your relentless advocacy on be-

half of your patients/clients/residents, ONA’s

campaign to ensure the Tim Hudak-led Con-

servatives were not allowed to dismantle our

precious public health care system and hard-

fought-for rights has succeeded!

When the provincial election was an-

nounced in early May, we moved our More

Nurses campaign into the next phase, focus-

ing not just on the need for more RNs in our

system, but on educating our members and

the public on what a Hudak win would really

mean: additional privatization of health care

services, the removal of $3.42 billion a year

out of provincial coffers – money needed to

fund health care – by giving corporations a

30-per-cent tax cut, the dismantling of our

defined benefit pension plans, and a wage

freeze. This marked the first time ONA has

taken a calculated stand against one party

during an election campaign.

The Provincial PlanProvincially, ONA prepared two powerful radio

ads, urging the public to choose care, not cuts

on Election Day. We organized phone banks in

all ONA offices from April to early June to talk

to our members about the harmful plans of

Hudak. We designed campaign leaflets with

the same strong message and sent direct mail

to 25 targeted regions where the race between

the Tory candidate and another was too close

to call. We produced eye-catching More Nurses:

No Hudak buttons and signs. We asked mem-

bers and the public to sign our More Nurses

postcards and send letters to their MPPs. We

made full use of social media. We ramped up

our More Nurses website to include specific in-

formation about the campaign. We provided

education to our members on political action

and asked them to help with our campaign.

And you certainly did (see sidebar for details)!

“Our goal from the start was to have per-

sonal conversations with as many members

as possible about the threats the PCs posed

to them,” ONA President Linda Haslam-

Stroud said. “What we couldn’t possibly have

anticipated was the overwhelming support

you showed towards that goal. You took our

campaign and went running with it in your

communities.”

On the Local FrontThose Local actions included staffing cam-

paign tables at grocery stores, community

events, etc., holding lunch and learns, dis-

playing our More Nurses items, leafleting

door-to-door, at major intersections and

events such as farmers’ markets, participat-

ing in Ontario Health Coalition actions and

all-candidates meetings, and writing letters to

the editor of your local newspapers. Fourteen

Locals also set up their own phone banks to

reach out to members.

And it wasn’t just personal conversations

taking place. Our campaign messages, sto-

ries and pictures were shared and retweeted

extensively, sometimes hundreds of times.

Our most popular Facebook post and Twit-

ter tweet was ONA’s response to a letter sent

to us from PC Health Critic Christine Elliott,

denying her party’s platform would hurt pa-

tients or cut nurses, which had a total reach

of approximately 200,000 users. You also

posted photos of yourselves holding our

More Nurses signs with your own personal

messages on Instagram.

During the recent June Provincial Coor-

dinators Meeting, our leaders were quick to

sing the praises of our campaign.

Local 81 Coordinator Dawn Armstrong

revealed that her team put campaign leaflets

in more than 80 per cent of Dryden residents’

mailboxes, and Local 100 Coordinator Jill Ross

revealed that just about everyone stopped to

Thumbs up to Local 100’s phone bank!

(June 23, 2014 / 14:25:13)



e off Hudak Win!

What we Accomplished…Together!• 1,458 members were educated on

political action, with 92 per cent

supporting our campaign and 57 per

cent asking how to get involved.

• 70,000 campaign leaflets were

distributed across the province.

• 12,000-plus letters were sent to MPPs

– our largest letter-writing campaign

to date!

• Close to 7,000 postcards were signed.

• 24,000 members were reached with a

personal conversation.

• Phone banks were conducted by 102

member and 62 staff volunteers in

210 shifts.

• Almost 9,000 contacts were

attempted during the phone banks

and close to 2,600 conversations

occurred. Of that number, 89 per

cent supported our campaign.

• ONA’s campaign commercial was

viewed on YouTube 27,000 times

(and counting!)

• We have seen a 30 per cent increase

in Facebook and 23 per cent in

Twitter followers since our campaign

began.

• PC candidates were not elected in all

25 of the close ridings we targeted!

ask about her More Nurses, No Hudak button,

which she was more than happy to explain!

“I want to thank ONA for educating us first

and showing leadership, and then providing

us with the tools we needed to go back and

work in our communities,” added Local 237

Coordinator Mandeep Sangha.

“Without a doubt, the outreach to mem-

bers and the public was a huge success,”

added Haslam-Stroud. “With all this work,

we reached a total of 24,000 members with

a personal conversation, but if those mem-

bers talked to just one other member, you

can double that number. And I can’t begin

to imagine how many conversations with

the public took place. We can hold our heads

high and be proud that we made a big contri-

bution towards the defeat of Mr. Hudak – and

protected our health care system, patients/

clients/residents and rights along the way.”

Bargaining Unit President Barb Deter

chats to members during Local 8’s

phone bank.

Local 51 adds our sign to the mix!

First Vice-President Vicki McKenna joins members and staff leafleting commuters in downtown Toronto.

Would you like some election information with your groceries? Compliments of Local 19.

Local 2 drives home the point.

(June 20, 2014 / 14:13:47)


MAY 201412 www.ona.org

With an arbitration award for our members in the hospital sector and a provincial election an-nounced just days before, this was a Nursing

Week like no other! But despite the flurry of activity, ONA members in all parts of the province took pause to give them-selves a well-deserved pat on the back.

During the week, held May 12-18, members of the ONA Board of Directors visited worksites and participated in spe-cial events planned by our Locals, under the theme More Nurses, Better Care, which piggybacks on our provincial campaign demanding an immediate moratorium on the elimination of RN positions in Ontario.

These two pages contain a region by re-gion pictorial of ONA RNs, nurse practitio-ners and RPNs, along with their colleagues and friends, enjoying Nursing Week 2014 and getting out our important election mes-sage of care, not cuts wherever possible. Thanks to all of you who submitted photos of your events. Many more photos of Nursing Week activities are available on our website at www.ona.org/news_details/nw2014.html.

REGION 1

Sault Ste. Marie Public Health Unit (Local 12)

Canadian Blood Services (Local 2)Sault Area Hospital (Local 46)

REGION 2Arnprior District Hospital (Local 49)Providence Manor (Local 67)

The Ottawa Hospital (Local 83)

REGION 5

Local 19 Huron Lodge Home for the Aged (Local 8)Windsor-Essex County Health Unit (Local 8)

MIXING BUSINESS WITH PLEASURE D

(June 23, 2014 / 14:25:13)


MAY 2014 13www.ona.org

It was and is a NurseIn 1980 who held my hand and offered assurance,

as if she were my own mom, to a scared 12-year-old

waiting on a bed outside the OR for an emergency

appendectomy.

In 1995 who provided loving care to my 93-year-old

grandfather, as if he was her own, in the palliative

care unit during his final days.

In 1996 who advocated for me to avoid a c-section

delivery after 27 hours of labour and then stayed

beyond her shift, providing me encouragement and

support until my son was born without the risks of

a c-section.

In 1996 who stayed by my father’s side in his final

moments when nothing more could be done,

ensuring he knew he was not alone.

In 1999 who single-handedly and safely delivered

my 8½ pound daughter into the world when my

daughter decided she was not waiting for the

doctor to arrive.

In 2002 at a nursing home who cared for my Nan

in her final years with kindness and dignity till her

peaceful passing at the age of 101.

In 2012 and 2013 in my most recent time of

need supported me through surgery and painful

procedures. Who took my vitals, helped me bathe,

changed my sheets, administered medications,

changed my dressing and removed my staples.

Ensuring my care and well being around the clock,

throughout three admissions in hospital. Who,

outside of any health care setting, provided advice,

encouragement or just listened when I needed to talk.

Who, in a budget-driven, overloaded and sometimes

poorly managed system, chooses to remain as the

heart and backbone of our health care system. Never

wavering from the advocacy and provision of quality

patient care because they truly do care.

It was and is a Nurse.

REGION 3Etobicoke General Hospital (Local 43)

Local 71

Local 124

MacKenzie Health (Local 237)

Cambridge Memorial Hospital (Local 55)

Local 75

REGION 4Local 7

Children’s Hospital of Eastern Ontario (Local 214)

The following poem was written by Jane Stapleton,

a “proud” ONA staff member, who penned it as

a tribute to the nurses who have made a real

difference throughout her life. We thought it was

a fitting tribute for Nursing Week 2014.

Local 4

RE DURING NURSING WEEK 2014!

(June 20, 2014 / 14:13:49)


ONA News


Retiring ONA Manager Receives Honorary MembershipOne of our union’s key negotiators, who has

been instrumental in the bargaining gains

we have made over the past four decades,

has received an honorary ONA membership

for her unwavering dedication to members.

A familiar face to many of those members,

Valerie McDonald, Manager of Contract Ad-

ministration and Bargaining Process, received

the prestigious honour at the March Provincial

Coordinators Meeting, before she retires this

summer, from ONA President Linda Haslam-

Stroud on behalf of the Board of Directors.

MacDonald, a former Local President

(now referred to as a Bargaining Unit Presi-

dent) and member of the Board of Direc-

tors, helped form ONA in 1973 while she was

working as a nurse at the (then) Wellesley

Hospital. She was subsequently elected to

the ONA Board of Directors for Region 6 (in

those days, there were 14 regions). In 1985,

MacDonald was hired as an Employment Re-

lations Officer (what we now call a Labour

Relations Officer). From there, she became

ONA’s Sector Coordinator and then South

District Services Team Manager, where she

was highly valued by her staff, before mov-

ing into her current position in 2008, serving

as the project manager for all bargaining and

contract interpretation at ONA.

“Throughout Valerie’s time with ONA,

she campaigned relentlessly for nursing, our

public health care system and our members’

rights,” said Haslam-Stroud. “She has actively

strived to achieve pay equity for ONA mem-

bers to end gender wage discrimination. She

has advocated for immigrant nurses in Can-

ada. And she has been an incredible leader,

mentor, resource and friend to many ONA

members and staff. She challenged me con-

stantly, and at the end of the day, she always

wanted the best for ONA members.”

And that “best” included trying to negoti-

ate contracts for our members that respected

and valued their worth. In fact, MacDonald

reveals that she is most proud of the bargain-

ing work ONA has done.

“We have achieved a lot for our mem-

bers throughout the years,” she said. “When

I first graduated, I was earning about $4,000

a year. We were in the hospital cafeteria one

day and figured out that with a one-per-cent

increase a year, it would take 17 years to

make $17,000. Garbage collectors were mak-

ing more than that! In 1973, we got a huge

increase and went straight to $17,000 with-

out a blink. We said, ‘hey, we can do this’ and

since then, we have gained a whole lot more,

including benefits and premiums.”

But MacDonald is quick to note that she

hasn’t been able to accomplish the gains she

has at ONA without tremendous support

from members, the Board and fellow staff.

“Valerie never failed to thank and rec-

ognize her staff and colleagues for their

contributions,” said ONA Director and Chief

Negotiator Dan Anderson, who has worked

closely with MacDonald over the years. “In

the circumstances, it could not be more ap-

propriate that ONA bestow an honorary

membership on Valerie as a token of thanks

for a lifetime of dedication to ONA and the

nursing profession.”

“I hope I have been able to influence peo-

ple,” MacDonald added. “I hope I have made

them think about things in a different way. If

I have changed people’s views of nurses and

the work that we do, that’s good. One of the

things I have always loved about my role is

coaching and mentoring; that moment with

members or staff when all of a sudden you

can see that ah-ha! in their face.

While MacDonald hasn’t quite figured

out what’s next for her as she moves on –

although she’s certain travelling, volunteer-

ing and taking classes will be part of it – one

thing is for sure: her finger will always be on

the ONA pulse.

“For 40-odd years, we have done amaz-

ing work for nurses and patients/clients/

residents in Ontario,” she said. “Do not give

up. Continue to fight the fight and do not be

afraid of change. It is constant. You need to

embrace it! And I’ll be watching.”

“This is a huge honour

and I thank you from the

bottom of my heart,”

said a visibly emotional

Valerie MacDonald (left),

a founding ONA member,

long-time staff member

and one of our chief

negotiators, after being

presented with an

honorary ONA

membership from ONA

President Linda Haslam-

Stroud at the March

Provincial Coordinators

Meeting in Toronto.

(June 20, 2014 / 14:13:51)



ONA Media Release Ranks in Top Ten! New Data Proves we are not the “Bloated” Public Sector!While the conservatives of this province would have the

public believe that public-sector workers like you enjoy a far

higher standard of living than your private-sector counter-

parts, new data proves exactly the opposite.

In fact, data from the Ministry of Labour shows that for

the fourth consecutive year, wage settlements in the broader

provincial public sector fell below the wage settlements in

the private sector – and quite significantly. While public-sec-

tor wage settlements averaged only about 0.3 per cent annu-

ally in 2013, private-sector settlements were a whopping 2

per cent higher at 2.3 per cent.

What’s even more alarming is that provincial public-sec-

tor settlements have been trending downwards consider-

ably since 2010 (just under 2 per cent in 2010, 1.4 per cent in

2011, 1.1 per cent in 2012, and 0.3 per cent in 2013), thereby

increasing the gap with the private sector even more. And

when you compare our settlements to inflation levels over

the past four years, we are falling further and further behind.

What does that really mean? It suggests a substantial

decline in your standard of living over a very short period of

time. Yet, there has been significant growth in the Ontario

economy over the same four-year period.

So the next time you hear some misguided comment that

we are the “bloated” public sector needing to make sacrific-

es, we encourage you to share these statistics, which clearly

prove we have done nothing but make sacrifices over the

past several years.

Explore and Learn: See our Website with a Fresh Pair of Eyes!

ONA is always in the news – and now we have even more proof!

Canada Newswire, which distributes media materials on behalf of a vari-

ety of customers throughout the country, including companies, governments

and non-profits, recently sent ONA a congratulatory letter because our news

release, “Ontario Nurses’ Association says no to concessions that would harm

patients,” which warned contract demands tabled by the Ontario Hospital As-

sociation during the recent round of hospital central bargaining would lead

to a nursing crisis reminiscent of the Harris government years, ranked in the

top 10 most viewed news releases at www.newswire.ca. In fact, our release was

viewed almost 1,300 times from March 16 to Saturday March 22!

When you consider all the releases that are issued at any given time

throughout Canada, this is an enormous feat and proof that when the media

wants the views of front-line nursing, they turn to ONA first!

To view the release, log onto www.ona.org and click on “Media Releases.”

Take a few minutes and explore ONA’s web-

site, www.ona.org. Updated every day, the

website is your one-stop shop to current

information about bargaining, health and

safety updates, important events and much

more.

The final version of the new hospital cen-

tral agreement is now available on the web-

site. Visit www.ona.org and, under the Quick

Links box, you’ll see it is listed first. The Local

collective agreements are found next or you

can visit www.ona.org/ca for direct access.

Important information about diseases

such as MERS-CoV, the measles and Ebola are

found on the home page tab, “Travel-related

Illnesses.” Read about precautions health

care professionals need to adhere to regard-

ing exposure. Or visit www.ona.org/news_de-

tails/ti.html for direct access.

Our teleconnects – which are a phone call

away – are an easy way to be in-the-know on

specific topics in your workplace. From la-

bour relations updates to nurse practitioner

connects, ONA’s teleconnects will keep you

informed. Visit www.ona.org/teleconnects for

information about and materials for our tele-

connects.

And be sure to visit our social media

channels to receive breaking news updates:

• www.facebook.com/OntarioNurses.

• www.twitter.com/OntarioNurses.

• www.youtube.com/OntarioNurses.

Have website feedback? Email Communica-

tions Officer Katherine Russo at katheriner@

ona.org.

(June 20, 2014 / 14:13:52)



QUEEN’S PARK Update

E ONA welcomes the announcement of 75 additional nurse practi-

tioners (NPs) in long-term care (LTC) homes over the next three years.

The government says the NPs will strengthen the quality of care re-

ceived by residents, enhance access to primary health care services for

residents, provide proactive continuity of care, and assist with address-

ing the multiple care needs of our increasingly complex LTC residents,

ensuring we can provide the support and care these residents deserve.

Specifically, the governments says funding for new NPs will help to:

• Reduce unnecessary ambulance use, emergency department

transfers and hospital admissions.

• Keep residents safer by preventing injuries from falls.

• Reduce the need for restraints by increasing patient supervision.

• Improve resident and caregiver experience.

E Ontario is more than doubling the number of hospital beds

for patients with epilepsy to enhance their care and reduce wait

times for diagnostic testing. The province is adding 21 new epilepsy

monitoring unit beds at seven hospitals across the province, includ-

ing three new beds at London Health Sciences Centre. These new

beds will help 750 additional patients with epilepsy get tested and

diagnosed faster for drug-resistant epilepsy. This type of epilepsy

cannot be treated with anti-seizure medication and may require sur-

gery to control seizures.

E Ontario is taking the next step to support new construction and

renovations at Toronto East General Hospital so that local residents

can access high-quality health care services. To support the plan-

ning and design of a new eight-storey, 380,000-square-foot tower at

the hospital, Ontario is providing $19.6 million in new funding. This

brings the total provincial investment to $28 million since 2007. The

new building will include:

• Up-to-date units of inpatient beds for surgery, rehabilitation, car-

diac care and adult, child and adolescent mental health.

• A new, modernized space to accommodate clinics for medical,

surgical and maternal, newborn and child programs.

• State-of-the-art laboratory and diagnostic imaging facilities.

E Ontario is protecting young people from skin cancer through a

new law that bans the use of tanning beds by youth under the age

of 18. Starting May 1, youth under 18 will no longer be allowed to

use tanning beds in the province. The new legislation protects young

people, who are especially vulnerable to the harmful effects of ultra-

violet (UV) radiation, from skin cancer. The act also requires tanning

bed operators to post signs in their business about this restriction,

which warn of the dangers associated with tanning bed use. Opera-

tors will be required to ask for proof of age identification and will not

be allowed to promote tanning services to youth under 18.

(June 20, 2014 / 14:13:53)



PENSIONS

We’re all Invested!

DB Pension Plans “Part of Solution” in Addressing Retirement Income CrisisA retirement income crisis awaits us if ac-

tion is not taken on expanding workplace

pension coverage in Ontario and across the

country – and defined benefit (DB) pension

plans are a key part of the solution.

That was one of the key messages deliv-

ered at “We’re all Invested,” an information

session held on March 17, 2014 at the MaRS

Centre in Toronto. The event was sponsored

by the Healthcare of Ontario Pension Plan

(HOOPP), the pension plan of the majority

of our members, along with the settlor orga-

nizations on its board, including ONA. Presi-

dent Linda Haslam-Stroud and Director Dan

Anderson sit on the HOOPP Board of Trustees.

Track Record of Success Michael Block of the Boston Consulting

Group presented research on the invest-

ment expertise of the nation’s public sector

pension funds and the significant impact

DB pension income has on the economy.

Canada’s top 10 pension funds, a group that

includes HOOPP, managed more than $714

DB Pensioners not the ProblemThe final speaker was HOOPP President and

CEO Jim Keohane, who said the real problem

with pensions is that there is a very large

number of people who are not covered. He

said that having a substantial group without

pensions may “cost us dearly” in the future,

noting that Old Age Security and the Guar-

anteed Income Supplement (GIS) are “a very

large expense for the federal government.”

DB pensions are “hardly gold-plated,”

with the average amount currently around

$23,000 a year, he said, adding that reliable

income allows seniors to be independent

and less reliant on government income sup-

port programs. “They (DB pensioners) aren’t

the problem,” he said.

Moving away from DB plans in the private

sector was probably more about the tough

accounting rules faced by private businesses

than the cost of pensions, Keohane noted.

There is likely no cost savings by switching

from DB to defined contribution plans, and

the burden of risk “is shifted to the employee.

The vast majority of people would be better

off in a more defined vehicle.”

DB plans feature risk-sharing through

pooling, professional investing, low fees and

cost-effectiveness. About 80 cents of every

dollar that HOOPP pays in pensions comes

from investment returns. Members and em-

ployers pay the rest, so the taxpayer is con-

tributing about 10 cents on the dollar.

“DB plans are a key part of the solution

for the retirement income crisis,” Keohane

concluded.

For more information on DB pension plans, in-

cluding a White Paper and video summarizing

the day’s findings, log onto www.hoopp.com.

HOOPP has also started tweeting about DBs;

follow @HOOPPDB.

billion in retirement assets as of the end of

2011, and their track record of success “has

built a great reputation for Canadian pension

funds around the world,” he said.

“Across Ontario, DB pensioners spend $27

billion annually on goods and services, and

pay $3 billion in income taxes. That money,

for the most part, all goes back into the econ-

omy, and there is a multiplier effect as well.

DB pensions are an important pillar of the re-

tirement system and the mandatory savings

enable investments that might not otherwise

have happened.”

A Retirement CrisisNext to speak was David Herle of the Gan-

dalf Group, who conducted public opinion

research on retirement, finding that two-

thirds of Ontarians are concerned they won’t

have enough income when they leave their

worklife behind. His research revealed that

those with DB plans expect they will have

about 95 per cent of the income they need

in retirement, while those without plans fear

they will be about 20 per cent short.

“People with DB plans don’t know how

good they have it – and those without them

don’t know how bad they have it,” he said.

The research also found there was not

envy amongst the public about the pensions

that public service workers have, but instead

a belief by 60 per cent that private sector

pensions should mirror them.

“There is a retirement income crisis right

now,” Herle said, adding that “a shocking

number of people have put nothing away

for retirement.” He added that employers and

government “both have a role to play” in de-

livering retirement security.

(June 20, 2014 / 14:13:54)



CLC NEWS

CLC Convention Delegates Vow to Protect Public Health Care Delegates at the recent Canadian Labour

Congress (CLC) convention, including those

representing ONA, have passed two impor-

tant resolutions on the preservation of our

publicly funded and administered health

care system.

These were among the many resolutions

passed at the 27th CLC convention, which

took place in Montreal from May 5-9, 2014.

The two resolutions vow that the CLC will

continue to work with the labour movement,

health coalitions, seniors’ organizations,

community groups and other allies to pro-

tect, strengthen and expand Canada’s public

Medicare system, and oppose all privatiza-

tion of public services.

Under the theme, Together Fairness

Works, the convention was attended by more

than 4,000 delegates from various labour

groups across the country, including more

than 300 from the Canadian Federation of

Nurses Unions (CFNU). Of that number, 54

were from ONA, including members of the

Board of Directors and Local leaders. ONA is

a member of the CLC through our affiliation

with the CFNU.

“The convention went further than the

fight for just unionized workers, but the fight

for fairness for all Canadian workers,” said

ONA President Linda Haslam-Stroud. “The

most important message we learned was

that our power lies in our members, and that

by working together, having those individual

conversations with our grassroots members

and understanding their issues, we can fight

together for better working conditions, wag-

es, pensions and safety in our workplaces.”

In keeping with the convention theme,

the CLC is rolling out a multi-million dollar

television advertising campaign, previewed

at the convention, which looks at the achieve-

ments of Canadian unions and protecting

those hard-earned rights for all unionized

workers. CFNU has provided $238,000 to-

wards this campaign (ONA did not support a

CLC request for an additional $350,000 from

CFNU for the campaign). To continue to do

its important work on behalf of Canadian

workers, a marginal increase of five cents per

member per month was also approved.

Hassan Yussuff, the CLC’s former Sec-

retary-Treasurer, was elected the first new

president of the CLC in 15 years, defeating

incumbent Ken Georgetti. Also elected to

the CLC executive were Secretary-Treasurer

Barbara Byers and Executive Vice-Presidents

Marie Clarke Walker and Donald Lafleur.

Full details of the CLC convention can be

found at www.canadianlabour.ca.

(June 20, 2014 / 14:13:55)



• • •

OCCUPATIONAL Health & Safety

Small Changes Make Big Difference, Health and Safety Caucuses HearONA’s health and safety representatives are making a huge difference in their workplaces

and must continue to engage their members in this important work, delegates to our recent

Health and Safety Caucuses heard.

Much like our annual Human Rights and Equity Caucus in November, the Health and Safety

Caucuses are held once a year in spring to provide education to ONA’s health and

safety reps and allow them to discuss their issues, brainstorm initiatives in their

workplaces, listen to guest speakers, learn the latest statistics in this area, and

network. Under the theme Driving your Workplace Health and Safety Agenda, the

2014 caucuses were held for all five ONA regions, and many northern and rural

members linked in via videoconference.

Region 3 Vice-President Andy Summers, who holds the portfolio for health and

safety, kicked off the Region 1 and 3 caucus in Toronto on April 30 with a sobering

statistics: each year in Canada, almost 1,000 people lose their lives on the job.

“Yet nothing is done,” he said. “But if a plane went down killing that many people, there

would be an outcry, and millions would be spent on a public inquiry to find out what happened.”

ONA Health and Safety Specialist Nancy Johnson, with the assistance of the Membership Edu-

cation and Events Team, led delegates through a review of recent research on how health and

safety representatives can make the most impact in their workplaces, including educating, involv-

ing, engaging and organizing fellow workers; providing solutions with costings to hazardous con-

ditions instead of just identifying them; and being persistent and assertive, not hostile or insistent.

During the concurrent half-day sessions, the Workers Health and Safety Centre described

the principle of “behaviour-based safety,” a dangerous approach of “blaming the worker,”

which is endemic in health care and gaining popularity with employers across the workforce,

so members are alerted to the notion and equipped to fight back. The Public Services Health

and Safety Association also discussed the concept of “risk assessment and job hazard analysis,”

providing members with the information and tools needed to identify hazards in their jobs,

assess the associated level of risk, and control that risk exposure through knowledge and

planning.

A highlight of the Region 1 and 3 caucus was a panel presentation of Local success sto-

ries, featuring Local 19‘s Elizabeth Hart, who fought long and hard to get Bluewater Health

to switch to isolation gowns that offer greater protection, and Judy Evans from Etobicoke

General Hospital, who has won many battles in health and safety, the most recent being

the introduction of special bags hospital-wide to collect biohazard waste, a viable solution

to the lack of places to clean bed pans. Region 1 Vice-President Pam Mancuso, and

members Deborah McIntosh and Denise Werner also sat on the panel in the other

regions’ caucuses. Johnson commended these members for their tenacity, noting

“we need to be making those small changes on the ground before we can make

the big ones,” as they can often have a ripple effect across the province.

“I’ve had multiple hospitals ask me for information and have used that to get

their own gowns,” said Hart, proving Johnson’s point. “Little things like that make

a huge difference and it’s all about team work. Everyone is thankful when every-

one is safe. You need to be proactive, but it’s worth it.”

(June 20, 2014 / 14:13:56)


HUMAN RIGHTS and Equity


ONA Member Calls on Nursing Colleagues to Tackle Racism “ONA is a leader in helping front-line nurses and giving us a voice in the political arena”

spoke about the patient to the charge nurse,

even though he or she was present and the

primary nurse for that patient. Others felt in-

visible when a less qualified white nurse got

a promotion instead of them. One nurse de-

scribed how others, especially her manager,

did not greet her in the morning. This nurse

said, ‘They just pass me as if I don’t exist.’”

Noting that this is exactly how she has

sometimes felt at her workplace, Kim added,

“unless people experience it for themselves,

it’s hard to see. You consciously have to look

for it.”

ONA is a LeaderBut still one question remained for Kim: Why

does racism exist when nursing is supposed

to be a caring profession? She has no answer,

but believes everyone needs to ask that

question. While some authors call for more

diversity training, Kim said studies show that

An ONA member who addressed attendees

at the November 2013 Human Rights and

Equity Caucus is grateful that our union has

an open forum on racism in nursing, noting

“ONA acknowledges that racism exists and

that it is a problem.”

However, Miae Kim, who received an ONA

Human Rights and Equity Bursary to support

her in studying racism in nursing, added that

although our union is highlighting this seri-

ous issue, it falls to all of us to address racism

on the front lines.

A Client Care Coordinator with North Sim-

coe Muskoka Community Care Access Centre,

Kim knows well of what she speaks. After

emigrating from South Korea as a young

child in 1973 to a predominantly white area

of Canada, Kim said she and her siblings were

the only Asian youth in the community and

she experienced racist bullying at school.

Her family’s convenience store was robbed

numerous times, once at knife point, but no

compensation or support was ever offered

by the police, she said, adding that her par-

ents responded by becoming very afraid and

mistrustful and refusing to discuss what was

happening to their family.

“Repressing experiences of racism and

growing up with emotional scars makes you

more vulnerable to re-experience similar

treatment because you don’t know how to

be proactive, you don’t know how to recog-

nize what’s happening until it’s too late and

you don’t know how to respond when you

experience similar treatment,” she explained.

And sadly that’s exactly what happened

when, as a third-year nursing student, Kim

again experienced racism, this time during

her clinical placement. Caught off guard by

derogatory comments from a coworker, she

was ill-prepared to confront the perpetrator

and unsure how to approach management.

While she reported it to the Clinical Nurse

Specialist, no support was provided nor ac-

tion taken to address the incident.

It’s not surprising then that when Kim de-

cided to pursue a Master of Science degree

at Toronto’s York University, she conducted

an extensive study of the issue of racism in

nursing as part of her learning. The ONA bur-

sary helped fund her studies, which she com-

pleted last year.

“I was surprised to find that there is actu-

ally very little in health literature that spe-

cifically looks at the experience of racism in

nursing,” she said, noting that one of her key

observations during her course work was

that no one likes to talk about racism in nurs-

ing, not even academics.

Patterns of RacismThrough her research, Kim identified distinct

patterns of racism that emerged from the

workplace experiences reported by racial-

ized nurses, including:

• A lack of trust by colleagues or managers,

including excessive surveillance and being

labeled as aggressive if they spoke up.

• Exclusionary practices, including unfair

promotions resulting in a lack of non-

white nurses in leadership positions.

• An experience of being devalued, report-

ed by internationally educated nurses,

who believed they were perceived as in-

competent or stupid.

“The term invisibility came up over and over

again in the literature,” Kim said. “Some ra-

cialized nurses said they felt invisible when

managers or other health care professionals

(June 20, 2014 / 14:13:57)



STUDENT Affiliation

equal opportunity policies are not effective

and nurses still experience racism and dis-

crimination. In fact, she argues that these

policies may make racism more invisible.

“We need research that bridges the gap

between policies and action. We need re-

search that evaluates the effectiveness of

anti-racist strategies to see if they work.”

Kim also believes that to be successful

in addressing racism in health care work-

places, nurses need to challenge the rac-

ism and racist practices that exist among

us – with the support of our strong union.

“You and I are responsible for treating

one another equally, with respect, and to

speak up when we see discrimination hap-

pening at our workplace,” she concluded. “I

want to thank ONA for moving forward on

the broader issues of human rights and eq-

uity. Take heart, have hope and find cour-

age because our nurses’ union is a leader in

helping individual nurses at the front-line

level as well as giving us a voice in the po-

litical arena. We are not alone.”

Member Plants Seed for Future Nurses

Now this is what we call dedication! When a colleague of ONA member Kim Davis, a

nurse practitioner from St. Joseph’s Healthcare Hamilton, became ill and was unable to

do a presentation to three local high school classes on a career in nursing earlier this

year, Davis was quick to jump in – and promote ONA’s exemplary services along the

way! With just a few days’ notice, Davis, who is currently on maternity leave, found

someone to watch her new baby and drove from Hamilton to ONA’s provincial office in

Toronto to pick up some union promotional material to distribute to the students, who

were thrilled with the presentation. They may not be ONA nursing student affiliates yet,

but they will one day if Davis has anything to do with it!

“Nurses need to challenge the racism and racist

practices that exist among us – with the support of our

strong union.”

(June 20, 2014 / 14:13:57)



AWARDS AND DECISIONS: The Work of our Union!

The following is a sampling of recent key awards and/or decisions in one or more of the following areas: rights arbitration, interest arbitration, Workplace Safety and Insurance Board (WSIB), Long-Term Disability (LTD) and Ontario Labour Relations Board.

RightsONA wins human rights victories for members with disabilities against sick leave plansONA has successfully argued in two cases

that provisions of the Hospitals of Ontario

Disability Income Plan (HOODIP) violate the

Human Rights Code. Entitlement to short-

term disability benefits to employees with

disabilities who are covered by the hospital

central collective agreement has, as a result,

been significantly altered.

Hospital, Region 3 (Rouge Valley Health System)This decision confirms that nurses covered un-

der the 1992 HOODIP who return to modified

duties should have their 15-week sick leave

benefit reinstated when they have worked full-

time for three continuous weeks, regardless if

they are not performing their regular duties.

The 1992 HOODIP provides that sick leave

benefits are reinstated once a nurse returns

to full-time work performing regular duties

for three continuous weeks. If a nurse returns

to full-time hours, but to modified duties, she

is not considered to be “actively at work.” As

a result, a nurse who is disabled and requires

modified duties will not have her 15-week

sick leave reinstated until such time as she

can return to regular duties. In addition, any

hours worked while on modified duties are

subtracted from the remaining 15-week en-

titlement, so that a nurse may exhaust the

initial 15-week benefit period while actu-

ally working full-time hours. In other words,

modified work doesn’t count to reinstate sick

benefits and counts towards the expiry of

sick benefits, even though it is valuable work

being performed for the employer.

In this case, a nurse was absent due to ill-

ness for approximately six weeks. When she

returned, she required modified duties to

accommodate lifting restrictions. During the

next nine weeks, she completely exhausted

her remaining sick leave benefits. A few

months later, she was absent for one day due

to an unrelated illness. She was not paid for

that day because her sick leave benefits had

not been reinstated.

The arbitrator agreed with ONA that the

provisions of the 1992 HOODIP discriminate

against disabled employees. Nurses who re-

quire modified work do not have the same

entitlement and access to sick pay benefits

as other full-time employees.

Importance to ONA: The reinstatement

provisions of the 1992 HOODIP have been

struck down. Nurses working full-time hours

on modified work will not deplete their 15-

week sick leave benefit period. After working

full-time modified work for three continuous

weeks, the 15 weeks of sick leave will be rein-

stated for the same illness.

Hospital, Region 1 (North Bay Regional Health Centre)In this case, ONA successfully argued that the

failure to pay a nurse for her sixth and subse-

quent absence pursuant to Article 12.07 may

be discriminatory in certain circumstances

where a member suffers from a disability.

Specifically, mul-

tiple absences caused by a chronic recurring

condition are to be considered one “period

of absence” for the purpose of Article 12.07.

Nurses with such conditions may receive

short-term disability benefits for what would

otherwise have been considered a sixth and

subsequent absence.

At issue was whether the 1980 HOODIP

definition of “one period of absence” resulted

in discriminatory treatment to a nurse who

was absent more than five times in a fis-

cal year. The grievor was absent once every

six weeks to receive treatment for a chronic

condition. She received short-term disability

benefits for her first five absences, but was

not paid for the sixth absence, pursuant to

Article 12.07. Article 12.07 restricts payment

of sick leave benefits on the sixth and sub-

sequent periods of absence during the year.

The 1980 HOODIP provides that one pe-

riod of absence may include more than one

absence as long as the absences are from the

same cause of disability and are separated by

a period of less than three weeks. Because

the grievor’s absences were separated by a

period of six weeks, each absence was count-

ed as a separate absence, which disentitled

her to sick pay on her sixth period of absence.

The arbitrator agreed with ONA that the

application of the three-week rule in the 1980

HOODIP discriminated against employees with

disabilities. He suspended the application of the

three-week rule in this and similar cases, pend-

ing revision of the provision by the parties.

Importance to ONA: Nurses may receive

short-term disability benefits for a sixth and

subsequent absence, where multiple absenc-

es are caused by the same disability. Such ab-

sences, despite the length of time separating

them, may be counted as “one period of ab-

sence” for the purposes of Article 12.07.

(June 20, 2014 / 14:13:58)



Charter Challenge Win Removes Barrier Stigmatizing Mentally DisabledA successful Charter challenge by ONA effec-

tively removes a barrier to workers’ compen-

sation for not only ONA members, but poten-

tially thousands of Ontarians.

The FactsIn this case, the worker from an Eastern On-

tario Hospital has been a dialysis/nephrology

nurse for 38 years with the employer. For ap-

proximately 10 years prior to June 2002, she

had been the subject of personal abuse and

harassment by one of the doctors with whom

she worked. The employer was well aware of

the abuse and did nothing. The worker chose

to try and cope.

On June 14, 2002, the worker was repeat-

edly interrupted by the doctor while perform-

ing her assessments with patients and liter-

ally “shooed” out the door. She was extremely

upset and her defenses started to crack. She

complained to the team manager, who again

spoke to the unit manager. The unit manag-

er’s response was another confrontation with

the worker in a public area where she was in-

formed that they were changing clinic prac-

tices and schedules, effectively demoting her.

She left work that day and has not returned.

The worker was diagnosed with Depres-

sion and Adjustment Disorder due to stress

from work, but her claim for compensation to

WSIB was denied on the basis that her case did

not meet the criteria of the WSIB’s Traumatic

Mental Stress Policy. ONA appealed the WSIB

decision and the case ultimately went before

the Tribunal in October 2009 and April 2010.

The Tribunal panel agreed with ONA’s

position on all key factors and allowed that

“the worker’s mental stress claim would suc-

ceed, but for subsection 13(4) and (5) of the

Workplace Safety and Insurance Act (WSIA).”

The panel could not find that the worker suf-

fered an “acute reaction to a sudden and un-

expected traumatic event” so the appeal was

denied “on the basis of the application of the

Act, which governs the claim…The Panel finds

that the worker’s claim would succeed under the

principles applied to mental stress claims under

the Workers’ Compensation Act…Therefore, the

worker may pursue the challenges raised pursu-

ant to the Charter and the Human Rights Code.”

The ArgumentWith this decision we had a very strong case

on which to challenge the law itself, and pro-

ceeded to the Charter challenge. The hearing

was held in May and June 2013. At this stage,

the Attorney General for Ontario (not the em-

ployer) was the intervenor, arguing in favour

of the law against the worker/claimant.

ONA’s argument was relatively straightfor-

ward. To succeed, it was necessary to establish

differential treatment on the basis of mental

disability, that this treatment was discrimina-

tory and that such treatment could not be jus-

tified under section 1 of the Charter.

We argued that it was not necessary to iden-

tify a perfect mirror comparator group, but by

comparing candidates for WSIB with entirely

physical injuries to those with entirely mental

injuries, it was clear that the provisions in ques-

tion were discriminatory. The WSIA imposed an

additional burden only on workers with mental

injuries: having to establish the injury was a re-

sult of an acute reaction to a traumatic event,

as defined by the policy. We submitted that this

burden alone was discriminatory as it furthered

negative stereotypes that mental disabilities are

not “real” and require more scrutiny. For claim-

ants who could not meet this burden, they were

deprived of access to benefits entirely.

The Win!The Tribunal accepted ONA’s argument and

held the impugned provisions of the WSIA

violated the Charter. It found that there was

a moderate causal connection between job

strain and the onset of depression; the provi-

sions impose an additional burden and fur-

thered negative stereotypes with respect to

persons with mental disabilities; and work-

relatedness is to be determined on the legal

standard and that workplace factors need

only be a significant contributing factor to a

mental stress injury.

While the Attorney General attempted to

argue that chronic mental stress cases are dis-

tinguishable from acute trauma cases, the Tri-

bunal effectively dismissed this and included

workers with acute trauma injuries in the dis-

criminated group because of the “unexpect-

ed” criteria in the provisions. This is significant

for ONA members, who are often denied en-

titlement to WSIB benefits because so-called

“traumatic events” are “expected,” or a normal

part of their jobs.

The worker is entitled to an award of ap-

proximately $378,000-plus in Loss of Earnings

benefits from June 2002 to September 2007

and a Non-Economic Loss award.

The ImplicationsThis decision is very significant. It effectively

removes a barrier to workers’ compensation

for thousands of ONA members and many

more Ontarians. Our members who are forced

to take “stress leave” or have a mental disorder

arise or exacerbated due to workplace events

that were expected, chronic or non-traumatic,

may now make claims for WSIB benefits.

Cases can now be argued – citing this de-

cision – in the same way as physical disable-

ment cases are argued and on the same stan-

dard of proof as all other cases. This decision

reflects an advance in human rights, Charter

and workers’ compensation jurisprudence.

Previous jurisprudence has struck down por-

tions of similar restrictions to workers’ com-

pensation legislation, but not to this extent.

Thanks to the resources available to this

member, through the services provided by

her union, an unconstitutional and discrimi-

natory barrier stigmatizing the mentally dis-

abled has been effectively removed. Without

unions, it is unclear when or if this result could

have been achieved.

WSIB

(June 20, 2014 / 14:13:59)


LEAP

One of your coworkers is returning after a long

sick leave. You are not exactly sure why she was

off work, but there were many rumours about

her and she was certainly acting odd before

her sick leave. Now your manager has asked

you and some other colleagues to act as your

coworker’s monitor when she returns. You and

your colleagues are concerned. Are you sup-

posed to supervise her work? Are you respon-

sible for the work she does? What if she makes

a mistake or something else goes wrong?

Sometimes, a nurse who has a health condi-

tion that could affect her ability to practice

nursing safely will have terms placed on her

license to practice nursing by the Fitness to

Practice Committee at the College of Nurses

of Ontario (CNO). Often, one of these terms is

that she cannot engage in the independent

practice of nursing and can only work in a

setting where another nurse is available to

monitor her practice.

The terms placed on nurses with these

health conditions are intended to allow the

nurse to continue to practice while minimiz-

ing the likelihood that patient safety will be

affected. Returning to work in these circum-

stances is difficult for the nurse involved. It is

important that her employer and coworkers

do not react to myths and stereotypes that

might be associated with her illness with dis-

comfort or fear, reinforcing the stigma that

often attaches to such illnesses. It is also im-

portant that everyone involved understands

her or his responsibilities.

A monitor is not a preceptor or a shadow.

She must be a RN who works in the same fa-

cility as the nurse and be at the facility dur-

ing the nurse’s shift. However, she does not

have to be with the nurse at all times or even

work on the same unit. The monitor does not

supervise the nurse and is not responsible

for the nurse’s work; like any other nurse, the

monitored nurse is accountable for the nurs-

ing care she provides.

Being unable to engage in the indepen-

dent practice of nursing does not mean that

the nurse cannot work independently within

the facility. This restriction means that the

nurse cannot be self-employed or work for

an agency. She generally is not able to work

as a community or visiting nurse. However,

she can work as an IV nurse or on a special

team that provides care to patients through-

out the facility.

Often, the monitor will be the nurse’s

manager or the occupational health nurse,

but this role can also be filled by any other

RN who works on the same shift as the moni-

tored nurse. Some employers have found

that pairing the returning nurse with a col-

league who has suffered from a similar illness

to be a very successful monitoring arrange-

ment.

The primary purpose of a workplace

monitor is to have someone with whom the

nurse checks in at the beginning of and then

once or twice during her shift to ensure that

she is not exhibiting behaviour that may in-

dicate that she will not practice safely. The

monitor is entitled to know the nature of

the nurse’s illness, but she does not need to

know the details of prior problems with her

employer or her case at the CNO. If the moni-

tor suspects that the nurse is not practicing

safely, she must inform both her supervisor

and the nurse in question and then docu-

ment specific examples of problematic con-

duct. It is then up to the employer to ensure

that the nurse does not practice until she is

medically cleared to return to work.

While the monitor, like all nurses, is re-

sponsible for reporting any unsafe conduct,

she will not be held responsible for any prob-

lems that emerge. Similarly, the monitor will

not be held responsible if a problem arises,

but she did not see any abnormal conduct to

report.

Being a workplace monitor for a col-

league is an added responsibility. It is not,

however, a difficult or time-consuming one.

Additionally, it will help accommodate a col-

league with a disability and assist her in rein-

tegrating into the work environment. If you

are asked, please consider becoming a work-

place monitor.

If you have any questions about your

responsibility as a monitor, call LEAP intake

(see www.ona.org/leap) and the team will be

happy to help.

Should I be a Workplace Monitor?

(June 20, 2014 / 14:13:59)


ona front lines magazine, july 2014

Documents