For 90 years, the Registered Nurses’ Association of Ontario (#RNAO) has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve. Many of RNAO’s #advocacy efforts can be traced back to frontline registered nurses, nurse practitioners and nursing students who have stood up and spoken out on issues that are important to them. This is the story of one courageous member who drew attention to elder abuse. What made her shine a light on this contentious topic? And how did it impact her personally and professionally?

Six years ago, on May 25, 2008, a client kicked over a pail of water at Cornwall’s Glen Stor Dun Lodge, a 132-bed long-term-care home located just steps from the St. Lawrence River. An employee responded by tying the resident’s shoelaces to a nearby table. A nurse came into the room and untied the client. But the employee grabbed the resident by the shoulders, pulled him up in his chair, and began to force-feed the man. The nurse documented the incident and the employee received additional education and was suspended for five days.

Diane Shay, an RN of over 20 years, was the City of Cornwall’s health and safety officer at the time. The case came to her attention several days after the incident. Familiar with the lodge’s non-abuse policy, and aware that any instance of resident abuse has to be reported to the police and Ontario’s Ministry of Health, Shay brought the matter to Robert Menagh, the city’s human resources manager at the time. According to court documents, Menagh told Shay to “be careful” about what she does and to “just leave it.”

Stunned, Shay then approached lodge administrator, Donna Derouchie, urging her to report the incident to the ministry. Derouchie said she couldn’t establish that what had occurred was abuse, and did not report it at that time. After repeated pleas to Menagh and Derouchie to report the incident, Shay took matters into her own hands and called the ministry on June 11, 2008, one day after Derouchie was also in touch with the ministry (a fact unknown to Shay at the time).

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The ordeal continued to escalate when Shay, a city employee for 18 years, was accused of being insubordinate and disloyal. Feeling intimidated, she reminded Menagh of the city’s whistleblower policy, which he later accused her of misunderstanding. Shay remembers driving into work in tears, and driving home in tears.

“I didn’t know what was going to happen next, or how I was going to…do my job.” She began to have difficulty concentrating. Muscle spasms and numbness in her hands and face followed. “The stress really started to get to me,” she says, adding she went on medical leave in September 2008. Six months later, Shay was fired.

As a member of RNAO, she called the association looking for support, and received it through the Legal Assistance Program offered to members. RNAO “supported me and believed me from day one,” she says. “It was the best feeling.”

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Shay retained a lawyer, filed a civil lawsuit against the city, and was eventually reinstated. Then, in a separate case that was settled in 2011, the Ministry of Health laid charges for illegal retaliation against the City of Cornwall and Menagh. In October 2011, the city pleaded guilty, was fined $15,000, and was required to pay $3,750 to the Victim/Witness Assistance Program. RNAO responded with a media release, praising the outcome of the case, and Shay’s courage to stand up for residents’ rights.

That same year, elder abuse was on RNAO’s radar. The association launched an initiative, in partnership with the Canadian Nurses Association, called the Prevention of Elder Abuse Centres of Excellence (PEACE) initiative. Ten long-term care homes across the country signed up for the project, which helped nurses and other health-care professionals better identify and report elder abuse.

Although preventing elder abuse was already part of RNAO’s work, Shay’s case catapulted it into the spotlight. One year after PEACE was launched, the federal government provided RNAO with support to create a best practice guideline (BPG) that addresses abuse and neglect of older adults. It was released in the summer of 2014.

Shay, who sits on the Canadian Standards Association’s working group charged with developing whistleblower guidelines, was pleased to hear about RNAO’s BPG, and continues to call for stronger consequences if elder abuse occurs, and if an employee raises concern. “Canada’s in a sad state of affairs when it comes to whistleblowing,” she says. “The (province’s) ministry of health has to get its act together.”

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Now on long-term disability, Shay isn’t sure she’ll return to work again. She paid a heavy price for doing the right thing. In 2013, she was diagnosed with benign multiple sclerosis, with prominent symptoms related to workplace stress. “It’s been devastating. I’ve lost something that I love doing,” she says of a career cut short. Still, she stands by her decision, saying “there was never a question, ever,” that abuse had taken place. As a nurse “you always have a responsibility to report,” she says. “(For me), there was never a choice.”

Shay wasn’t the first and won’t be the last RN to blow the whistle on elder abuse. RNAO plans to continue raising awareness around the issue and its BPG. “What scares me (is) nurses who are going to be afraid to come forward…who’s the advocate now?” Shay says. “That’s why I continue to fight.”