Canada is hemorrhaging nurses
A hospital, much less a health system, can’t function without nurses.
They are an integral part of health care delivery infrastructure, and health ministries across the country are putting a lot of pressure on universities to train more nurses so as to alleviate Canada’s dire shortage.
Unfortunately, though many young nurses are starting work in the public health-care system, they’re also leaving at record rates.
In 2022, Canada lost 40 young nurses for every 100 that entered the profession. This represents a 25 per cent increase over the last 10 years.
While this worrying trend varies in intensity from province to province, even the best performer, i.e., Manitoba, is burning 30 young nurses for every 100 that enter the field.
For our health-care systems to lose one in three of the people who embark on a career in nursing within the first few years of their practice is clearly unsustainable.
Even in British Columbia — the second-best performing province — we can see the consequences of this exodus of nurses. In the northern parts of the province, a shortage of nurses caused some emergency rooms to close this summer. Because of this, patients had to be sent to more distant hospitals, up to four hours away and far from their families.
If we don’t tackle the problem of nurse retention at its source, this type of situation is likely to happen more and more.
Nurses all over the country are very clear on what’s wrong in their profession.
In a recent survey, nine in 10 nurses said they experienced “some amount of burnout” in the past year. Among the causes identified are chronic staff shortages and excessive overtime. The constant struggle to maintain their work-life balance has left them dejected.
Only 30 per cent of Canadian nurses are satisfied with their career choice, and the studies are unambiguous: nurses’ work satisfaction is a good predictor of burnouts. You can’t expect a burnt-out nurse to continue for long.
So, what affects nurse satisfaction most? Having flexibility and autonomy in their workplaces.
Almost half of the nurses polled by the Canadian Federation of Nurses Unions said they would definitely stay in their current role if changes were made to scheduling and the process was more flexible. Another quarter of those polled said they would consider it.
And how can we achieve this? By giving nurses more control over their schedules, like B.C. has started doing with its job swapping and sharing pools.
Nurses also need the freedom to choose who they want to work for and where, lest they are more likely to leave. This might be in a government-run hospital or a clinic, but it could also be in a specialized nurse practitioner clinic, for an independent nursing agency, or through self-employment.
In a context in which nurses are burning out due to their poor working conditions, independent agencies often act as a safety net to catch those who might otherwise leave the profession.
Almost one in three nurses who expects to leave their job expresses an interest in agency work.
Restricting nurses’ employment opportunities in an effort to keep them in the public system is likely to backfire and cause more of them to leave altogether.
Already, patients in provinces such as Quebec are starting to feel the effects of government’s attempts to crackdown on independent nurses.
Just this summer, patients in Forestville, in the Côte-Nord region, saw their local emergency room hours reduced to Monday to Friday from 8 a.m. to 5 p.m., due to a lack of personnel. Unless their health emergency occurred during regular business hours, patients were stuck driving an extra 60 kilometres to get to the next nearest emergency room.
Similar stories about emergency departments shutting down partially, or even entirely, are becoming common throughout the province in places such as Outaouais, Abitibi and Montérégie, for example.
In every case, the blame for service reductions was placed squarely on the dearth of available independent nurses.
The provincial government’s attempt to force nurses to work for its own system, rather than for independent agencies, has backfired, and patients have suffered the cost.
What the Legault government failed to understand, and what so many other provincial governments are still struggling to grasp, is that the growth in independent nursing isn’t what’s making our health systems sick. Rather, it is the way our government-run hospitals churn through personnel.
Unless that problem gets addressed, things are only going to get worse.
Emmanuelle B. Faubert is an Economist with the MEI and the author of “Which Provinces Struggle the Most to Keep Young Nurses?” The views reflected in this opinion piece are her own.