Canadian nursing is in the midst of a staggering brain drain, with one in
three nurses opting out of the profession or moving to the United States
within three years of graduation, a study says.
Twenty per cent of new nurses walk away because of poor working conditions,
low wages and a shortage of full-time work. And another 10 per cent move
south, according to a report to be made public today.
"When I saw these numbers, I was taken aback at how bad things really
are,"
said Lynda Kushnir Pekrul, president of the Canadian Nurses Association,
which commissioned the research.
"When you put it all together, you realize that the availability of quality
nursing care in Canada is seriously threatened," she said yesterday in an
interview. "This report demonstrates we have some big problems here and
it's
time to get down to brass tacks and start finding solutions."
Two years ago, the CNA warned that the aging work force and an inability to
attract and retain nurses spelled long-term trouble.
The association estimated that the health system could be short 113,000
nurses by 2011.
These new data suggest that those predictions may have been too low, Ms.
Kushnir Pekrul said, "because we didn't realize how much trouble we were
having retaining new graduates."
Canada has about 263,000 registered nurses, and approximately 8,000 new
graduates annually, but many already work and are upgrading.
Only half the country's nurses work full-time. And two-thirds of those who
work part-time say they do so involuntarily and juggle multiple jobs.
Earnings for nursing graduates are actually declining, falling to an average
$31,200 annually in 1997 from $36,876 in 1988. Job dissatisfaction is also
high, with one-third of nursing graduates saying they would opt for a
different career if they could turn back the clock.
"The national focus on reducing health-care costs has created an
environment
in which retaining and attracting the number of registered nurses to meet
the future demand has become increasingly difficult," the report states.
Employers are reluctant to hire full-time, opting instead for part-time,
contractual workers. Most nurses in Canada have also been subject to wage
freezes or imposed contracts that keep their wages stagnant.
The result, according to the new study, is that nurses are either getting
out of the profession or fleeing to the United States, where full-time jobs
for skilled nurses are plentiful, and they are doing so in record numbers.
In fact, four times as many graduates of the class of '90 have left nursing
as graduates of the class of '86. They tend to leave for more stable jobs in
the health-care sector where the pay is better.
Between 1995 and 1997, nearly one in 10 nursing graduates migrated to the
United States. That ratio is seven times higher than for Canadian graduates
in other fields.
Last week, Ontario hospital nurses ratified a contract that makes them the
highest-paid in the country.
The contract covers 38,000 registered nurses working in 135 of Ontario's 165
hospital corporations. On April 1, most hospital nurses will have a starting
wage of $20.50 an hour, rising to $30.25 in the eighth year.
By contrast, the country's lowest-paid nurses, in Newfoundland, start at
$16.83 and rise to $20.92.
However, the Newfoundland government is trying to stem the brain drain by
offering new nurses $3,000 to stay on the Rock.
The plan, which will provide the cash incentive if graduates agree to work
in the province for the year, is believed to be the first formal incentive
program offered by a provincial government.
The nurses association report, entitled The Labour Market Integration of New
Nursing Graduates in Canada 1986-97, was prepared by the Canadian Council on
Social Development, based on data from Statistics Canada.
In a preface to the report, the CNA makes a number of recommendations to
better retain and integrate new graduates, including the creation of
full-time jobs, paying for the education of nurses who want to upgrade,
internship and mentorship programs, better job-orientation programs, and a
campaign to entice Canadian-educated nurses to return from the United
States.
But Ms. Kushnir Pekrul said that working conditions are "without a doubt
the
No. 1 priority. The working environment is not at all satisfactory. In fact,
it's so bad that many nurses are leaving their chosen profession." The
study
reveals that college-trained nurses have been much harder hit by
deteriorating employment conditions than their university-educated
counterparts.
THE NURSING LABOUR MARKET
There were 254,964 registered nurses in Canada in 1998.
Only 50.8 per cent of nurses work full time.
The median age of nurses in Canada is 45.
The median age of nursing graduates is 32.
Seventy-seven per cent of nurses have a diploma, 21 per cent a
baccalaureate, 1.5 per cent a master's and 0.1 per cent a doctorate.
By 1995, 46 per cent of new RNs were graduating with a university degree, up
from 37 per cent in 1986.
One in four nursing graduates from the class of 1995 works part time.
Two-thirds of the part-timers say that is not their choice.
Nursing graduates who work in nursing earn less than nursing graduates in
all other occupations.
>From 1995 to 1997, 9.3 per cent of nursing graduates migrated to the United
States, compared to 1.3 per cent of other graduates.
More than 89 per cent of nurses who migrated to the United States cited the
ability to work full time as the reason; 51 per cent also cited work
conditions in Canada.
Two out of 10 graduates of the class of 1990 have left nursing.
Sixty-two per cent of registered nurses work in hospitals, 12 per cent in
nursing homes, and 11.5 per cent in home and community care.
Nurses represent three-quarters of all health-care professionals.
More than 95 per cent of nurses are women.