Interest in nursing is running high, but a massive shortage is making it hard for universities to find the in-class and in-hospital instructors to train them.
Hospital vacancy rates for nursing positions sit at around 20 per cent in Nova Scotia and Ontario, and 25 per cent in Manitoba. Other hospitals across the country are facing similar crunches.
“On the hospital floors right now, it’s kind of chaos everywhere. So every single nurse is being a teacher,” said Kaitlyn McCarthy, a fourth-year nursing student at the University of Windsor, who explained that due to the lack of on-the-floor instructors, other nurses are stepping in to fill the gap. “They’re taking a moment to say, ‘Here’s where you put the dirty linen’ or ‘Come watch me do this dressing on a patient.’ I want to applaud them because their whole work world has been impacted. And yet they’re still willing to have us on the floor.”
Linda Ross, acting dean in the faculty of health studies at Brandon University, said the shortage is partly due to the aging workforce. “Many people have been hanging on and postponing their retirement. And the pandemic was kind of the last straw.” The British Columbia Nurses’ Union estimates that 40 per cent of nurses will hit retirement age in the next 10 years.
While nurses leave in droves, young people are signing up to join the profession in droves. Elizabeth Saewyc, director of the school of nursing at the University of British Columbia, said their bachelor of science in nursing program saw a 31 per cent bump in applications last year, at the height of the pandemic. Other schools are seeing similar interest. For instance, McMaster University’s applications are up 20 per cent.
Dr. Saewyc said that in their letters, applicants “are expressing a greater awareness of the expertise that’s required, the intensity, the huge variety of what the nursing role can be.” She credits that awareness to an uptick of news interviews with nurses during the pandemic that are “challenging the stereotypes of what people mostly have seen of nursing on TV.” Dr. Saewyc also thinks young people are attracted to nursing because they want to do their part to help in a first-in-our-lifetimes pandemic. Plus, she said, “we can’t dismiss that at a time when many other careers were in jeopardy… health care was still desperately needed.”
Adding more spaces
The shortage is a long-standing problem, and provincial governments were announcing funding increases to nursing school spots even before the pandemic. But their efforts have intensified. The government of Manitoba announced this past summer it will increase nursing school spots by 400 over the next few years. Nova Scotia announced 70 more spots this year; Ontario a whopping 2,000.
“In the media, I see calls to give more money to nursing programs. We’re happy to have the money, but it’s complicated,” said Dr. Ross. “You can’t just throw money at it. This is not something that can be resolved overnight.”
One of the biggest struggles over the past two years has been finding clinical settings able to take in students. Ruth Martin-Misener, director of Dalhousie University’s school of nursing, said “there were definitely times where it was sort of touch and go as to whether we were going to be able to maintain our clinical placements… it was a lot of collaboration back and forth with employers, at times hourly communication, to identify who is going to be available to be a clinical instructor, and where within the hospital or the community setting.”
Joanna Pierazzo, assistant dean of McMaster’s undergraduate nursing programs, said administrators have come up with innovative solutions, including working with hospitals to identify more registered nurses (RNs) for clinical teaching. “That becomes a win-win,” she said. “When there’s an opportunity to take a day a week to help teach, that can be a great incentive for nurses.”
She’s also calling on governments to increase funding for fast-tracked nursing programs, such as those that exist at McMaster and Dalhousie for applicants who have sufficient university-level science courses. These RN degrees, which run through the summer months, take two years instead of four.
Learning via ‘The Sims’
While Dr. Pierazzo said their school hasn’t increased simulation-based learning during the pandemic, other schools have had to move labs online. (Labs are where nurses learn skills like making a bed properly, changing wound dressings and inserting intravenous lines.)
Ms. McCarthy said a couple of her labs and placements switched from in-person to online. “Everyone kept referring to their online placements as The Sims,” she said, referring to the popular life simulation video game. “You have your person and then you go into a clinical setting, ask questions and say, ‘now I’m going to take your blood pressure’… it wasn’t really as much practicing as walking through scenarios.” But Ms. McCarthy said students behind her missed out on more, because many of their fundamental first- and second-year labs were online instead of in person.
Linda Silas, president of the Canadian Federation of Nurses Unions (CFNU), said she’s hearing that nurse graduates “are scared of not being able to provide the sphere of care they should be providing.” And rather than taking full-time jobs, they’re far more interested in part-time ones. “That’s a big red flag,” she said.
This past spring, the CFNU and the Canadian Health Workforce Network urged the federal government to increase funding to the provinces and facilitate standardized data collection across the country, to get a more detailed picture of the workforce gaps in the sector.
Ms. McCarthy sees those staffing gaps and stress they cause firsthand, but it’s not deterring her. “I know that burnout is a thing. You see it in the nurses right now, and it is scary,” she said. “But I think that once we get over this pandemic, and as we keep fighting for ourselves, we’ll see how amazing the job can be…. I know this profession is where I’m meant to be.”