RNAO’s Nursing Career Pathways calls for breaking barriers to support and retain Ontario’s nurses

March 2, 2023

A strong and vibrant nursing workforce is the key to a well-functioning health system and a healthy population. To ensure the health and wellbeing of Ontarians, government must dedicate full attention to nursing and provide adequate and sustained funding and supports, argues a new report by the Registered Nurses’ Association of Ontario (RNAO).

Released Thursday during RNAO’s 23rd annual Queen’s Park Day, Nursing Career Pathways examines the nursing profession and the opportunities before the government to build nursing careers and fix Ontario’s health system. The report also highlights the barriers to retaining and recruiting nurses in Ontario – inadequate and inequitable compensation and unsafe and unhealthy workloads – and identifies opportunities for short-term and longer-term improvements. 

Educating the public and elected officials about nursing and providing detailed health human resources information on the nursing crisis, the report demonstrates the richness and breadth of the profession. RNAO President Dr. Claudette Holloway says “this report will encourage nurses to reflect on their role and become inspired by their colleagues, their profession, and most importantly, themselves. Our report celebrates all nurses.”

Nursing inspires, attracts and fulfills people who choose to care for others. And it is a profession of lifelong learning, with nurses constantly drawing on their education and the experience they gain throughout their careers and from their mentors. “The nursing profession is a world of opportunities, with many education and career pathways, each pathway deserving equal recognition and support,” says Holloway. The report features several Ontario nurses and nursing students showcasing diverse and rich journeys available to personal support workers, registered practical nurses (RPN), registered nurses (RN), and nurse practitioners (NP).

Over the past three years, RPNs, RNs and NPs across Ontario have selflessly risked their health and safety, endured staffing shortages, and experienced burnout and mental health challenges to provide care. Shockingly, the real income of nurses has been declining since 2010. “The fall in nurses’ incomes has steepened with high inflation and the government’s wage restraint legislation (Bill 124),” Holloway decries. Because of overload and financial constraints, many nurses have left the province or the profession – and the number of RN and RPN vacancies is growing. “Nurses – the backbone of our health system – must be fulfilled and valued if they are to continue their essential work,” Holloway adds. “The crisis in nursing is real, is tragic, and we all pay dearly for it with our health. We will pay even more if we don’t address it,” she says.

According to RNAO CEO Dr. Doris Grinspun, “the crisis results from system-wide failure to recognize the centrality of nurses’ work and their fundamental role.” Nursing Career Pathways is the most recent in a sequence of hard-hitting reports by RNAO aimed at exposing the current state of nursing in our province and outlining solutions. “Our key message is that we must build nursing careers in Ontario through better retention and recruitment strategies.”

Among the report’s 24 recommendations to break down longstanding barriers and actualize opportunities:

  • Provide competitive compensation and address pay disparities across health sectors.
  • Ensure safe workloads and healthy work environments.
  • Focus on full-time employment, mentorship and professional development, occupational health and safety, leadership training, and other workplace supports.   
  • Expand scope of practice, such as RN prescribing, NP scope of practice and NP-led clinics. 
  • Offer continuing education and professional development opportunities.
  • Fast-track registration of internationally educated nurses residing in Canada with the province’s regulatory body in a timely manner.
  • Expand nursing education seats by further increasing enrolments and funding in key educational programs (RNs, NPs, bridging programs, masters and PhD/DNP/DN-prepared RNs).
  • Expand nursing education pathways so nurses can advance their education and careers.
  • Create a return to nursing program to attract 33,000 non-practising nurses in Ontario.
  • End systemic racism and discrimination by mandating the collection of race-based data, cultural safety education, as well as diversity, equity and inclusion policies and programs.

Grinspun calls on the Ontario government and employers to immediately adopt in full these recommendations. “We must unleash our powerful profession to best serve Ontarians. This investment will pay off in the healing of our health system for tomorrow and for years to come. Today, we put policymakers, government and employers on notice: You must fast-track funding and opportunities to enable nurses and their workplaces to thrive and build careers in Ontario. A stronger nursing workforce means better health outcomes for Ontarians. Our nurses – and our communities – deserve nothing less.”

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 or follow us on TwitterFacebook and Instagram.

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Contact info

Madison Scaini
Communications Officer/Writer
Registered Nurses' Association of Ontario (RNAO)
Marion Zych
Director of Communications
Registered Nurses' Association of Ontario (RNAO)
Victoria Alarcon
Communications Officer/Writer
Registered Nurses' Association of Ontario (RNAO)