Amidst staffing shortages, how does the province get more nurses to the front lines?

Burnout among nurses and other front-line staff has been widely reported across the province and the country, with no quick fix available to solve the resulting staffing shortages.

It's a complicated issue with no simple solution, say nursing professionals

Two health-care workers in blue scrubs are seen in a hospital hallway.
The County of Lennox and Addington is struggling to hire a nurse practitioner to work at the John M. Parrot Centre for long-term care, after zero applicants responded to the job posting made in November 2022. (Evan Mitsui/CBC)

Athena Liu, a fourth-year nursing student at the University of Calgary, spends a lot of time watching what happens in the city's hospitals.

She's focusing on internal medicine and respirology, working with a clinical group at Rockyview General Hospital.

She says her peers, instructors and the nursing staff work incredibly hard, but she does see them struggling.

"I think there is burnout, for sure. Like nurses are just trying their best to give, you know, the best care they can. But it's hard when you have two, three nurses, four or five nurses who call in sick," she said.

"Now we have a much higher patient load than what we're used to.… It is very hard."

Earlier this week, five health-care unions representing health-care workers from across Alberta gathered to warn of a continuing staffing crisis.

Burnout among nurses and other front-line staff has been widely reported across the province and the country, and nursing professionals say there's no quick fix.

"The reality is we went into COVID with deficits and those just continued to climb," Heather Smith, president of United Nurses of Alberta, said this week.

As of Friday, more than 130 registered nursing positions — for jobs within 50 kilometres of Calgary — were posted on the Alberta Health Services careers website, with even more posted for licensed practical nurses, registered psychiatric nurses and nurse practitioners. 

In a statement, an AHS spokesperson said they have 1,800 more registered nurses working today than in 2019. They did not say if AHS is short-staffed and by how many nurses.

"Vacancy filling and recruitment is always a priority for AHS and takes place all year, in real-time," the statement said.

Students like Liu say they are seeing nursing shortages as they continue their schooling. She says on one hand, she knows she'll have her pick of jobs when she graduates next year.

But she's not sure what will await her.

"There's a reason why nurses have been quitting and why there has been a turnover," she said. "There's definitely some apprehension going in."

No one solution

Despite the hardships some nurses are facing, there isn't a lack of interest in joining the profession. 

"It's been historical over the last … five years and more that we've typically had, you know, two to three qualified applicants for every seat that we have," said Sandra Davidson, dean of the University of Calgary's faculty of nursing, in an interview on the Calgary Eyeopener.

And the grades of those applicants are driving up admission averages. 

(Ose Irete/CBC)

Spokespeople with Mount Royal University, the University of Alberta, the University of Lethbridge and the University of Calgary's nursing programs all identified 90 per cent or higher as the current bar. 

"The great qualifications that people bring with them push that bar higher," Davidson said. 

"We basically start with the most qualified, the highest grades, the highest GPA and work our way down that list until we are full."

Faith Moghaddami has always wanted to be a nurse. She says it's a privilege to help people, and even through the pandemic's trials, she's maintained her enthusiasm for the profession.

Moghaddami is a third-year student with the University of Calgary's nursing program. She says that when she applied to schools in 2020 with an average above 90 per cent, she still was put on wait lists.

"It sucks that when universities are accepting students that they really don't have an assessment to kind of take in … personality and what is your real reasoning for being in nursing," she said.

"I met a couple first-year students … and they were saying, 'Yeah, like I wanted to get into nursing, but I unfortunately didn't. So I went with anthropology or I went with kinesiology' or something like that."

Faith Moghaddami is the vice-president of communications for the Undergraduate Nursing Society at the University of Calgary. (Submitted by Faith Moghaddami)

If the profession is losing people who are passionate and well-suited for the work, that's a shame, according to Kathy Howe, executive director of the Alberta Association of Nurses.

She thinks it may be time to look at creating a new standard across post-secondary schools when it comes to admitting nursing students, such as an interview, to be assessed along with grades.

"Does a 96 high school average make a good nurse? … What's your ability to critically think? What's your ability to empathize with others? What's your ability to take knowledge and apply it," she said. 

"Particularly now when we're so short of nurses, we want every nursing seat to count."

The University of Calgary is looking at ways it might be able to assess some of these other qualities, Davidson says. It's also trying to expand enrolment by running some clinical programs in rural communities.

Boosting nursing seats

On top of better analyzing candidates, schools could also look to boost the number of students in their programs — but it's not an easy task. 

There's a limited number of spots at each school, and there's other resources, like nursing instructors, that would need more support.

"If the health-care system is depleted of nurses, you can imagine it starts to put pressure on us recruiting enough clinical instructors as well," Davidson said.

"There has to be enough capacity in the system for those students to get the clinical hours in practicum and experiential learning that they require." 

According to the Ministry of Advanced Education, there are just over 9,200 nursing seats available in the province. In May, the ministry announced it would create 1,338 more nursing spaces as part of a $171-million investment in high demand post-secondary programs.

Earlier this month, the government also announced it would be expanding educational opportunities for internationally-trained nurses. Alberta Health noted it also signed a new collective agreement with United Nurses of Alberta to ensure they're competitively paid.

An ambulance is parked outside the Emergency Room at Foothills Medical Centre
An ambulance sits at the emergency entrance of Foothills Medical Centre in Calgary in January 2022. (Ose Irete/CBC)

While creating more nursing spaces is a good idea, Howe says, there also needs to be a focus on retaining the nurses already on the front lines, many of whom haven't been able to take time off throughout the pandemic and beyond.

"It's a worker's world. There's fewer of them and more demand. So they're able to say, you know, I'm going to step back and I'm going to work in a casual position," said Howe.

"We need to find a way to get more people so that units can be well-staffed, nurses can feel safe in their workplace and in the care they're delivering."

These are all things Liu is considering as she nears the end of her schooling.

"Nursing can be very emotionally, physically, mentally draining," she said.

"I am excited, but I'm also kind of mindful because I understand that when I'm working out there like I need to, I guess, take care of myself but also take care of my colleagues because we're going to be in this together."

With files from Lisa Robinson, Rob Brown