Health-care workers take a rest in the employee break room in the intensive care unit at the Humber River Hospital during the COVID-19 pandemic in Toronto on Jan. 25, 2022. According to a new report, a growing proportion of nurses are opting out of the work force.Nathan Denette/The Canadian Press
The total number of nurses employed in Ontario rose this year compared to last, but a growing proportion are opting out of the work force or leaving the province, according to a new report that underscores the pervasiveness of the country’s health worker shortage.
The College of Nurses of Ontario, the governing body of nurses in the province, published a report on Wednesday detailing the registration renewal and employment data of nurses in 2023. It shows that 158,430 nurses reported employment in Ontario for this year, up from 155,018 in 2022 and 150,304 in 2020.
More than 15,000 new nurses registered in the province this year, while about 9,000 nurses did not renew.
New registrations by internationally educated nurses (IENs) are helping drive the general upward trend, according to the report. The college has changed some of its rules to make it easier for IENs to start working in Ontario in response to a shortage of health workers that has led to delays and emergency room closures, among other problems, across the country.
But the proportion of actively working nurses has declined in recent years, going from 90.6 per cent in 2020 at the start of the pandemic to 88.9 per cent in 2023. On top of that, the proportion of nurses who are taking leaves of absence or moving outside the province has risen from 3.3 per cent in 2016 to 4.6 per cent in 2020 to 5.8 per cent in 2023.
While the shifts are relatively small, they temper the gains made in the overall number of nurses working in the province, according to the report.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said the report highlights the fact that many people want to enter the nursing work force. But too many nurses are leaving the profession and not enough is being done to retain them once they are on the job, she said.
“Year after year after year, we are seeing this trend,” she said.
Ms. Grinspun said that nurses are being asked to do more than their duties entail and that poor working conditions and inadequate salary need to be addressed to keep them on the job.
Nurses’ salaries have been a contentious issue in Ontario since 2019, when Doug Ford’s government passed legislation that capped wage increases for nurses and other public workers at 1 per cent a year for three years. The legislation was struck down as unconstitutional last year. The government appealed the decision and the case will be heard at the Court of Appeal for Ontario this week.
The new report from the CNO found that the number of nurses – specifically, registered practical nurses – who are working in long-term care settings has dropped significantly in recent years. In 2016, 38.7 per cent of RPNs reported employment in long-term care, which dropped to 31.3 per cent in 2023.
Dianne Martin, CEO of the Registered Practical Nurses Association of Ontario, said this represents a major concern, given the aging population and the increasing need for more nurses to care for vulnerable patients.
Ms. Martin said RPNs are leaving long-term care because the demands are overwhelming and the pay is far less than they would receive in other workplaces, such as hospitals.
“It’s just mind boggling when nurses tell me what they are expected to do,” she said.
She said the only way to address this is to ensure that nurses are receiving equal pay regardless of workplace and to provide them with better conditions.
“You have to create an environment where nurses are paid the same across all sectors and where workloads are managed, so nurses who love working in long-term care don’t have to give that up to get a decent wage,” Ms. Martin said.
One of the challenging issues in solving the nursing shortage is that it’s not clear how many nurses would be needed to ensure adequate staffing of all health facilities, said Brent Knowles, director of analytics and planning at the CNO. That kind of data isn’t tracked well across Canada, although there is a growing push from the medical community to address this long-standing gap.
As part of the federal-provincial-territorial health funding agreement reached earlier this year, the country’s premiers agreed to start tracking and sharing more health work force data.