Nursing Shortage
There are sound, fundamental reasons why nursing should be a very
attractive professional choice. The nursing profession has the ingredients
to be an exciting and fulfilling lifetime career option, offering
challenging and diverse practice opportunities. It allows for flexibility
of employment and the opportunity for a balanced family and work
life. It provides for endless career experiences in practice, administration,
education, research, policy, and combinations of all these. Nurses
work with people, addressing holistic human needs throughout the
health-care continuum: health promotion, illness prevention, cure,
care, rehabilitation and palliation. The profession attracts people
dedicated to care.
Nurses are critical for a healthy society and societal trends are
increasing the need for nurses. These trends include: a growing
and aging population; an heterogeneous, differentiated and more
unequal society; contrasts between urban, rural and northern contexts;
cultural diversity and vulnerable social groups facing marginalization;
a technologized health-care delivery system thirsty for human touch;
and finite resources. These trends call for providers that are competent
to deal with multiple challenges. Nurses are prepared and eager
to respond to the call.
Although nurses provide vital services and nursing is an exciting
career option, we are in a serious situation provincially, nationally
and internationally. As the need for nurses increases, the pool
of available nurses continues to decline. Funding cuts have resulted
in unbearable working conditions and unhealthy work environments.
Poor staffing patterns resulting in heavy workloads, and the lack
of professional development opportunities, have lead to an emotionally
and physically exhausted nursing workforce. The widespread forced
move to part-time and casual work has led to fragmented patient
care and the disillusionment of nurses with their profession.
All of these serve as disincentives for the retention of nurses.
Furthermore, boom and bust cycles of nursing employment, in the
context of widening career opportunities for women, do not contribute
to the recruitment of women and men into the profession.
The Ontario government has begun to address some of these issues
through their $50
million nursing strategy.
Contributing to the Shortage
Registered nurses also know that their own health critically depends
upon a well-functioning health system and upon healthy workplaces.
The profession is at risk provincially, nationally and internationally.
A global nursing shortage means Ontario must increase its leadership
to protect and strengthen the profession. Ontario is poised to lose
6000 RNs to retirement or death in 2004. It could lose up to 23,000
RNs by 2006.
Health-care professionals, and in particular nurses, have borne
the burden of past funding cuts and restructuring. It is only through
the dedication and perseverance of these professionals that the
system has continued to deliver quality services.
However, the situation is no longer sustainable. Our aging and
exhausted nursing workforce is retiring in increasing numbers, and
requires immediate relief. For example, by 1997, 46 per cent of
working RNs were over 44 years of age; this figure rose to 53 per
cent by 2002. The total supply of RNs registered in Ontario has
fallen from 113,823 in 1994 to 107,221 in 2002. Recruitment has
not kept pace with departures. Nursing in Canada has ironically
become one of the sickest professions, due to stresses and burnout.
Consequences of the Shortage
At the same time as the RN supply has shrunk and employment has
remained stagnant, Ontario’s population continues to grow.
As a consequence, we are suffering from an acute shortage of registered
nurses. The Ontario public currently needs about 14,000 more RNs.
Furthermore, Ontario has the worst RN-to-population ratio in the
country (65.0 RNs per 100,000, compared to 78.6 for the rest of
Canada. The situation has been deteriorating for many years and
much faster than it has for the rest of the country.
Ontario is losing RNs in many ways; they are leaving Ontario to
work elsewhere (6,336 of those who retain Ontario registration alone;
we do not know how many others left without retaining registration
here), they are leaving for other kinds of work, and they are retiring,
often well before age 65.
Gaps in Care
The nursing profession in Ontario is also experiencing the destabilizing
effect of inequities in salary and other working conditions between
the hospital sector and the home health care and long-term care
sectors. When positions come available in the hospital sector, nurses
from home care and long-term care are attracted to move because
of compensation disparities. This contributes to gaps in continuity
of care and reduced morale within the nursing profession.
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