Registed Nurses' Association of Ontario


Evidence highlights danger of cutting RNs in Ontario


TORONTO, May 8, 2017 ‒ Despite decades of evidence that registered nurses (RN) keep patients safer and make the health system stronger, Ontario continues to put patients at risk by replacing RNs with less qualified care providers.

The Registered Nurses' Association of Ontario (RNAO) reviewed 70 years of health-care research to create the comprehensive 70 years of RN effectiveness database, which is now available to the public. Of the 626 research studies identified by RNAO's scoping review, more than 95 per cent show RNs have a positive impact on a wide variety of health outcomes, including reduced mortality, increased quality of care, increased patient satisfaction, and cost savings. Yet Ontario has the lowest RN-to-population rate in Canada and RN replacement is commonplace.

"A long history of evidence has overwhelmingly shown that RN care improves health outcomes and strengthens health systems. It's remarkable to see all this evidence together," says RNAO President Carol Timmings. "RNs must be fully utilized across our health system, but Ontario is currently falling far short of this goal."

As of 2015, there were 694 RNs per 100,000 people in Ontario, compared to 833 RNs per 100,000 people in Canada. RNAO's 2016 Mind the safety gap in health system transformation: Reclaiming the role of the RN report highlighted how Ontario RNs are being replaced with less qualified health professionals to save money. This has caused the RN share of the nursing workforce to plummet. The report recommended an immediate end to this troubling and dangerous trend.

"The evidence compiled in this database reinforces what RNAO stated in our Mind the safety gap report. It is dangerous and unsustainable for Ontario to be losing RNs," says RNAO CEO Doris Grinspun. "In fact, the evidence is clear we need more RNs if we're going to keep people healthy, safe, and keep our health system running well."

Ontario has undertaken a major shift in how health care is delivered as part of Health Minister Eric Hoskins' Patients' First initiative. But RNAO insists the province can't achieve its health-care transformation goals without a stronger RN presence in the workforce. This includes mandating an all-RN workforce in tertiary and quaternary hospitals, cancer centres and large community hospitals, requiring that all first home care visits be completed by an RN, and legislating minimum RN and nurse practitioner staffing levels in long-term care.

"It's no secret that RNs are foundational to a high performing health system with positive patient, organizational and financial outcomes," Grinspun says. "The provincial government now has extensive and conclusive evidence, and it's up to our elected officials to act so our health system can be strengthened today and for the future."

RNAO is the professional association representing registered nurses, nurse practitioners, and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system, and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit our website at or follow us on Facebook and Twitter.


For more information or to interview a nurse, please contact:

Daniel Punch
Communications Officer/Writer, RNAO
416-208-5606/1-800-268-7199, ext. 250