More nurses left the profession in Canada last year than entered it for the first time in two decades, according to a new report that raises flags for nursing groups.
Tuesday's report from the Canadian Institute for Health Information shows the supply of registered nurses, the largest category, declined 1.0 per cent in 2014, the first such downward move in almost 20 years.
"The number of regulated nurses not renewing their registration exceeded the number of nurses entering the profession," the report's authors said.
Given population growth and the complexity of patients discharged after shorter hospital stays, the decline is a concern, said Doris Grinspun, CEO of the Registered Nurses' Association of Ontario said Tuesday from the International Council of Nurses conference in Seoul.
"We want to show the government sector by sector what's happening to the workforce because by the time they will wake up, it will be too late and we will have patients that will suffer the consequences," Grinspun said.
CIHI said the total supply of nurses in Canada was 406,817 in 2014. Specifically, there were 293,205 registered nurses, 107,923 licensed practical nurses and 5,689 registered psychiatric nurses.
Overall, the supply of regulated nurses eligible to work in the country dropped 0.3 per cent last year.
There are 4,400 fewer RNs working in nursing homes and long-term care facilities than in 2005, the Canadian Nurses Association said. The group called the decline in the system's backbone a concern, particularly outside acute care settings, given that Canadians are living longer with more chronic diseases.
CIHI said several factors influenced the reduced supply of regulated nurses with active licences:
- The number of graduates from Canadian regulated nursing programs slowed.
- Fewer regulated nurses applied for registration.
- More chose not to renew their registration because of retirement, leaving the profession or migrating outside of Canada.
Last year in Ontario, a change in regulations from the college, a self-regulatory body, required nurses who weren't working for three years to switch their category or drop their registration. The result was 12, 273 nurses officially left the profession in that province alone.
The Canadian Federation of Nurses Unions, which represents about 200,000 nurses and student nurses, said the decline in supply may be fuelling overtime hours. In its report earlier this year on overtime and absenteeism, nurses worked more than 19 million hours of overtime in 2014.
"The decrease in the nursing supply combined with an aging workforce and fewer students admitted to [entry-level] programs is a sign that our health care workforce is in transition," CFNU president Linda Silas said in a release Tuesday. "To ensure patient safety and a sustainable health care system, we need a national health human resources plan."
The decline in supply of nurses also occurred in Newfoundland and Labrador, Prince Edward Island, New Brunswick, British Columbia, Northwest Territories and Nunavut.
The Canadian Nurses Association noted some of these jurisdictions have higher numbers of people living in rural communities and some of the most senior populations, meaning the impact of reductions could exacerbate challenges in delivering health care.