Shockingly, 91 per cent of nurses have directly witnessed patient care being negatively impacted due to continuously deteriorating staffing issues
Toronto, ON (July 19, 2023) – The Registered Practical Nurses Association of Ontario (WeRPN), the professional voice of over 60,000 Registered Practical Nurses (RPNs) across the province, released findings today from its annual survey, entitled “The State of Nursing in Ontario: A 2023 Review.” Collecting and analyzing nursing experiences over the past year, the research provides a stark outlook on the worsening healthcare crisis that is in full swing across the province. The consequences of Ontario’s ongoing nursing shortage are becoming increasingly difficult to ignore, as staffing issues and unsustainable workloads continue to take a serious toll on nurses and the quality of care Ontarians are receiving.
According to the survey, 91 per cent of nurses in the province have directly witnessed worsening patient care due to the impact of dire staff shortages. Today, the majority of nurses (76 per cent) do not feel they have the time or resources needed to provide adequate care to patients, residents, or clients – a figure that has increased 8 per cent from the year prior. Further, nearly 4 in 5 nurses (79 per cent) impacted say they feel ethically conflicted knowing they are unable to deliver the appropriate care they are educated to provide given current constraints. Together, the harsh realities have led to a steep decline in pride in the nursing profession.
Despite the persistence of the nursing shortage, the province has not taken sufficient steps to address the retention of experienced nurses, leading to increasingly pressurized working environments. The research suggests the realities of Ontario's healthcare system are driving many nurses away from direct patient care on the front lines, prompting some to consider leaving the province, and some to consider leaving the profession entirely. Among the many insights uncovered, this is the most alarming revelation — that Ontario could experience a greater loss of nursing care, a significant concern considering the healthcare system is already under severe strain.
“As our population ages and the needs of patients become more complex, we have an urgent need for more nurses. While we may see more nurses being registered to practice, those numbers don’t tell the full story,” says Dianne Martin, Chief Executive Officer, WeRPN. “What’s not visible is how much more risk patients and nurses have been subjected to in the past year with unmanageable nurse-to-patient ratios. Without swift action and a true focus on retention, we are at risk of losing an alarming number of nurses from direct patient care positions. It’s not a question of if the Ontario public healthcare system will be damaged beyond repair, it’s when.”
Concerning statistics from WeRPN’s survey findings show, amongst other impacts, that patient care is being compromised by the ongoing nursing shortage:
- Nurses are expected to take on greater patient loads, despite not having enough time and resources to meet growing care needs: 92 per cent of nurses say their workload has increased over the last few years. Nearly 7 in 10 nurses surveyed (68 per cent) do not feel they have the time and resources available to provide adequate care to their patients. This is the third year that nurses are reporting an increase in their workload – the figure is now higher than it was at the height of the pandemic.
- Patient care is being compromised: 91 per cent of nurses have witnessed patient care be negatively impacted due to staffing issues. Among these nurses, 83 per cent are seeing increased wait times for patients, and 70 per cent have noted that it has gotten harder for patients to receive access to the necessary care they need, such as surgeries and diagnostics. An alarming 62 per cent of nurses say they’ve directly seen how delays in such assessments have resulted in a decline in patient health.
- Nurses feel moral distress with no end in sight: Among nurses who experience moral distress, the leading factors include knowing patients deserve more, but being unable to offer it (87 per cent), witnessing the impact of staffing shortages on patients (83 per cent) and not having the proper resources to provide quality care (73 per cent). Shockingly, the majority of nurses (78 per cent) have experienced a breaking point related to their job this year, and 89 per cent say their mental health is suffering due to workplace conditions.
- Workplace pressures continue to take an insurmountable toll: 91 per cent of nurses say their daily experiences in the workplace have become significantly more stressful, and almost all (97 per cent) say working short staffed has negatively impacted their workplace culture. As a result of staffing shortages, 91 per cent cannot get their shifts covered, 82 per cent cannot take time off, and a third (31 per cent) do not feel they are able to decline shifts without consequence. Further, 63 per cent of all nurses surveyed have experienced or witnessed an increase in workplace violence against nurses, and 74 per cent impacted by the nursing shortage have felt pressured to work in unsafe conditions.
- Pride in nursing has dramatically eroded since the pandemic: When the provincial healthcare system was being tested to its limits in 2020, 67 per cent of nurses in Ontario said they had never been more proud to be an RPN. Sadly, three years later, pride in nursing has plummeted to a mere 31 per cent. The morale of 7 in 10 nurses (72 per cent) have suffered to the point that they admit their pride in nursing has worsened in the past year.
- Ontario’s nursing profession is in jeopardy: Over 6 in 10 nurses (62 per cent) will, or are considering leaving nursing. Two facts that are perhaps the greatest cause for alarm are that 86 per cent intend to leave within the next two years, and among those planning to leave the profession, 59 per cent are considering leaving healthcare altogether. One in five nurses (19 per cent) are considering moving outside of Ontario, with wage dissatisfaction being the leading catalyst, followed by dissatisfaction with the Ontario healthcare system (76 per cent), hiring bonuses offered in other locations (71 per cent), and more opportunities, among other factors. Some nurses are also shifting their practice – 38 per cent have changed roles in healthcare in the last two years, and within that group, 40 per cent have transitioned away from a direct patient care role.
“With a healthcare system already stretched, who are we expecting to take care of our Ontarians when these nurses leave?” asked Martin. “We must stop the bleeding in this profession, otherwise, every day, both our nurses and patients will end up paying an awful price.”
Unfortunately, the government has not taken sufficient steps to address the realities nurses are facing. RPNs who are thinking of leaving the profession suggest that better wages (90 per cent), better nurse-to-patient ratios (72 per cent), and improved support in the workplace (69 per cent) would get them to reconsider. The consensus among RPNs (93 per cent) is that if wage discrepancies were not a factor, more would want to remain in nursing in the province.
Instead of investing in nurses, the province’s healthcare system is using strategies that are exponentially more costly to taxpayers. Sixty per cent of nurses report that their workplace is overly reliant on nursing agencies which cost three times as much to meet staffing needs. WeRPN’s research found that 54 per cent of nurses surveyed this year are now considering working for a for-profit nursing agency, seeking better pay and greater flexibility.
In response to these findings, WeRPN is calling upon the government to take the following four tangible actions immediately:
- Legislate manageable workloads: Urgently establish standardized nurse-to-patient ratios to reverse deteriorating patient care and ensure workplace safety for nurses.
- Prioritize retention with growth opportunities: Streamline education for experienced nurses looking to expand their careers by supporting continued education and enhancing spaces in schools.
- Establish professional compensation: Establish a fair and professional level of compensation for RPNs that reflects their knowledge and skills and is more closely aligned with their RN counterparts.
- Guard against cost inefficiencies and privatizing healthcare: Reduce over-reliance on for-profit nursing agencies with the development of more strategically planned full-time nursing positions.
Ninety-six per cent of nurses say they don’t feel there is an end to the nursing shortage, and almost every nurse surveyed – 99 per cent – believes the government isn’t doing enough to address this critical and ever-worsening nursing shortage.
“Solutions for effective retention strategies are not complex, and we have been imploring government leaders for some time to do right by Ontarians,” says Martin. “The growing crisis is significantly reducing the overall capacity for care in the province, and the time to act is now – the future of our profession and the healthcare system depends on it.”
Learn more about this year’s survey findings here.
About the WeRPN study: From May 17 to 25, 2023 an online survey was conducted among 1,208 Registered Practical Nurses across Ontario by the Registered Practical Nurses Association of Ontario (WeRPN). For comparison purposes only, the sample plan would carry a margin of error of +/- 3 percentage points, 19 times out of 20. Discrepancies in or between totals are due to rounding.
About WeRPN: WeRPN is the professional voice of Ontario’s 60,000+ Registered Practical Nurses (RPNs) across the province. WeRPN builds the profile and professional capacity of RPNs so they can better care for patients and better support their fellow healthcare workers. Follow us on social media, Facebook, Instagram, LinkedIn, Twitter, YouTube and TikTok.
Media requiring further information, or to coordinate an interview, please contact:
Ciara Dalziel, LABOUR | 416.564.6918 | firstname.lastname@example.org
Jessica Huynh, LABOUR | 647.985.5378 | email@example.com