Deep crisis in nursing demands urgent action by government, employers, educators and associations

New survey results shared in a pivotal report released Thursday by the Registered Nurses’ Association of Ontario (RNAO) highlight instability in the nursing profession that, left unchecked, will have profound impacts on the profession, the effective functioning of the health system and the quality of care Ontarians receive.

The results are detailed in the report Nursing Through Crisis: A Comparative Perspective. RNAO carried out a detailed survey from May to July 2021, during the height of Ontario’s third wave. Responses from 5,200 Canadian nurses, most of them from Ontario, were analyzed and compared with the association’s earlier Work and Wellbeing Survey Results report, as well as with similarly focused national and international surveys that examined the struggles of nurses working throughout the pandemic.

RNAO CEO Dr. Doris Grinspun says “the numbers are both sobering and alarming and represent a call to action for the government, health employers, educators, and nursing associations.” More than 75 per cent of Canadian nurses who responded to the survey were classified as burnt out, with higher percentages among hospital and front-line workers. Sixty-nine per cent of nurses said they planned to leave their position within five years. And, among those who indicated they wanted to leave their position, 42 per cent said they were planning to leave the profession altogether and seek opportunities elsewhere or retire. 

Among other major findings from the survey:

• 73 per cent of nurses reported that their workloads increased moderately or significantly during the pandemic
• 60 per cent of nurses were moderately or extremely concerned about staffing levels
• 53 per cent were moderately or extremely concerned about workloads
• 54 per cent were moderately or extremely concerned about skill mix
• Only 35 per cent of nurses said they had adequate support services to spend time with patients/clients
• Nurses struggled in all sectors and domains of practice during the pandemic with hospital and front-line nurses reporting higher levels of depression, anxiety, stress and burnout

RNAO says the results are even more stark when you consider that Ontario went into the pandemic with a shortfall of 22,000 registered nurses (RN) on a per-capita basis compared to the rest of Canada. Grinspun says the survey echoes what RNAO has been saying all along: “Without a detailed health human resources plan that is laser-focused on retaining nurses in the profession and building Ontario’s RN workforce, people’s health and the system’s ability to operate effectively are in danger.”

The report’s recommendations include:

• Repeal Bill 124 – Ontario’s wage restraint legislation – and refrain from extending or imposing any further wage restraint measures
• Immediately increase the RN workforce by expediting applications and finding pathways for 26,000 internationally educated nurses (IEN) living in Ontario that are eager to join the province’s workforce
• Increase enrolments and funding for baccalaureate nursing programs, including second entry and compressed programs by 10 per cent for seven years and compress the RPN-to-BScN bridging program to two years
• Develop and fund a Return to Nursing Now program to attract RNs back to Ontario’s nursing workforce
• Support nurses throughout their careers by expanding the Nursing Graduate Guarantee, reinstating the Late Career Nurse Initiative and bringing back retired RNs to serve as mentors to new graduates and IENs
• Establish a nursing task force to make recommendations on matters related to the retention and recruitment of RNs

In addition to sharing its recommendations, RNAO announced its launch of four programs that will address nurses’ needs for better workplace supports, more professional development opportunities and more control over their working lives. These initiatives include: the Advanced Clinical Practice Fellowship program, the Leadership and Management for Nurses program, the Mentorship for Nurses program, and the Nursing Student Preceptor for Long-Term Care program.

RNAO President Morgan Hoffarth says RNAO’s call to build up Ontario’s RN workforce is backed by the Ontario Hospital Association, Ontario’s Long-Term Care COVID-19 Commission, Colleges Ontario and the Council of Ontario Universities – entities that have all recognized the need for more RNs in the province.

“Nurses play a central role in the lives of Ontarians, in health and in illness. That’s why we need to ensure that all nurses feel valued. And, we must pay unique attention to RNs – who are the ones exiting the profession en masse. We know nurses are committed and have vital expertise, compassion and skills to share. What we need is sustained effort to retain the nurses we have, and ensure welcoming workplaces for new graduates and others who join the profession,” says Hoffarth, adding that “the silver lining is that there is a 35 per cent increase in applications to baccalaureate nursing programs across the province.”   

Join the conversation on social media using #NursingThroughCrisis

The Registered Nurses’ Association of Ontario (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 we serve. For more information about RNAO, visit RNAO.ca or follow us on Twitter, Facebook and Instagram.

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