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Survey reveals Ontario’s Registered Practical Nurses continue to face unsustainable conditions amid ongoing staffing shortages

by WeRPN

Nearly 1 in 2 RPNs consider leaving the profession amid challenges in providing adequate patient care

Toronto, ON, May 23, 2024 – The Registered Practical Nurses Association of Ontario (WeRPN), the professional voice of Registered Practical Nurses (RPNs) across the province, has released findings today from its annual survey titled “The State of Nursing in Ontario: A 2024 Review.” This comprehensive report, reflecting the sentiments and experiences of over 1,300 RPNs over the past year, sheds light on the complex state of healthcare and the ongoing impact of the nursing crisis in Ontario. Though slight improvements have been observed in some areas, the impact of the staffing shortages continues to be evident, and the data is clear that further action is needed to better support nurses and ensure patients receive optimal care.

Nearly 4 in 5 RPNs surveyed (78 per cent) have been directly impacted by the nursing shortage. Amid continued staffing challenges, the majority of RPNs (84 per cent) report an increase in their workload over the past year, compared to 92 per cent the year prior. At the same time, nearly half of RPNs surveyed (49 per cent) say that the quality of patient care worsened over the past year, and 45 per cent noting no improvement in the quality of care during this period. Ninety-three per cent of RPNs affected by the nursing shortage indicate having seen firsthand patient care being compromised because there are not enough nurses to meet patient needs. What’s more, over half of RPNs (58 per cent) say they still do not have the time or resources needed to provide adequate care to patients, residents or clients.

“While we have seen some marginal improvements, the overall pace is not moving in the direction where it needs to be to appropriately address the effects of staffing shortages that persist across the province,” says Dianne Martin, Chief Executive Officer, WeRPN. “Ontario’s RPNs are in a unique position and continue to bear the brunt of pervasive staffing shortages that not only jeopardize the quality of care they can provide to patients but also impact their personal well-being. If we want to return nursing to a thriving profession, we need to focus much more on retaining experienced RPNs as well as growing our nursing workforce to meet the needs of our patients now and into the future”.

In 2024, nearly half of Ontario RPNs surveyed (48 per cent) say they are considering leaving the profession. While this is an improvement from last year’s figure of 62 per cent, the impact of a further loss of RPNs at this time would be devastating for patients across the province. According to the survey, 7 in 10 respondents (69 per cent) say they have witnessed an increase in experienced nurses (RNs and RPNs) leaving their workplace in the past year, and concerningly, 1 in 2 (50 per cent) do not feel as though their workplace has enough experienced nurses to consult with on more complex cases.

The latest findings from the report provide a snapshot into the challenging realities RPNs in Ontario are facing, highlighting the importance of immediate action to ensure continued quality care for patients:

  • RPN workloads continue to reach unmanageable levels: While there has been a marginal improvement compared to last year’s survey, it remains concerning that 84 per cent of RPNs report an increase in their workload from a year ago. As well, 59 per cent of RPNs surveyed report working more hours on average than scheduled. Three-quarters of RPNs (75 per cent) have assumed more responsibilities, 74 per cent have had to miss meals or breaks, 62 per cent were asked to care for more patients, residents or clients, and 40 per cent were unable to take earned time off. Further, a majority of RPNs (69 per cent) are being asked to take on additional shifts or work overtime to cover staffing shortages.
  • Unsustainable conditions continue to negatively impact patient care: Alarmingly, 91 per cent of respondents say that the staffing shortages have led to a negative impact on patient care. Among RPNs impacted by the shortage, 93 per cent have directly witnessed patient care compromised due to insufficient staffing in the past year. The most common indications cited among this group include: patients enduring longer wait times (84 per cent), less consistency in patient schedules (70 per cent), longer times to be assessed (67 per cent), and more difficulty accessing necessary care (64 per cent).
  • Mental health toll continues to be a serious concern: A majority of RPNs (64 per cent) reported that the self-care and overall mental health of themselves and their colleagues had worsened in the last year. Seventy-two per cent say their mental health has been adversely affected because of the work they do. More than half of RPNs surveyed (60 per cent) are experiencing moral distress, defined as knowing the ethically appropriate action to take, but being unable to act upon it in their environment. This figure is higher among nurses who’ve been impacted by the staffing shortages (81 per cent). The top contributors for moral distress include: knowing patients deserve more but being unable to offer it (85 per cent), witnessing the impact of staffing shortages on patients (81 per cent), and not having the resources to provide quality patient care (69 per cent).
  • The relentless strain of workplace pressures shows small signs of easing: Eighty per cent of RPNs surveyed say their daily experiences in the workplace have become significantly more stressful, while 81 per cent of RPNs indicated feeling unsupported in their role–a figure that increased significantly from 68 per cent last year. Over half of RPNs (54 per cent) experienced or witnessed an increase in workplace violence against nurses, and 67 per cent of those impacted by the nursing shortage felt pressured to work in unsafe conditions.
  • Reliance on agency nurses is impacting workplace dynamics: Half of RPNs impacted by the nursing shortage (51 per cent) believe their workplace is overly reliant on nursing agencies, which in some cases costs the province three times as much to meet staffing needs. In addition to the steep cost, the reliance on for-profit agency nurses is causing a divide in the workplace, which could have long-term effects on the nursing workforce and culture. Forty per cent of those who report working with more agency nurses acknowledge there is resentment towards these nurses as they receive more pay and 42 per cent find it more difficult to work with them as they have less familiarity with the patient population.
  • New nurses require more support when entering the field, experienced RPNs are short on time to train: This year, almost half of respondents (46 per cent) say a large number of new graduates are employed at their workplace. As the province ramps up its efforts to recruit new nurses, the addition of new graduates and Internationally Educated Nurses (IENs), while needed, presents challenges that need to be considered. The survey revealed only a third of new graduates (32 per cent) feel prepared to enter the workforce after graduation and the majority (62 per cent) say they work with more patients than expected. Additionally, 52 per cent of surveyed Ontario RPNs report an increase of IENs in the workplace, while half of this group expressed concerns about the need for more onboarding support.
  • Financial stress remains a concern for RPNs: 3 in 4 RPNs (75 per cent) are experiencing financial stress, with 72 per cent stating they have not seen a significant improvement in their wages over the past year. Eighty-nine per cent believe that if wage compression were not a factor, RPNs would want to remain in nursing in the province. Among RPNs intending to leave the profession, wages (84 per cent) and workloads (77 per cent) are the two leading factors contributing to their decision, followed by workplace culture (66 per cent), the impact of the nursing shortage (64 per cent), moral distress (62 per cent), and unfair compensation practices (61 per cent).

While the government has made some strides, adding 1,752 RPNs, the province also saw a loss of 2,166 RPNs, resulting in 414 fewer RPNs registered this May compared to last year . Although Ontario continues to graduate new RPNs, the province is losing experienced RPNs at a faster pace. As experienced RPNs continue to leave direct care roles, challenges with retention paired with the slower pace of recruitment leaves the provincial healthcare system–and the well-being of Ontarians in an increasingly vulnerable state. In the past year, nearly a third of RPNs surveyed (29 per cent) have changed roles in healthcare, and among that group, 40 per cent transitioned away from direct patient care roles. Moreover, the entry of a large number of new nurses into the workforce underscores the necessity for better support and training programs in order for those nurses to grow experience-based expertise.

In response to these findings, WeRPN is calling upon the Ontario government and healthcare leaders to take the following tangible actions immediately:

  1. Introduce legislated nurse-to-patient ratios: Urgently establish standardized, legislated nurse-to-patient ratios to reverse deteriorating patient care and ensure workplace safety for nurses.
  2. Establish competitive and harmonized nursing wages to incentivize retention: 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 to incentivize RPN retention.
  3. Ensure all efforts are made within organizations to meet regularly scheduled staffing numbers in order to make sure the impacts of short staffing do not become normalized: Recognize and address that the current benchmarks for RPN workloads and conditions in the workplace are harmful, and far exceed what would have been considered appropriate a few years ago.
  4. Enhance access to streamlined educational opportunities: Streamline education for experienced nurses looking to expand their careers by supporting continuing education and enhancing spaces in schools.
  5. Reduce reliance on nursing agencies: Reduce reliance on for-profit nursing agencies with the development of more strategically planned full-time nursing positions.

“The provincial government and healthcare leadership teams must continue to take action to further tackle increasing RPN staffing shortages head-on,” adds Martin. “We are at a critical inflection point in our healthcare system, and we are asking leadership to demonstrate to RPNs that they acknowledge the significance of these challenges, that they understand their invaluable contributions to the health of Ontarians, and that they will take urgent action to return to RPNs their ability to provide optimal care for patients.”

Learn more about this year’s survey findings here.

About the WeRPN study: From March 15 to 25, 2024 an online survey was conducted among 1,304 Registered Practical Nurses across Ontario, by 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 Registered Practical Nurses (RPNs) across the province. There are 60,000+ RPNs in Ontario. 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.
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Media requiring further information, or to coordinate an interview, please contact:
Carla Silvestrone, LABOUR | 416.986.9835 | carla.silvestrone@labourcreative.ca
Ciara Dalziel, LABOUR | 416.564.6918 | ciara.dalziel@labourcreative.ca
Jessica Huynh, LABOUR | 647.985.5378 | jessica.huynh@labourcreative.ca

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