The Ontario government recently passed legislation relating to post-traumatic stress disorder (PTSD) diagnosed in first responders (police, firefighters, paramedics, etc). Bill 163, Supporting Ontario's First Responders Act, creates a presumption that a PTSD diagnosis in first responders is work-related, thus allowing for faster access to benefits.

The legislation, which amends the Workplace Safety and Insurance Act (WSIA) and the Ministry of Labour Act, has been welcomed by advocacy groups such as the Canadian Mental Health Association because it means first responders seeking disability benefits no longer have to prove their PTSD is the result of their job.

However, there is one major problem. The presumption does not include nurses among first responders. The Registered Nurses' Association of Ontario (RNAO) noted it was "dismayed with the exclusion of nurses in Bill 163" and rightly so.

PTSD is a reaction to a traumatic event with long-lasting symptoms that disrupt a person's life. It could lead to job loss, relationship troubles and the deterioration of one's overall health – among other things. Nursing professionals – and this I know first-hand as a former nurse – are exposed to violent and traumatic interactions all too frequently.

Like doctors and paramedics, emergency department nurses repeatedly bear witness to trauma as a part of their day-to-day work and may also experience physical violence from patients who are cognitively or psychologically impaired1. Moreover, these nurses are also routinely exposed to death and the resulting grief expressed by family members and loved ones who must hear this troubling news. According to the RNAO, "It is both offensive and ludicrous to exclude nurses as first responders when they are regularly among the first to assist during emergency situations."2

Ontario was not the first province to introduce a presumption for first responders. Alberta introduced similar legislation in 2015, while Manitoba took the presumption one step further covering "all workers," including nurses. Sandi Mowat, president of the Manitoba Nurses Union, said "Nurses are often misdiagnosed with occupational burnout or compassion [burnout]."3 It remains to be seen which model other provinces will take, the more narrow approach of Alberta and Ontario or the more inclusive approach of Manitoba.

This omission means nurses who have been diagnosed by a psychiatrist or psychologist with PTSD may still need to prove that the cause of their PTSD is directly related to their work (and not personal life) before they can access disability benefits.

Like other first responders, Ontario's nurses spend much of their working lives dealing with traumatic situations while helping us at our most vulnerable. They too should be able to access timely medical and disability benefits when diagnosed with PTSD, without the burden of proving the condition was related to their work, by way of a disability-related presumption.

Footnotes

1. http://www.thesudburystar.com/2016/04/11/sudbury-letter-nurses-doctors-also-suffer-ptsd

2. http://rnao.ca/policy/submissions/letter-premier-kathleen-wynne-amend-bill-163-include-nurses

3. http://www.theglobeandmail.com/news/national/manitoba-to-ease-ptsd-claims-for-all-covered-workers/article24869020/

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