Executive Summary
Challenges Facing the Nursing Profession
The nursing workforce – registered nurses (RNs), licensed practical nurses (LPNs), registered
psychiatric nurses (RPNs) and nurse practitioners (NPs) – is struggling with numerous complex
intersecting issues including chronic shortages, inadequate staffing, excessive workloads,
mandatory overtime, toxic workplaces, and endemic violence. The pandemic has both
compounded these challenges and introduced new concerns with occupational exposures,
overcapacity issues and significant moral distress. Feeling disrespected, frustrated and
overwhelmed, and lacking control over the way they practice their profession with little to no
work-life balance, many nurses have left and many more are contemplating leaving full-time
positions. This leaves those remaining in the profession with little hope unless there is clear,
decisive, and coordinated action to change the dire situation.
How Did We Get to This Point?
Over the past 20-plus years, report after report has detailed the toll on nursing as a result of
several systemic challenges. Although the federal government and the provinces and territories
have implemented a number of strategies and initiatives in the early 2000s to address nursing
shortages, many of these have been ad hoc and time limited. Further, they have failed to address
the systemic and intersecting nature of the challenges facing nurses, many of which are linked
to poor planning for the whole of the nursing workforce.
Impacts on Nurses, Patients and the Health System
Leaving these chronic nursing workforce issues unaddressed has critical impacts beyond the
nursing workforce. Patient safety, quality care, and health system sustainability are also at risk.
There is extensive evidence linking the inadequacy of nurse staffing to missed care and patient
morbidity and mortality. The perpetuation of these issues will worsen the current crisis, increase
the health care disparities across the country, and have adverse economic impacts. Indeed, the
health sector is not only critical for the services it provides, but it is also a key employment
sector where over 10% of Canadians work, the largest group of which is nurses. Health spending
constitutes nearly half of provincial/territorial budgets and over 8% of Canada’s gross domestic
product (GDP), making the lack of planning in this sector that much more egregious.
What Are the Solutions to Move Forward?
Because the global nursing workforce is also in crisis, we need to implement a coordinated
series of collectively planned, carefully sequenced, and evidence-informed made-in-Canada
solutions to this complex, multi-layered problem that starts with the retention of nurses in the
workforce, fosters return of nurses who have left and considers local recruitment in that order
of priority. Nurses from coast to coast to coast deserve respect and recognition of the critical
role they play in the health care system. Listening to their concerns and acting on the solutions
put forward are essential to addressing the crisis unfolding across our health systems.