By Xiao Xu, Special to The Globe and Mail* – Sep, 2021
The COVID-19 pandemic has exhausted nurses and many are getting out of the field. Experts at nursing schools and hospitals say the country faces an urgent shortage just as some of those wanting to get into the profession are being shut out.
They say the solution should include more provincial funding to increase the numbers of university seats for students, and new approaches to training on the job, better working conditions and possibly expedited schooling.
The Globe and Mail canvassed more than a dozen postsecondary institutions about applications to their nursing programs. Some reported a dramatic surge. The University of Manitoba this year had an increase of 65 per cent in applications to its undergraduate nursing programs, while the increase was more than 60 per cent for Queen’s and more than 30 per cent at the University of British Columbia.
Nursing professors say several factors may have led to the surge in interest: COVID-19 has demonstrated that the work can be rewarding, people who postponed their education last year applied this year and the high demand for nurses meaning lots of opportunities will be available.
“We were very pleasantly surprised to see the numbers coming in,” said Elizabeth Van Den Kerkhof, director of the School of Nursing and Midwifery at Mount Royal University in Calgary, which had a 5.5 per cent increase in applications to its bachelor of nursing program over the past year.
Dr. Van Den Kerkhof said her school had expected the pandemic to prompt students to have second thoughts about nursing as a profession.
“It could have gone either way. There’s some pretty serious stories that we’ve seen in the news with respect to the pandemic and health care professionals.”
But enrolment numbers at most schools have stayed the same or increased only slightly, because spaces are based on the funding received from provincial governments.
“I do think this is an issue that our governments will need to discuss, because we will be entering another nursing shortage probably within the next, well … really depending on COVID,” said Cheryl Pollard, associate dean for the faculty of nursing at MacEwan University in Edmonton.
Some nursing schools have added seats in recent years and some are hoping to get funding to do the same.
Erna Snelgrove-Clarke of Queen’s University’s nursing school said for the four-year program, seats increased from 100 to 125 this year.
Dalhousie University in Nova Scotia had an increase of seven seats at its Yarmouth campus last year. According to Ruth Martin-Misener, director of the nursing school, the bachelor program has 192 seats, but the number of applicants is usually more than 1,000.
The University of Manitoba is in discussions with the province regarding a potential expansion of its capacity. And UBC’s nursing program has pledged to add eight more students to this year’s enrolment, with one-time funding to support it.
In May, the Ontario government announced a $35-million investment in nursing education programs for the 2021-22 cohort, which it said will add 2,000 nurses to the health care system. In British Columbia, the Advanced Education Ministry said the government’s 2021 budget pledges 500 new seats to train individuals who want to become practical or registered nurses.
But several educators, including Elizabeth Saewyc of UBC’s nursing school, said simply adding money for spaces won’t solve the shortage. “We are also limited by the availability of clinical practice sites that can accept students, and by the number of nursing faculty and clinical instructors who can teach them,” she said.
According to a study published by the Canadian Federation of Nurses Unions in December, 60 per cent of nurses said they would leave their jobs within the next year. It also says Canadian nurses’ average overtime hours increased 78 per cent since the beginning of the pandemic, an indication of a shortage.
Ru Taggar, executive vice-president and chief of nursing at Sunnybrook Health Sciences Centre in Toronto, said the vacancy rate for nurses at her hospital during the pandemic has doubled, from 6 per cent last year to 12 per cent this year. Meanwhile, the resignation and retirement rate of nurses has gone up from three per cent to 5.6 per cent.
Ms. Taggar said it happened because nurses have been experiencing more stress and heavier workload.
“So based on those trends alone … I would argue that maybe the intake needs to increase or at least be looked at carefully,” she said.
“Given the fact that it takes four years for nurses to graduate from a nursing program, there definitely is a time sensitivity to this matter. And my sense is this nursing shortage is going to continue for some time.”
Linda Silas, president of the federation of nurses unions, which represents nearly 200,000 unionized nurses and nursing students, said more significant changes are required than just additional places at nursing schools.
“What governments need to do is to fund seats, but fund seats within the expedited program, which means instead of a four-year program, bring it down to a three-year program,” Ms. Silas said, adding that it will also be necessary to find ways to help working nurses upgrade their skills to move up the career ladder.
“We have licensed practical nurses in this country that want to become registered nurses; we have personal care workers that want to be licensed practical nurses; and we have very, very few bridging programs … These health care workers are already in the system. They love what they do. They just want to expand their career options.”
Andy Smith, president and chief executive officer of Sunnybrook, said adjustments to the work environment are likely also necessary to ensure retention of newly trained nurses. The crushing workload most have come to expect isn’t sustainable, he and others have suggested.
“I think it means looking at … reinventing the types of shifts and the types of teams in which people work. I think we’ve been stuck in a kind of model for a while. Let’s look at new models.”
Dr. Saewyc said nursing programs also need to adapt to students with differing backgrounds. People who have just graduated from high school and are starting their four-year university program need a different level of training than, for instance, internationally educated nurses and those who have previous education.
“I would not necessarily recommend that we try to speed up the education process,” she said. She added that it is equally or more important to ensure that nurses have input into the way they work. Dr. Smith said there is a need for “unprecedented collaboration” between nursing schools and colleges, hospitals and governments.
“I am abundantly confident that this will be the top issue in the year and years ahead,” he said. “Nobody’s crying wolf on this one … It’s a big and escalating problem.”
Meantime, new nurses are heading into this school year invigorated by their career choices.
Abbey Green, a second-year nursing student from UBC Okanagan, has been volunteering at BC Children’s Hospital and BC Women’s Hospital & Health Centre since October. The 19-year-old said she feels for nurses who are facing a lot of challenges during the pandemic. But she said the supportive environment at the hospital has motivated her.
“I’m excited to be able to help. I think it’s a really noble career,” she said. “And it’s really exciting to be able to help people and help in such a great effort in such a challenging time.”
*Xiao Xu – Staff Reporter, Vancouver, Canada
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