Canadian nursing is in a crisis
Exhausted nurses are retiring or quitting, and without change the future is bleak
A doctor might swoop in to save the day, but we mostly deal with nurses. They are the face of medicine — they assess needs, do triage, visit bedsides, check vital signs, dispense medications, answer questions and spot problems before they spread.
But, when nurses are burnt out, they’re less able to see the whole patient. When they can’t relate to their patients as individuals or take time to provide education, patients are less likely to comply with medication instructions. Burnout and lost compassion cost time and money and decrease quality of care.
We should all be deeply concerned, because after nearly two years of COVID-19, Canadian nursing is in crisis. Overtime hours are up 78 per cent. Exhausted nurses are quitting or retiring early and hospital units are cutting services at the worst possible time. Statistics Canada says the country is short nearly 100,000 registered nurses and psychiatric nurses.
While supporters have been ringing bells and putting hearts in their windows, young people have been offering to serve. Across the country, Canadian nursing schools are reporting application surges of 30 to 60 per cent. But while that feels like fresh blood, it won’t be that simple. Our demographics are getting older, creating more burden on health systems. And many provinces lack the clinical practice sites or funding to capitalize on the boom in applications.
The CBC recently interviewed a young Nova Scotia woman who wasn’t accepted to nursing school at St. Francis Xavier despite a 94 per cent average and a deep affinity for nursing. Nova Scotia has a 20 per cent nursing vacancy rate and would love to train more nurses, but it can’t. Grade requirements are actually
increasing because chronic staffing shortages have starved provincial systems of clinical placement spots, which require supervision by working nurses. They are literally turning young people away because they’re too busy to train them — the very definition of a crisis.
Until the provinces solve for demographics and funding, health systems will have to make the most of the staff they have and the limited number of new hires they can take in. But how?
First, they need to make life better for practising nurses, to stop stanch departures and free up time for training. They need to lighten the load on these irreplaceable staff — economizing on overtime, eliminating workplace violence and abuse, revisiting wage freezes, restoring orientation and mentoring hours, and addressing systemic burnout.
Second, they need to draw in recently retired or departed nurses. In some parts of the country, they’ve been coming out of retirement to serve on the front lines or free up younger nurses. Even after the pandemic ebbs, hospitals need to retain and find more of them for training.
And third, if they can’t increase hiring, they need to be certain the young candidates they take in will stick around. That means fostering resilience and soft skills in nursing school, screening prospective students thoroughly during the admissions process and not selecting solely for grades. Until recently, nearly all Canadian undergraduate nursing schools ran admissions exclusively on grades, but this is changing. I’m not picking on St. Francis Xavier — they take this as seriously as any school in Canada. Just 60 per cent of a St. FX nursing school application is based on raw grades. The other 40 per cent is driven by situational judgment and aptitude, with the help of the Casper test (developed by Altus).
Nursing has always required good grades and cognitive scores. But schools, employers and students must understand they’ll need passion, resilience, soft skills and support to help them through COVID, the nursing crisis and beyond. Nurses are the face of Canadian hospital medicine — we have to make the most of them, and we can’t afford to lose them.