Big cities feeling nursing shortage crunch

What was once a problem only in rural parts of Canada is now being called a national crisis. A shortage of nurses across the country is creating more challenges for hospitals who are struggling to recruit them.

“We’ve had widespread nursing challenges in Ottawa and the surrounding region for quite some time. The pandemic amplified that significantly,” said Greg Hedgecoe, VP of People, Performance & Diagnostic Services, Queensway Carleton Hospital.

“It’s quite a bit higher than the norm, but it’s been coming down as a result of our regional recruitment campaign.” 

The hospital launched the campaign alongside 19 partner hospitals back in November, identifying over 1,000 nursing vacancies, an all-time high for the region. The national ads, viewed over 18 million times, have made a difference and their hope is to bring workers from outside Ottawa to the nation’s capital.

“Every month we’re bringing in about 25 workers from outside of our region into our region,” said Hedgecoe. “Who are we targeting? Everyone from every province. Toronto is definitely a target market for us.”

The candidate pool is much larger in Toronto and the GTA. There are also more students graduating from nursing programs in the region.

The health authority in northern British Columbia, mainly comprised of rural communities and smaller cities, is no stranger to shortages in healthcare either.

“We’re struggling at this time,” said Angela De Smit, the Northeast Chief Operating Officer at Northern Health. “Nursing recruitment is one of the key recruitment needs and even more so in the northeast. With the mounting national nursing shortage, it has made it even more of a challenge to keep our nursing positions filled to maintain the services we currently provide.”

The COVID-19 pandemic has no doubt been putting added pressures on the healthcare system.

Some hospitals needed to add more beds to accommodate more patients in critical and intensive care units. Healthcare workers, including nurses, have also been operating and working at vaccine clinics and testing centers.

Unions have previously warned of nurses wanting to leave their jobs due to their working conditions and lack of pay, especially during the pandemic where many nurses have reported burn-out.

“There’s been a nursing shortage looming for a number of years that we’ve been warning the federal and provincial governments about,” said Vicki McKenna, President, Ontario Nurses Association (ONA). “We have a situation where we haven’t been graduating enough new nurses into the system, so that’s been a problem.”

McKenna adds that some organizations have previously laid off registered nurses, registered practical nurses and nurse practitioners. That has impacted the level of staffing at hospitals, public health agencies, long-term care, and home care.

“What’s happening with the current workforce is not focused on retention and that is a huge problem and I believe will be a huge barrier to keep people here,” McKenna said. “The nurses tell me they don’t feel respected and acknowledged and they’re angry about that because they feel like the retention piece is being forgotten and not acknowledged by our government policy.”

The ONA also represents 18,000 nursing students in all stages of their schooling, saying they are worried because some employers in the province aren’t hiring full-time workers.

The competition for nurses isn’t only restricted to Canada. McKenna adds that the U.S. has also been heavily targeting newly graduated nurses north of the border.

“They’re really active with those new graduates and the recruiters are working pretty hard, virtually because the borders aren’t open,” she said. “There’s big recruitment bonuses there, there’s lots of opportunities being offered there for post-grad, tuition, and housing. Lots of things that would entice someone coming out of a nursing program with a student debt, for instance, or looking for a different experience.”

Incentives offered to new recruits

Hospitals have been offering incentives to new recruits, particularly nurses, including up to $10,000 in bonuses, offers to cover rent, money towards training, accelerated specialty nursing and thousands of dollars to relocate.

Queensway Carleton Hospital provides relocation assistance to people moving to Ottawa and is also advertising provincial incentives, which include up to a $10,000 bonus to move to the province and work for a healthcare intuition.

A tweet from Queensway Carleton Hospital promotes a $10,000 signing bonus to attract more nurses to the region. TWITTER/QCHOttawa

“There’s greater competition between regions for talent because the reality is nationally, provincially, regionally we don’t have enough qualified nurses,” Hedgecoe said. “It’s new for us to need to be so aggressive with our recruitment.”

With larger cities, like Ottawa, the GTA and Windsor facing a shortage in healthcare workers, Northern Health is faced with more competition as well.

The region has used similar strategies to attract new nurses, even on a temporary basis. However they face a number of other challenges with more nurses retiring, an increase in agencies and travel nurses moving to a variety of areas across Canada.

“One of the key things that we have in Northern Health is permanent, full-time positions,” De Smit said. “We have different shift premiums and our overtime, statutory holidays is all at double-time compared to time-and-a-half elsewhere.”

The region also has a referral program for their nurses, shelling out hundreds of dollars to current employees who can recruit other nurses. Additionally, Northern Health will pay $15,000 to nurses moving to the region, that will go towards paying for a one-year specialty certification program.

In some cases, nurses from Toronto and the GTA have also traveled to the region during the pandemic.

“Some agency nurses will come out during COVID just to get a break, because we have less cases than some of the communities in Ontario,” said De Smit. “We get them from all across Canada — Nova Scotia, PEI, and Quebec.”

The ONA confirms that nurses in Ontario, who have been working in some of the hardest hit hospitals and long-term care homes, have also been traveling to the east-coast because COVID cases aren’t as high in those communities.

According to McKenna, the incentives being offered to attract new nurses isn’t sitting well with some healthcare professionals who work in the same organization.

“The nurse who has been there for 10, 15, 20 years and more isn’t receiving any sort of acknowledgement or retention for being there,” she said. “So that’s causing some rift in some cases in some of the organizations, which is unfortunate.

In some instances, nurses have also been poached by other regions.

“We have been the victim of poaching, but we haven’t taken that step and we’re not going to take that step,” Hedgecoe said. “We’re going to talk about how great of an employer Queensway Carleton is, but we’re not going to start cold-calling people and asking them to leave their employer to join ours.”

Northern Health and other hospitals in the Ottawa region are also promoting their facilities. A selling point for them is comparing housing prices, cost of living and traffic to Toronto and the rest of the GTA.

“A lot of people don’t know it, but Ottawa is ranked amongst the top three cities in North America for quality of life,” Hedgecoe said. “We’re getting the message out there for people — if you want to love the people that you’re working with, Queensway is the place to be.”