South of the border, nurses are being lured to jobs with signing bonuses of up to US$30 000. In Canada, however, an improved work environment appears to be a more important recruiting tool.
In a new report, the Canadian Nurses Association (CNA) says nurses here want full-time employment, appropriate workloads, involvement in decision-making and educational opportunities. During the cutbacks of the 1990s, many nurses were forced into part-time or casual jobs, and by the late 1990s 48% of nursing positions provided only part-time work. Desperate for stable employment, up to 15% of new Canadian graduates now move directly to the US; the CNA, which represents 115 000 nurses, wants to reduce this to 5%. It predicts that the country faces a shortfall of 78 000 nurses by 2011 and 113 000 by 2016. “Physicians should ponder what this will mean to them and their patients,” CNA President Rob Calnan told CMAJ.
There is no national record concerning unfilled nursing positions, but shortages have been seen in specialty areas such as cardiac care and emergency medicine. American hospitals, which have been recruiting heavily in Canada, sell themselves with offers of a balanced worklife and professional autonomy. The federal government is worried enough to have launched a $250 000 project to develop guidelines to improve nurses' working conditions here.
Although retention of Canadian-trained nurses is considered essential, more new graduates are also needed. Even though half of Canadian RNs are expected to retire within 15 years, there was a steep decline in the number of nursing graduates produced throughout the 1990s. In 1991 Canada produced nearly 9000 nurses, but by 2000 the number had slipped to 4600. It rose to 6782 this year, with another 1200 foreign-trained nurses being recruited from countries such as New Zealand. However, the total still falls far short of the anticipated need for 15 400 new nurses annually by 2011. — Barbara Sibbald, CMAJ