How the current provincial government is failing us by pushing for privatization.
What is Happening?
The Ontario nursing shortage is finally getting the attention of the general public as emergency rooms and intensive care units have been forced to temporarily close. At least 14 hospitals in the province were operating without these key services one weekend earlier this month (Dyer, 2022), and these closures will only worsen without adequate action from the provincial government.
Nurses and quality of patient care are suffering:
One study found that nearly 7 in 10 nurses (68%) in Ontario cannot provide adequate patient care, as they do not have enough time or resources, and 66% said they have had to take on more patients with higher patient–to-nurse ratios (Rodriques, 2022).
86% said they have been asked to take on more shifts or overtime to cover staffing shortages (Rodriques, 2022).
79% said they are experiencing moral distress on the job – up from 68% in 2020 survey (Rodriques, 2022).
86% said their mental health is hurting because of the work they do and 67% said they do not feel they have adequate mental support (Rodriques, 2022).
Alarming Findings
Some alarming findings to help you grasp the severity of this issue:
In the first quarter of 2021, nearly 1 out of 5 unfilled jobs in Canada was in the health-care and social assistance sector, which includes nurses, according to Statistics Canada's Labour Force Survey data (Weikle, 2021)
Almost half (47%) of RPNs from one study said they are considering leaving the profession for good, which jumped from 34% in the 2020 survey (Mastroianni, 2021)
At least 13% of RNs between the ages of 26-35 reported they were very likely to leave the profession after the pandemic and 4.5% of respondents who are late career nurses say they plan to retire now or immediately after the pandemic (Tsekouras, 2022)
The Canadian COVID-19 nursing workforce survey found that 68.5% of respondents plan to leave their current position within the next five years, 12.6% of whom plan to leave the profession altogether, while 29.4% plan to retire (RNAO, 2021)
How Long Has This Been a Problem?
The COVID-19 pandemic has only exacerbated existing issues. The nursing shortage in Ontario isn't new. The number of RNs per capita in the province has trailed the rest of Canada for 3 decades. In fact, Ontario entered the COVID-19 pandemic nearly 22,000 RNs short of the rest of Canada on a per-capita basis in March 2020 (RNAO, 2021).
The Registered Nursing Association of Ontario (RNAO) reported that nursing vacancies in Ontario have more than quadrupled over the last 5 years - RNs in Ontario have been steadily leaving the public workforce since early 2015. There was a 56% increase in vacancies over the first half of 2021, nearing 9,000 by the middle of 2021 (Tsekouras, 2022).
The COVID-19 pandemic was a breaking point for many nurses, along with the introduction of Bill 124 in 2019, wage suppression legislation that caps public sector compensation increases to 1%, a slap in the face to nurses.
COVID-19 brought additional challenges - unmanageable patient assignments, increased overtime, extreme stress and burnout, managing health and safety protocols, and so on.
What is Causing This Issue?
The number of RNs employed in nursing in Ontario continues to decline – 76.3% in 2003 to 65% in 2021 (ONA, 2022). The replacement of RNs with RPNs combined with population growth and more demand from more complex patients is contributing to the shortage in addition to poor workplace conditions.
The Ontario Nursing Association (ONA) surveyed 628 members who recently exited workplace and major themes included:
Workload
Lack of work-life balance
Wages and benefits
Lack of respect and feeling valued
Disrespectful treatment of nurses by government and employers
Concerns about health and safety
Concerns about mental and physical health
There is a vicious cycle occurring → poor working conditions discourage nurses from staying in profession, while the shortage of people joining the profession further exacerbates issues.
Recommendations to Improve Nurse Retention from the RNAO and ONA
We improve nurse retention by improving working conditions and showing nurses that they are respected and valued:
Repeal Bill 124 to restore the right to collective bargaining
Guarantee access to appropriate PPE
Implement 10 permanent paid sick days for all workers
Expand funding and access to mental health services
Tackle violence in the workplace - fully implement recommendations in the Workplace Violence Prevention in Health Care Progress Report
Repeal Bill 195 – allows employers to strip RNs of hard-won constitutional contract rights outside of a state of emergency
Implement the SARS Commission recommendations
Increase supports through WSIB for front-line and essential workers with COVID-related mental stress claims + claims from those suffering with long-haul COVID symptoms
Fund wage parity with hospitals across all health sectors and create more full-time nursing positions to a minimum 70% full-time
Bolstering the workforce:
Increase number of RN seats at Ontario universities and colleges and ramp up financial supports (OSAP)
Expand bridging programs (RPN to RN)
Fund new jobs for late-career and recently retired nurses to mentor new nurses + students
Expedite processes for internationally educated nurses (IEN) to become RNs in Ontario
Fund and develop a Return to Nursing Now Program (RNNP) to attract RNs back to nursing workforce
Improve working conditions to attract more workers
Improving healthcare for all:
Stop privatization of home and community care to improve continuity of care for patients
Phase out “for profit” long-term care homes
Repeal Bill 218 – shields long-term care owners and operators from liability for their negligence during the COVID-19 pandemic
Reverse the 2019 cuts to public health programs
What are Premier Doug Ford and Minister of Health Sylvia Jones Doing About it?
Doug Ford loves to talk about all the beds he's added to hospitals, but what's the point if there's no one to staff them? He also loves to how he's hired more nurses but what the point if he's doing nothing to retain them? The healthcare system cannot function without our experienced nurses.
Despite nursing leaders in the province providing various recommendations, Ford refuses to listen. In the recent provincial election, every other major party leader had planned to repeal Bill 124 (Bond & McAllister, 2022). Ford proves time and time again that he doesn't care to listen to nurses. Meanwhile, in a rare appearance by Sylvia Jones, she recently blamed the nursing crisis on nurses taking vacations.
This crisis didn't happen by accident, it was years in the making through insufficient planning, inadequate funding, and blatant disrespect for nurses. Now, Sylvia Jones says they aren't ruling out privatization. This fight isn't just about repealing Bill 124, it's about improving working conditions for nurses to ensure nurse well-being and patient safety, as well as the fight for a public and accessible healthcare system.
What Can You Do?
Listen to nurses and other healthcare workers and call on the government to do the same
Call on the government to repeal Bill 124
Advocate to keep healthcare public
Vote for people committed to improving working conditions for nurses and all healthcare workers
Get vaccinated
Donate money to charities supporting healthcare workers, such as ones ensuring adequate PPE in healthcare settings
References
Bond, M., & McAllister, M. (2022). Ontario parties vying for power in 2022 election need to address nursing shortage: ONA. Retrieved from https://toronto.citynews.ca/2022/05/24/ontario-election-promises-2022-nurses/
Dyer, O. (2022). Covid-19: Ontario hospitals close wards as nursing shortage bites. BMJ, 378. doi: https://doi.org/10.1136/bmj.o1917
Mastroianni, J. (2021). Jobs in demand: The pros and cons of becoming a nurse in Ontario. Retrieved from https://nowtoronto.com/lifestyle/education/jobs-in-demand-pros-cons-become-a-nurse-ontario
Ontario Nurses’ Association [ONA]. (2022). Front-line nurses offer concrete solutions to improve staffing, fix critical issues plaguing health care. Retrieved from https://www.ona.org/news-posts/nurses-pre-budget/
Registered Nurses’ Association of Ontario [RNAO]. (2021). Ontario’s RN understaffing crisis: Impact and solution. Retrieved from https://rnao.ca/sites/default/files/2021-11/Ontarios%20RN%20understaffing%20Crisis%20Impact%20and%20Solution%20PAB%202021.pdf
Rodriques, G. (2022). 7 in 10 Ontario nurses say they can’t provide adequate patient care, study says. Global News. Retrieved from https://globalnews.ca/news/9033637/ontario-nurses-study-adequate-patient-care-profession/
Tsekouras, P. (2022). Ontario's nursing shortage has been an issue for years. Why weren't we prepared for the COVID-19 pandemic? Retrieved from https://toronto.ctvnews.ca/ontario-s-nursing-shortage-has-been-an-issue-for-years-why-weren-t-we-prepared-for-the-covid-19-pandemic-1.5754102
Weikle, B. (2021). Canada was already desperately short of nurses before COVID-19. Now nurses say they're hanging on by a thread. CBC Radio. Retrieved from https://www.cbc.ca/radio/whitecoat/canada-nursing-shortage-covid-pandemic-1.6174048
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