Alicia Jaques: Bumping Nurses Out of the Workforce in Canadian Health Care

On July 10, Canada suffered one of its worst tragedies in its history. A nursing home resident who was ill and dehydrated began suffering from a respiratory and cardiac condition. Days later, 95-year-old Edna Creighton was found dead on the floor, covered in cold soil.

No one could tell investigators what happened, because her last, and greatest, wish was that her fellow residents do not suffer from similar health problems.

When the investigation began in July, a pattern emerged: Some employees had been making everyday visits, and had a built-in system in place that followed a litany of protocols. Visits were slowed down and combined with two-way conversation, to confuse and lull residents. Staff knew to look in one direction when stopping to talk to residents, which made them know when the resident was awake. Staff knew that residents tended to fall asleep when walking and would not be able to wake up. In the end, no medication was used to help slow patients down. Instead, residents were given a choice of “60 seconds to drift away.”

On July 13, under police direction, the 35 permanent employees and one temporary staff member at the long-term care facility all were fired. In addition, an additional 19 caregivers resigned.

Such instances are not isolated. We repeatedly hear about these kinds of failures. However, we rarely get the names of the individuals who are on the receiving end of medical emergency care.

That’s because, if you don’t have a permanent license from the College of Registered Nurses of Ontario (CRN), you’re one of millions of Canadians suffering in silence.

Like Americans, Canadians also suffer from a dearth of nurses in many health sectors and professions. According to estimates, one nurse for every five Canadians is currently absent from care. Based on average salaries and retirement rates for nurses, this translates to more than 19,000 certified registered nurses absent from active practice. And a significant number of these nurses are not required to have been licensed by the CRN.

Still, even when licensed to practice as nurses, employees are sometimes denied entry into the field by local education boards due to antiquated regulations, such as those requiring a master’s degree before they could become registered nurses.

The challenges these educated individuals face, far from being unique to Canada, are alarming.

On average, students are 15 years behind the average experience of the current workforce. On average, nurses in Canada are 2.1 years older than the current 10-year workforce. In Michigan, nurses are more than six years older than the current workforce. And half of Canadian nurses with a master’s degree have lost employment, meaning their salary will be cut by $60,000-$90,000.

For working Canadians, the future is bleak. Because of long-term issues with skilled immigration and struggles to obtain permanent residency, access to foreign trained nurses is increasingly limited. Canada will continue to need more graduates of international programs for the foreseeable future. But the ability of foreign qualified health workers to get a license to practice is in crisis.

The entrance of international nursing graduates is critical. More than 75 percent of nursing students have never even taken a computer science course. Their international training will greatly benefit everyone in Canada as well as the health sector.

In an important report published last fall, the Council of Canadian Academies (CCA) highlighted the need for a robust licencing system for internationally trained nurses. This would allow graduates to immediately get involved in frontline health work without having to wait years for recognition.

These people are uniquely qualified to provide nursing care and are already standing ready to do so. When access to international trained nurses is made easier, the health care system will be provided with the medical and nursing workforce it desperately needs.

Alicia Jaques is the advocacy director of the Canadian Nurse Association.

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