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The State of Nursing in Ontario: A 2022 Review

by WeRPN

Unsafe Workloads Being Normalized in Provincial Healthcare Systems, Warns Head of Registered Practical Nurses Association of Ontario

A new WeRPN survey reveals patients are being put at risk, as nearly 7 in 10 nurses say they are unable to provide adequate care due to lack of available time and resources.

Toronto, ON (Aug 2, 2022) — The Registered Practical Nurses Association of Ontario (WeRPN), representing the voices of over 55,000 registered practical nurses (RPNs), is raising the alarm after a new survey has found patient care is being critically compromised due to staffing shortages and the standardization of unsafe workloads.

“I believe these findings will shock the public — close to 7 in 10 nurses are seeing patients’ health being put at risk because adequate time, resources and staffing levels are simply not available,” says Dianne Martin, chief executive officer, WeRPN. “Alarmingly, this is now being normalized.”

The comprehensive survey, conducted in May 2022 and entitled “The State of Nursing in Ontario: A 2022 Review,” polled more than 760 RPNs in Ontario. It is a follow-up study from a December 2020 survey that has enabled WeRPN to measure the conditions of provincial healthcare systems through the eyes of those caring for the public on the front lines every day.

WeRPN is sharing its findings with government leaders and policymakers, calling attention to the perilously declining situation for nurses in Ontario. Nurses today are working more hours, with more responsibilities, and handling more patients per nurse, all without appropriate adjustments to their wages.

Moreover, their moral distress and mental health are worsening, and a shocking number are considering leaving the profession. Consider for example

  • Patient care is suffering: 68 per cent of nurses say they do not have enough time or resources to allow them to adequately care for patients, and 66 per cent report that they’ve had to take on more patients with continuously increasing nurse-to-patient ratios. In addition, 87 per cent say they’ve had to take on more responsibilities in their role, while 84 per cent have been asked to take on additional shifts or overtime to cover staffing shortages.
  • The nursing shortage is having massive impacts: The majority of RPNs (88 per cent) have been directly impacted by the nursing shortage, which has caused nurses to work more hours, consider leaving the profession, work more isolated with less interactions with colleagues, have less time to build relationships and worsen their mental health. In fact, 83 per cent of respondents reported missing breaks and meals as a result of growing workloads.
  • Moral distress is up: 4 in 5 nurses (79 per cent) are experiencing moral distress on the job, reflecting an emotional state arising from situations where nurses feel that the ethically correct action to take differs from what they are tasked to do. This figure has risen considerably from 68 per cent in 2020.
  • Nurses’ mental health is hurting: The mental toll on nurses is very high right now — 86 per cent of nurses admit that their mental health is being adversely affected because of the work they do. What’s more, 67 per cent do not feel like they have enough mental health support, a figure that has unfortunately remained unchanged over the past two years.
  • Reaching their breaking point: An overwhelming 4 in 5 nurses (79 per cent) admit that they’ve experienced a breaking point related to their job. What is disconcerting is, in the initial shock of the COVID-19 pandemic in December 2020, this figure was lower, at 71 per cent. Additionally, a full 94 per cent of nurses now report experiencing increased stresses from their daily work.
  • Pride in nursing is eroding: In 2020, a large majority (67 per cent) of RPNs said they had never been prouder to be a nurse. Less than two years later, this statistic has tragically plummeted to just 36 per cent — an undeniable reflection of the present-day realities in nursing.
  • Potential to lose half the workforce: Nearly 1 in 2 RPNs (47 per cent) are considering leaving this critical profession. This figure has jumped significantly from 34 per cent in 2020. The #1 catalyst for this is wage dissatisfaction. An overwhelming majority of nurses (91 per cent) believe they are not fairly compensated for their role as an RPN. Additionally, 1 in 3 RPNs working in long-term care say they will leave the sector.

“While these findings can feel dire, there are concrete actions that can be taken and, in fact, must be taken to restore the quality of healthcare that Ontarians expect,” says Martin. “This is why we at WeRPN are issuing urgent calls-to-action to the provincial government, with a specific focus on reversing the dangerous normalization of unsafe workloads that is currently taking place.”

Martin outlines these calls-to-action as follows:

  1. Repeal Bill 124 immediately and increase RPNs’ wages: WeRPN is asking the Ontario government to immediately repeal Bill 124 to allow RPNs to secure an appropriate wage. WeRPN estimates RPNs’ wages need to be increased at minimum by 20 per cent to ensure their compensation is proportionally in line with other nursing groups and reflects cost of living increases. Right now, 9 in 10 nurses (91 per cent) do not believe they are being fairly compensated in their roles as RPNs. While the overarching nursing shortage cannot be immediately relieved in the short-term, such an increase will help immensely in retaining nurses who are contemplating leaving. It will also provide nurses with important recognition to boost morale, which has been hit very hard over the past two years.
  2. Urgently address the ongoing normalization of unsafe workloads: WeRPN is asking leaders to take measures now, with a deep sense of urgency, to return to safe staffing levels as soon as possible. It is integral for leadership to acknowledge on a daily basis that nurses today are tasked with unsafe workloads and that the situation they are encountering is not normal. Especially now, leaders have an obligation to set the tone and prioritize the safety and well-being of nurses — this means creating an environment where nurses feel supported and heard, ensuring at a minimum they are able to take their breaks, vacations, and the rest they are entitled to, not making them feel pressured to take on more shifts than they have the capacity for, and facilitating the necessary dialogue to improve these conditions.  An immediate step towards this is to create more full-time positions for RPNs. An overwhelming 93 per cent of nurses report increased workloads in the past two years. The pressures nurses are facing are not sustainable and are, in fact, dangerously compromising the safety of both nurses and patients.
  3. Ensure RPN voices are included in policymaking: The Ontario government has the opportunity to leverage RPNs’ valuable, first-hand experience and depth of expertise in their work. Their voices must be valued as foundational to healthcare reform and decisive policy development, considering RPNs have a unique perspective having experienced a particularly significant level of wage compression among healthcare providers.

Martin says she is often asked by concerned members of the public how they can support nurses. Her advice is to “Directly and unapologetically ask if you or your loved ones are receiving care in an appropriately staffed environment.” She says it is critical to normalize such conversations and the public has a right to make such a demand.

“Every voice counts when it comes to driving public policy change,” adds Martin. “Ontarians can share their concerns on social media, ask questions and write to their local MPPs and last but not least, always demonstrate kindness and respect for nurses, who do everything they can to care for us when we need it the most.”

For more information about the study,  visit WeRPN.com.

About the WeRPN study

From May 1 to 9, 2022, an online survey was conducted among 762 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 +/- 4 percentage points, 19 times out of 20. Discrepancies in or between totals are due to rounding.

 About WeRPN

The Registered Practical Nurses Association of Ontario (WeRPN) is the professional voice of Ontario’s 55,000 Registered Practical Nurses (RPNs). WeRPN builds the profile and professional capacity of RPNs so we can better care for our patients and better support our fellow healthcare workers.

Media requiring further information, or to coordinate an interview, please contact:

Jessica Huynh, LABOUR  |  647.985.5378  |  jessica.huynh@labourcreative.ca

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