John, president & CEO

"I can't ask people to do this if I don't do it myself."

John’s story

My name is John Yip. I’m currently the president and CEO of SE Health. During COVID, I was the president and CEO of Kensington Health.

Kensington Health is a community not-for-profit provider located in the heart of downtown Toronto, by Kensington Market. It provides a wide range of community-based services: long-term care, hospice, and ambulatory programs.

I was there a total of seven years, of which three of them were managing through COVID.

At Kensington, on a day-to-day basis, it’s a vibrant campus of care. But largely our programs revolved around older adults, particularly around long-term care, our seniors’ activation centres, and our residential hospice.

The pandemic was officially declared March 20th, 2020, and it went from, “Oh, this is a thing we should be aware of,” to, “Okay, maybe we should start to mobilize to full-on crisis mode.”

And so, the panic gets ingrained deep inside and I try not to show it. And what comes out instead is more about problem solving, action oriented, trying to inspire, trying to lead with a sense of calm.

But deep inside? Oh yeah. Mass panic inside.

And it certainly hit home when we had our first positive test, which was maybe a week or two after the official declaration of the global pandemic.

And at that time, there were no vaccines, very little knowledge of how to proceed. I go up on the floor, the staff are crying. They’re not happy, they’re scared.

I think what I learned the most myself during that time was being honest and transparent is the best policy. And we did that with families. At the town hall, our medical director was very blunt. “If you don’t have a will, prepare. If you don’t have your advanced care plans in place, get them ready now.”

We were suffering a significant staffing shortage. Residents weren’t getting the care they needed and they were — their status was deteriorating.

So I went up on the floor and looked around and I was appalled what I saw, which was empty rooms, residents roaming around unsupervised.

And that day, I worked a full shift, 12 hours, and said, “We’ve got to change this.”

The next day, I called an all-staff meeting and said, “I’m going to volunteer to work on this floor. I’m not qualified to do much aside from these tasks.”

But my philosophy at the time was, I can’t ask people to do this if I don’t do it myself.

And eventually, what we also did is, when the hospitals had a shortage of nurses, we also asked for volunteers to go help in the hospitals as well. We have nurses from our surgical side. We have trained PSWs as well, outside of the long-term care home. But we also have volunteers, corporate staff, finance, research.

And I said, “If you’re willing, can you please help? We’ll train you up, three days versus three months of training. Three days, we’ll train you up, come on the floor.”

And they did it because they wanted to.

The residents in our COVID area, 25 rooms, 100% of those residents had some form of dementia, cognitive impairment. 100% were on multiple medications, on average 12 medications. Half of them were bedridden. Half of them that were mobile had no sense of where they were. Or what was going on and had difficulty in communicating. Some didn’t speak.

I remember a gentleman I’d spend a lot of time with, because I did go up on the floors to support the team as a resident aide, because I wasn’t trained to do anything else.

The gentleman couldn’t swallow, so all the food’s pureed, and I made sure he ate every single morsel, even if it took two hours, which it did. And remember those moments, it’s one spoonful at a time. We didn’t talk. He couldn’t talk. It was one spoonful for two hours. One at a time, pausing.

When I looked in his eyes, I actually knew we had a relationship. That he was grateful for what I was doing. And that, to me, kind of personifies the whole COVID experience, is that one interaction with that gentleman feeding him one spoonful at a time.

What were the mental health concerns for your staff?

I was seeing a lot of the cracks in our staff in terms of their well-being and mental health. It shows itself up in multiple ways. Increase in absenteeism, like spot absenteeism. They’re due to show up, they don’t show up. Don’t call. A lot of turnover in staff, a lot of quiet tears. I had a lot of private conversations where there was a lot of tears.

But I also saw moments of extreme kindness, of staff putting an arm around another staff member, volunteering to take an extra shift so they could go home and take care of their children, or their sick loved one. Those coming on their days off to bake a cake and give it to their colleagues.

There are other things that I think the Kensington staff to this day don’t know what we did, which was we actually improved their benefits plan to include an employee assistance program, which was not included previously.

We increased their compensation quietly, without government funding. That was our decision.

We provided additional time off in order for staff to recuperate, because they were pulling double shifts.

We asked them to provide more. We asked them to care more. We asked them to put themselves and their families at risk.

And then when the pandemic subsided, nothing changed.

We need to do better.

I believe a lot of the front line staff still to this day have been traumatized by those events. We didn’t pay attention to their well-being before the pandemic. We tried to pay attention during, and we still haven’t scratched the surface post-pandemic.

How were you managing your own mental health?

When I worked the COVID floor, I didn’t see my family for three months. I would go in through the basement, and I would shower before going upstairs. I would eat separately, and I would sleep separately. It was tough. I’m not going to lie. It was tough.

As of March 2021, reports showed nursing and seniors’ homes accounted for the greatest proportion of outbreak-related cases and deaths, representing about 7% of all cases and more than 50% of all deaths.

— Public Health Agency of Canada

Twenty-four residents died under my watch from COVID. I feel guilty. That there’s nothing I could have done, I know that rationally.

But sitting there, holding this woman’s hand as she took her last breath, because her loved one couldn’t be there and was on the iPad. Sat there for hours, and I just, I’d never seen anyone die before.

I saw three or four people die, during COVID, in my hands.

Front line staff see this all the time. Something new. Death, life. It’s not new.

I felt absolutely horrible after. Couldn’t sleep for weeks.

But it pales in comparison to the challenges where you’re being paid 17 bucks an hour, you’ve got to take two hours on the TTC every day, your daughter has COVID and you can’t be there? And you know if you take a day off work, you’re not buying groceries next week. Like that?

I’m in a very privileged position — and I think that’s another thing, it’s the privilege I have. I know it. Which is why I don’t want to talk about it. Because I am in a position of privilege where many of our staff are not.

The pandemic didn’t create the stress. The stress has always been there for our front line, based on underinvestment in our healthcare system, poor wages, poor working environment.

[It’s] why we see the huge swaths of our healthcare workforce leave the workforce entirely.

The pandemic only exposed the vulnerabilities of our healthcare system. Preparation for the next pandemic is one thing, but we’ve had a multi-decade issue around health human resources, and with that, the mental health and well-being that has been ongoing for decades.

But we haven’t addressed it. The time to address it is now.

A special note of thanks from Healthcare Salute

Over the course of the COVID-19 pandemic, healthcare providers from across Canada have participated in our research on “COVID-19-Related Stress, Moral Injury and Minority Stress in Healthcare Workers and Public Safety Personnel in Canada.” Their struggles, heartbreak, courage, and resilience have inspired and moved us, and formed the bedrock of our research for this project. We are deeply grateful and committed to sharing their experiences.

We would also like to express our heartfelt thanks to our funders, the Public Health Agency of Canada, for giving us the opportunity and the autonomy to share our research with the larger Canadian audience without bias or restriction. This work would not have been possible without their generous and arms-length funding support. We also wish to thank our collaborators and supporters — McMaster University, St. Joseph’s Healthcare Hamilton, Homewood Health, and Homewood Research Institute.

After viewing, visit “Applying cultural competency in practice,” an education module for mental health providers and peer supporters.