Agencies are cashing in on nursing crisis
Privately operated nursing agencies are taking advantage of the widespread nursing shortage and creating havoc within our profession, pushing profit margins to astronomical levels while bringing publiclyfunded organizations close to bankruptcy.
In many circumstances, agencies are creating more harm than good within our healthcare system and have become predatory.
Nursing agencies have been around for decades and served a necessary and valuable part in health-care services, especially for addressing short-term staffing shortages. They have now become bandages for a chronic nursing shortage which has been exacerbated by COVID-19.
They were never intended to fill chronic, provincewide, fulltime nursing staff shortages, and the Ministry of Health cannot accommodate the spending this permanent patch-job demands.
Unfortunately, many rural hospitals and long-term-care homes, particularly under the strain of more than two years of crisis-level COVID-19, have had no choice but to use them, having been left with few options and little support. Using agency nurses at agency prices has raised such facilities’ total spending on outsourced nursing to six times what it had been before the pandemic. This is unsustainable.
The citizens of Minden, Ontario learned April 20 that their emergency department will be closing on June 1, with Haliburton Highlands Health Services citing staff shortages as the main cause. The impact of this decision is being felt across the entire community, and more than 16,000, including permanent and seasonal residents, have signed petitions against the planned closure.
Nursing agencies can take advantage of staff shortages because there is so little regulation or restriction on how they can operate. For them, there is opportunity in the current lowsupply, high-demand dynamic that permeates the health-care system. Some agencies are testing how far they can push their rates, with some charging as much as $300 an hour when the typical salary of a nurse is about $40 an hour.
Public hospitals in Ontario are, by public statute, not allowed to offer wage premiums or provide incentives.
The situation breeds conflict among colleagues since local nurses are earning far less than the agency nurses who work side-by-side with them, and lower-paid permanent staff must often train agency nurses in procedures specific to their facilities and supervise their clinical work.
It’s not surprising this has led many to quit their staff jobs to earn more with agencies. This dynamic is harming the nursing profession, often creating a toxic environment and making it harder for our students and new nurses to grow and flourish within the public health-care system.
Attracting nurses to agency work has become very competitive, with new graduate incentives and sign-up bonuses as high as $25,000 in some rural areas for those who agree to stay and work for two years.
The worldwide shortage of nurses has led provinces to attract nurses from abroad. Is this the right solution? It takes time and money to assure foreigntrained nurses are certified and equipped to deliver safe and competent care here. Further, this practice depletes nursing resources in countries that desperately need nurses themselves.
We should be training more homegrown nurses to meet the needs of our Canadian healthcare system, and be helping, not hurting, other countries.
We need to stabilize our nursing shortage here in Canada and have support from the Ministry of Health with the recent expansion of nursing student seats in our undergraduate programs, to build sustainable health care in rural hospitals and elsewhere.
More partnerships between universities and rural hospitals for student placements will build capacity and attract new nurses, nurse practitioners and physicians to rural areas. At the same time, we can build a more equitable system so all Canadians can access modern, adequately resourced health care.
Minden is just the beginning.