The Nursing Shortage in Ontario

The Role of Nursing

According to David Coburn, Nursing is a vital health occupation (Coburn, 1988). Nurses provide professional care for patients in hospitals (Coburn, 1988). Registered Nurses Association of Ontario (RNAO) states that there is convincing evidence that reported nurse (RN) care is linked to positive patient outcomes and a decrease in mortality and morbidity rates (RNAO, 2021). RNs save the healthcare system overall, for example, through fewer complications and fewer readmission (RNAO and ONA, 2022). There are so many specialized areas in that RNs can work in Ontario. I know fellow RNs who work in acute and community health care settings. I know RNs who work in public health, in schools, in long-term care, in private homes, in clinics, in the judicial system, in family physician offices, in cosmetic surgery clinics, in remote northern areas, in the pharmaceutical industry, in corporate offices, etc.

The Nursing Shortage in Ontario and Covid 19

I believe the Covid 19 pandemic has drawn more public attention to the importance of nursing roles within the healthcare system. It has highlighted the nursing shortage, especially in Ontario, and the nursing shortage. In my opinion, I believe that mainstream media has created more public awareness about this shortage. According to the RNAO, “Ontario’s long-standing RN understaffing problem has become an RN human resource crisis magnified by the COVID-19 pandemic” (RNAO, 2021). Before the Covid 19 pandemic, Ontario was already dealing with a nursing shortage based per capita compared to the rest of the country (RNAO, 2021). Throughout the Covid 19 pandemic, “RNs have fought tirelessly to save the lives of those in their care, while also doing the best they can to protect themselves and their families” (RNAO, 2021). A global news journalist stated that Canada is about to experience a nursing shortage that we have never seen before (Stewart, 2022). Nurses, especially those in acute and long-term care settings, are burnt out from constantly working understaffed and pressured to work overtime hours (Stewart, 2022).

My Experience During the Beginning of the Covid 19

Pandemic Working in an Acute Care Setting

I went on maternity leave during the pandemic in late 2020. Before going on maternity leave, I was told I would have to work in a Covid 19 Mental Health unit because my unit was closing down temporarily. I had to tell my manager at the time that I was pregnant and at considerable risk if I contracted Covid 19. I got the support of my union and my family doctor at the time, so I worked remotely in my office, on a floor by myself (in a building outside of the main hospital), as an addiction consultant for the hospital. In my temporary role as the addiction nursing consultant in the hospital, I held the pager for the Addiction Services program. I would have to coordinate MD requests for addiction consults on patients. I also assessed patients remotely over the phone who would show up in the family medicine department for the Rapid Access to Addiction Medicine clinic twice a week (RAAM).

Fears that I Would Be Forced Back From Maternity Leave Early and

Reassigned to A New Unit

I remember receiving an email from the Union that I used to be a part of when I worked at the Local Health Integration Network (LHIN)/Ontario Health. This email highlighted that the Ministry of Health was looking to transfer nurses in care coordinator positions to work in acute and long-term care settings to combat the nursing shortage. This plan fell through because many feared being of these nurses had no recent nursing experience. Some had not done bedside nursing for over 20+ years. Many of these nurses felt that if they were forced to work in unsafe high-risk environments, especially without the proper training, they would be putting themselves, their license, and patients at risk. I feared I would be forced back early from my maternity leave in 2020/2021 because of the nursing shortage. I was apprehensive about my newborn, but at the same time, I felt compelled to want to help patients, especially in Long-Term care settings.

Registered Nurses Association Ontario (RNAO) and Recommendations to

Combat the Nursing Shortage

The following are recommendations from the RNAO to the provincial government on how to retain and recruit RNs:

1. Repealing Bill 124

Bill 124 caps compensation increases for a broad range of public sector workers, including nurses, at just one percent. Despite their tireless efforts to care for Ontarians during the pandemic, nurses’ incomes are not keeping up with the cost of living. The lack of respect implicit in Bill 124 triggers many RNs to leave their profession or practice outside of Ontario. Bill 124 must be repealed as an immediate first step for RN retention in Ontario.

2. Increasing RN supply:

a. Increase enrollment and corresponding funding many in four-year

baccalaureate (Bachelor of Science in Nursing (BScN)) programs, second

entry/compressed programs, and RPN-to[1]RN bridging programs by at

least 10percentt annually for eight years.

b. Compress RPN-to-BScN bridging programs to two years.

c. Fast-track applications and develop funding pathways for

Internationally educated nurses (IEN) to become RNs in Ontario.

d. Support faculty retention and recruitment in both CAATs and university programs as a crucial strategy to increase RN supply in Ontario.

3. Immediately developing and funding a Return to Nursing Now Program (RNNP) to attract

RNs back into Ontario’s nursing workforce.

4. Supporting nurses through their careers by expanding the Nursing Graduate Guarantee

(NGG) program and reinstating the Late Career Nurse Initiative (LCNI).

5. Immediately establishing a nursing task force to make recommendations on matters related

to recruitment and retention of RNs, including but not limited to:

a. increasing full-time employment opportunities

b. competitive salary and benefits across all sectors

c. reducing workloads

d. increasing opportunities for mentorship and professional development

e. increasing occupational health and safety measures and enforcement hereof (RNAO, 2021)

Undoubtedly, it is evident that there has been a mad exodus of nurses leaving the profession altogether. RNAO believes that “Ontario will not be able to sustainably retain and recruit an RN workforce in the absence of substantially improved working conditions,” (RNAO, 2021). RNAO insists that an urgent task force of government officials, nursing associations, unions, health-system employers, and employer associations is developed to ensure the necessary improvements are made (RNAO, 2021). RNAO has repeatedly called for this task force and says delays harm Ontarians and the health system (RNAO, 2021). I have had conversations with other RNs about the possibility of being forced to work in healthcare settings facing nursing shortages, especially if we experience another pandemic/Covid 19 wave. I hope that it never comes to that point and that the government develops a sustainable, realistic, and desirable plan to combat the nursing shortage.

References

Coburn, D. (1988). THE DEVELOPMENT OF CANADIAN NURSING:

PROFESSIONALIZATION AND PROLETARIANIZATION. International Journal of

Health Services, 18(3), 437–456. http://www.jstor.org/stable/45130872

Mulligan, C and M. Bond. (2022, January 6). City News Everywhere: Ontario short thousands of

nurses as staff burn out during COVID-19 pandemic. City News Everywhere.

Retrieved May 31, 2022, from https://toronto.citynews.ca/2022/01/06/ontario-

nurses-burnout-covid19-pandemic/

Registered Nurses Association Ontario (RNAO). (2021, November). RNAO Political Action Bulletin - Ontario’s RN Understaffing Crisis: Impact and Solution. Https://Rnao.ca/Sites/Default/Files/2021- 11/Ontarios%20RN%20understaffing%

20Crisis%20Impact%20and%20Solution%20PAB%202021.Pdf.

Retrieved May 31, 2022, from https://rnao.ca/sites/default/files/2021-

11/Ontarios%20RN%20understaffing%

20Crisis%20Impact%20and%20Solution%20PAB%202021.pdf

Registered Nurses Association of Ontario and Ontario Nurses Association. (n.d.). RNAO and ONA - Joint Statement: Ontario Needs More Nurses. Registered Nurses Association. Retrieved May 31, 2022, from https://www.ona.org/wp- content/uploads/ona_rnao_jointstatement_may2018.pdf

Stewart, A. S. (2022, January 6). Canada Headed for Nursing Shortage Beyond anything that we have experienced. Https://Globalnews.ca/News/8487144/Canada-Covid- Nursing-Shortage-Alarm/. Retrieved May 31, 2022, from https://globalnews.ca/news/8487144/canada-covid-nursing-shortage-alarm/