Nova Scotia's new health minister is being warned the province could face "alarming" shortages across a range of professions in the health-care system as workers approach retirement, which includes a shortage of 800 nurses within five years.
The warning is contained in ministerial briefing notes prepared by the Health Department soon after the Liberals took power two months ago
"Current supply levels for professions in the province are monitored and are relatively stable; however future shortages predicted in certain sectors are alarming," says the document, obtained by The Canadian Press under freedom of information legislation.
The briefing notes identify specific areas that need to be watched: "Professions requiring close monitoring include physicians, registered nurses, licensed practical nurses, continuing care assistants and lab and diagnostic imaging staff to name a few."
'That's a disaster waiting to happen.' - Chuck Porter, PC MLA
The Health Department tracks the numbers through various sources including registration data from the colleges that regulate health professions.
The best available data is for the province's 10,000 registered nurses. Health Department figures provided separately from the briefing notes show about 45 per cent of registered nurses are over the age of 50 and many will be able to retire in the next five years.
The department says there could be a "gap" of about 800 registered nurses if a number of factors remain the same, such as the number of seats in nursing schools, the number of nurses projected to retire and demands that are placed on the system.
Department figures also say that 39 per cent of the province's nearly 4,000 licensed practical nurses and 37 per cent of 851 medical laboratory technologists are over the age of 50. Of the 574 medical radiation technologists currently working, 129 plan to retire within the next five years, which amounts to 22 per cent.
Gap of 800 nurses predicted
Health Minister Leo Glavine said his department has to improve its tracking of all professions to better develop strategies aimed at heading off a shortage of health-care workers.
Potential solutions would involve increasing the number of seats available to training doctors and nurses at universities and colleges, along with stepping up international recruitment of health professionals, he said.
Glavine also said the government would have to look at additional incentive programs, as well as different ways of delivering health care that maintain high levels of service with fewer staff.
"Any time there is a shortage new approaches and innovative ways of training people may need to be employed," he said.
The president of the Nova Scotia Nurses' Union said the looming shortage of nurses is a "huge" problem to a system already dealing with fewer staff.
Janet Hazelton said a shortage of 800 would be equal to losing the entire nursing staff at the IWK Children's Hospital in Halifax or would be more than the total number of registered nurses now working in Cape Breton.
"Everyone sees [shortages] coming, but I'm not sure any one group has the right answers," said Hazelton.
She warned that the number of retirements among nurses is a national problem, which could drive Nova Scotia into a competitive "war" to retain graduates and highly trained nurses who are already in the system, but without full-time work.
Burnouts a concern for union
Cindy Cruickshank, director of health system workforce policies and programs for the province, said current estimates mean planning will have to be done to avoid workforce gaps, adding that ongoing efforts to address staffing needs may mean shortages don't end up being as great as projected.
Cruickshank said it's not always a matter of replacing every job lost with a corresponding job because of changing models of care, which allow for the use of fewer staff.
That's true of most hospitals, she said, which had previously operated with a full complement of registered nurses.
"We simply don't have the numbers to allow us to do that any longer, nor is it necessary to do that," said Cruickshank.
But Joan Jessome, president of the Nova Scotia Government and General Employees Union, said that approach has led to burnout and added overtime costs where staff-patient ratios have not been maintained.
Jessome, whose union represents 14,000 workers in the acute care system, said there has been a lack of full-time hirings across the system, which leads to further shortages when people leave to take permanent positions elsewhere.
She argues while it would be costly up front, greater costs could be avoided in the future if hiring practices were changed.
"If you can hire permanent people, over time that [cost] will balance itself," said Jessome.
Chuck Porter, the Progressive Conservative party's health critic and a former paramedic, said the number of professionals will have to be kept at acceptable levels to meet the increasing demands placed on the system, which is why the figures for registered nurses are troubling.
"If we don't start right now, figuring out how we are going to answer that need in five years' time, that's a disaster waiting to happen," said Porter.