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August 30, 2021

Op-ed: Without a nurse, a bed is just a bed

Nursing Shortage

The following opinion editorial first appeared in Toronto Star on August 30, 2021.  

Without a nurse, a bed is just a bed

Solutions for the nursing shortage in Canada 

By Linda Silas

Throughout the COVID-19 pandemic, we repeatedly heard about a shortage of beds in hospitals and long-term care. Field hospitals were deployed, equipment was relocated and supplies were stockpiled. In marshalling these resources, governments often failed to ask a basic question: who will provide the care?

The diverse roles and highly specialized skills of nursing staff were frequently overlooked during the pandemic. A competent critical care nurse can’t be produced on demand. Nor are nurses readily interchangeable; their unique training, on the job experience and regulatory bodies dictate what they can (and cannot) do to care for certain patients.

As we move through the second year of this global pandemic, it is time we recognized the heavy physical and psychological toll this experience has had on nurses. Burnout is now endemic, and nurses are leaving the profession in droves.

When COVID-19 arrived at our doorstep, our health care system was already stretched thin. Now, after hundreds of thousands of overtime hours, countless back-to-back shifts of up to 24 hours in length, and many cancelled vacations, nurses are being told they cannot rest because our health care system has no give.

To make matters worse, some governments are eagerly looking to balance their books on the back of nurses through wage cuts, wage freezes and rollbacks. Quite a thank-you gift!

Many nurses have had enough of being under-supported, undervalued and outright disrespected; many are taking early retirement or heading back to school to shift to other, more rewarding, work. Others, in quiet desperation, are quite simply walking out the door.

In the first quarter of 2021, there were almost 100,000 vacancies in the health care and social assistance sector, representing nearly one in five vacant jobs in Canada. As the pressure on nurses continues unabated, these numbers will surely grow. Workload issues existed pre-pandemic; COVID-19 has made them worse.

The repercussions of the predicted nursing shortage, along with its negative impacts on wait times and patient care, are now evident in every province in Canada. Governments and employers are looking to fill the gaps by offering thousands in signing bonuses, attempting to lure nurses from other provinces. This is a temporary solution at best; moving nurses from place to place won’t solve the nursing crisis.

Nurses’ unions have repeatedly sounded the alarm about insufficient staff; this is now our main message for employers and governments.

Tragically, it took a global pandemic, and many deaths, to finally highlight the complete absence of federal leadership when it comes to health workforce planning and the implication this has for meeting Canadians’ health care needs. Without basic data on health workers, including nurses, decision-makers are forced to plan in the dark. Significant federal investments are also needed to better manage and support the health workforce.

Other countries, such as New Zealand and Australia, have taken proactive steps to bridge the gap between the nursing supply and public demand. They have created national coordinating bodies to provide better data and tools for workforce planning. We should follow suit. The federal government should create a health workforce agency with an explicit mandate to significantly enhance existing health workforce data.

To date, over 50 health care organizations, representing employers, associations, unions, and educators along with over 200 individual signatories, notably including hospital CEOs, have signed onto this proposal.

In the meantime, the federal government urgently needs to invest in retention programs to stem the exodus of nurses from the profession. While recruitment and new hires are essential, new graduates depend on the mentorship of more experienced nurses, especially in the early stages of their careers.

The health workforce is an important public investment; it accounts for more than 10 per cent of all employed Canadians and nearly eight per cent of GDP. The construction industry in Canada has better workforce planning through Buildforce, than the health care sector. This enables the construction industry to forecast its qualified labour needs years into the future.

We need to do the same in health care.

If we value nurses, if we want to keep patients and residents safe, and if we want to ensure wait times don’t continue to grow, we need to invest in better national health care planning.

In poll after poll, Canadians rate health care as a top priority; it’s time for the federal government to invest in what matters to Canadians.

Linda Silas is a nurse and president of the Canadian Federation of Nurses Unions.