Looming shortage of nurses – Update

Possibly nurses are leaving because they are underutilized? 

Almost a year later and the situation is not getting better
Patient care about to be cut, nurses warn
Unionized nurses at a downtown health services network are angry about planned staff cuts they say will reduce patient care and increase their workload.
16 November 2009
Medical establishment prevents nurses from assuming new roles
Study published in Recherches Sociographiques by University of Montreal researchers
Montreal, November 16, 2009 – Physicians still retain the bulk of decision-making power over nurses in Quebec – a situation that’s detrimental to evolving nursing roles. According to a new study by Université de Montréal researchers, published in Recherches Sociographiques, nursing functions are still very much assigned by physicians who often oversee family medicine groups (FMGs), specialized nurse practitioners (SNP) and oncology nurse navigators (ONN).
“MD power is legal, political and organizational and exercised through positions of managers and directors, which leaves nurses with the feeling of being underutilized. In FMGs, physicians decide the nature and extent of nursing roles such as whether nurses serve as assistants or follow-up on patients,” says co-author Danielle D’Amour, a professor at the Université de Montréal Faculty of Nursing and scientific director of the FERASI Centre.
Job description defined by physicians
The influence of physicians has also shaped SNP training and job descriptions. The result is that the role of these nurses varies from consultant to first responder, depending on the establishment and depending on the will of physicians.
Oncology nurse navigators have fared better. Under recommendations from a renowned oncologist involved in several levels of the Quebec health-care system, physicians and managers have accepted ONNs as part of inter-professional teams.
Underutilized nurses
Nurses in all three groups do feel underutilized and must still convince physicians that they contribute differently to patient care. The study reveals many physicians feel the new role of nurses is an unacceptable intrusion into their area of expertise, which could explain their resistance of sharing professional responsibility.
14 May
Is the grass any greener? Canada to United States of America nurse migration
Nursing study published today in the International Nursing Review concludes it’s not just about the money
(Toronto: May 14, 2009) A study looking at Canadian-educated registered nurses working in the USA found that opportunities for ongoing education, including formal support for graduate education and ease of licensure, in addition to full-time employment, were key factors that contribute to the migration of Canadian nurses to the USA, particularly baccalaureate-educated nurses.
“These findings are important for Canadian health services policy-makers to consider, as they develop strategies to retain nurses in Canada,” says Hall. “The emigration of Canadian RNs to the USA worsens existing shortages in Canada, and creates shortages where none might have existed if these RNs had remained.”
The study also found that:
* A greater proportion of Canadian RNs working in the US were employed full-time than their American counterparts, or their Canadian counterparts in Canada
* A higher proportion of Canadian nurses working in the US hold graduate degrees, compared with those working in Canada
* Canada is viewed as a rich source of young, well-educated RNs with the added advantage of low recruitment costs due to geographic proximity, similar cultures and language, reciprocally recognized orientation and basic nursing training
These findings suggest a serious depletion of nursing human capital is on the horizon, as degree-educated nurses emigrate to the United States, says Hall. The purpose of this study was to gain an understanding of Canadian-educated registered nurses working in the USA, why nurses leave Canada, remain outside of Canada, or under what circumstances might return to Canada. Data for this study include the 1996, 2000 and 2004 USA National Sample Survey of Registered Nurses and reports from the same time period from the Canadian Institute for Health Information.
12 November 2007
Couillard sounds alarm on nursing crisis
Aaron Derfel, The Gazette
Quebec’s nursing crisis has taken a turn for the worse as a growing number of nurses are quitting hospitals to work for private nursing agencies, Health Minister Philippe Couillard said today. What’s more, the province will face a shortage of 7,300 nurses in five years and 23,000 nurses in 15 years, according to the latest projections by the Quebec Order of Nurses.
“When I see the percentage of nurses that leave hospitals, when I see the rates of compulsory overtime in some hospitals, when I see the importance and phenomenon of nursing agencies, I’m worried,” Couillard told reporters after addressing the annual convention of order of nurses. More
Looming shortage of nurses begins in the classroom
Schools across the country lament lack of teachers
JANICE TIBBETTS AND RENE BRUEMMER,
October 08
Nursing schools are suffering from a shortage of teachers to educate the next wave of Canadian nurses, and stalled recruitment is hurting efforts to deal with an expected shortfall of tens of thousands of nurses in the next few years.
In Quebec, where the government granted early retirement to thousands of nurses in 1997, and where nurses are trained in the CEGEP system, the problem is growing and expected to worsen.
“The first generation of CEGEP teachers started in 1967 or the early ’70s,” said Denyse T. April, a past president and current board member of Quebec’s college nursing instructors’ association.
“In the next couple of years, that first generation will be going, and we will lose a lot of that expertise as well.” The shortage is being felt across the country. “Canada simply lacks a critical mass of qualified candidates with a completed doctoral or master’s degree,” Wally Bartfay, a nursing professor at the University of Ontario Institute of Technology, says in the current issue of Canadian Nurse.
… a 2004 survey by the Ottawa-based Nursing Sector Study Corporation indicat[es] 60 per cent of nursing schools do not have enough faculty to teach their students properly.
…
During its age of plenty in the nursing field, Quebec imposed a quota on the number of students that could enroll in nursing school. With the provincial shortage, the quota has been lifted, but that’s of little help if there’s no one to teach them, April said.
Hospitals used to have an agreement with CEGEPs to release nurses for one or two days a week to do clinical training, teaching students by taking them on rounds. But with the nursing shortage, that agreement has dried up.
The Canadian Nurses Association estimates there will be a shortfall of 78,000 nurses by 2011 and 113,000 by 2016 because the number of new nurses is not keeping pace with retirements. more