Retaining nurses top priority to stem exodus, report says

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Canada needs a multi-pronged strategy to stem the outflow of nurses from the profession, according to a report by two University of Ottawa researchers.

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“The crisis is unprecedented. We need bold action and we need it fast,” said Ivy Bourgeault, the uUniversity Research Chair in Gender, Diversity and professions and co-author of Sustaining Nursing In Canada, published Thursday.

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“We need a number of people whose full-time jobs are to solve this problem,” Bourgeault said. “It’s a problem that quickly spirals out of control. People leave because the environment is toxic. Or they retire by working part-time. It’s a huge exodus.

According to Statistics Canada, the number of job vacancies in the health care and social assistance sector hit a new high of 136,800 in the first quarter of 2022, up 5% from the peak in the fourth quarter of 2021 . This included 22,9000 vacancies for registered nurses and registered psychiatric nurses, while vacancies for licensed practical nurses reached 11,300.

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For nurses, the crossing problems to understand inadequate recruitment, excessive workloads, forced overtime, toxic workplaces and violence, the researchers note. The the pandemic has exacerbated these problems and introduced new problems such as overcapacity issues.

It is a complex problem on several levels. But Bourgeault and co-author Houssem Eddine Ben Ahmed also see it as a vicious cycle that can be interrupted, starting with restraint nurses already in the workforce, promote the come back of those who left and recruitment — in this order of priority.

“There are things we know we can act on now. We have to stop the bleeding with retention, we have to create pathways to get the nurses back,” Bourgeault said.

Among dozens of other measures, the report calls for national patient nurse reports ; mental health days to prevent stress and burnout; more time for professional development to improve job satisfaction; funding flexible programs for nurses who have left the field to allow them to return; and a national public awareness campaign on workplace violence against healthcare workers.

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One of the most promising measures is to reduce the workload, says the report, which also recommends streamlining the immigration and registration process and helping to facilitate the hiring process for internationally educated nurses.

« The crisis is global, » said Ben Ahmed, part-time professor at the Faculty of Social Sciences and holder of a doctorate in nursing sciences. « We have nurses in Canada who are still struggling with the immigration process, the registration process and the hiring process. »

Researchers looked at successful programs and policies in other jurisdictions, as well as academic studies. For example, a program in British Columbia allows nursing students to enter a paid internship program up to 300 hours before graduation, helping them gain skills and experience while earning a salary.

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The proposed solutions must be seen as an integrated package for coordinated action, said Ben Ahmed.

« If we only took one of the two solutions, it wouldn’t solve the problem, » he said. “We have report after report that suggests the same thing. if you want to support the nursing workforce, you have to take all the solutions together.

Canada doesn’t have a national health workforce strategy — and that’s a major problem, Bourgeault said. Health expenditure is nearly half of provincial and territorial budgets and more than 8% of Canada’s GDP, making the lack of workforce planning is even more glaring, she said.

The federal government has announced a number of recent initiatives to address health workforce challenges, including $26.2 million in the latest budget to increase the repayable amount of student loans for doctors and nurses working in rural and remote areas.

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On November 1, Health Canada held the first meeting of its « coalition for action for health workers”, which consists of advising on immediate and longer-term solutions.

The coalition provides a discussion forum on workforce planning. But that doesn’t take into account health professionals other than doctors and nurses such as pharmacists, paramedics, diagnostic technicians and mental health professionals, Bourgeault said. This is unfortunate as some solutions will involve deploying health workers in different ways. We can’t keep doing the same thing with fewer workers working the same way, she said.

Nursing shortages occur every 15 to 20 years and nurses’ unions have warned governments there will be another, said Linda Silas, president of the Canadian Federation of Nurses Unions , which funded the independent report.

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A national strategy would allow employers to predict how many nurses would be needed in five or 20 years, Silas said. “We have one of the largest workforces in Canada and one of the most expensive, and there is no planning.

One of the problems is that about half of nurses work part-time, casual or contract. Often they find full-time work too difficult and their workplace toxic, Silas said. In a recent survey, the union found that half of nurses want to change jobs because of workload and lack of respect.

« We need to talk about it, » she said.

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