The Issues of the Nursing Shortage in Canadian Government and Medical Practice

The nursing shortage is currently a problem experienced in countries worldwide. Nationally, Canada is experiencing its own nursing shortage. According to an article published by the Canadian Nurses Association, by 2022 Canada will experience an estimated nursing shortage of up to 60,000 registered nurses (RNs) (Murphy, et al., 2009). There are 3 major factors that contribute to the nursing shortage analysed in this paper. The first factor is the many aging RNs, part of the baby boomer demographic, on the verge of retirement. Secondly, the remaining baby boomer population are also ageing and on the verge of retirement. This large population of Canadians are living longer and will put a strain on the healthcare system. This is due to the fact that along with increased age, more health services will be needed in hospitals, nursing homes, and in home care. Thirdly, there is not enough supply of graduate RNs that will be required to provide care to the influx of the health care needs to the ageing Canadian population. The present nursing shortage, if not adequately dealt with, will lead to a failure to sustain and advance healthcare (Buchan & Aiken, 2008). From a RNs perspective, this paper will discuss, analyze, and comprehend, how the nursing shortage is negatively impacting delivery of health care to patients by producing long and frustrating wait times in hospitals, adverse events for patients, and untenable work situations for RNs (Murphy et al, 2009).

Long and Frustrating Wait Times in Hospitals

The present nursing shortage is negatively impacting the delivery of care to Canadians as it produces long and frustrating wait times in hospitals. Wait times are increased due to the increase amount of Canadians seeking health care services compared to the amount of health care providers that can assess, monitor, and treat these individuals. There is an increased demand of health care services from the ongoing surplus of aging baby boomers while the supply of RNS is not meeting this demand. Once individuals arrive at the hospital they will wait to be assessed by a RN and doctor. Then, they would have to wait until there is a bed available for admission. According to Medicare (2009), 90% of individuals in Ontario spend a maximum of 4.5 hours in the emergency department for minor conditions. Unfortunately, as individuals become older there are physiological changes that become impaired. For example, the immune system, responsible for detecting and fighting infections, has a decreased ability to perform this function as the body gets older (Baker, & Heitkemper, 2014). Without these normal physiological functions there is an increased risk for hospitalization of older adults. With the current aging population the demand for health care services is increased which result in an increase amount of emergency room visits. Furthermore, nurses make up one third of the Canadian health care workforce (Canadian Federation of Nurses Union, 2013). That being the case, the supply doesn’t meet the demand which results in increased wait times and a need for more RNs. Although the nursing shortage has a significant impact on wait times, it is not the only reason wait times are long. According to Medicare (2009), other reasons for long wait times are “poorly organized services, cuts to hospital services, the need for more long-term care and home-care, and better patient outcomes” (p. 1). These are only a few other reasons that increase wait times in emergency rooms. For future RNs, once some of these other issues impacting wait times are resolved; there will be more jobs available. For example, once the government revokes hospital cutbacks, more beds will be available for patients to be looked after by RNs.

Adverse Events for Patients

The present nursing shortage is negatively impacting the delivery of care to Canadians as it produces adverse events for patients. Studies have shown that a decrease in the amount of RN staff directly correlate with “higher rates of outcomes potentially sensitive to nursing- urinary tract infections, pneumonia, shock and cardiac arrest, upper gastrointestinal (GI) bleeding, failure to rescue — and length of hospital stay in both medical and surgical patients” (Duffield et al., 2011, p. 245). These adverse events can be reduced if there were fewer patients per RN. As a result of the nursing shortage, hospitals have developed their own quick fix. Hospitals are currently over-utilizing their RNs by making them work overtime and increasing their patient loads. According to the Canadian Federation of Nurses Union (2013), not only does this contribute to a decrease of quality patient care but there is also an escalation of 7% in patient deaths for every added patient to a typical RNs assignment. This is significant because with the increase demand for health care services and the lack of funding provided to hospitals to increase nursing staff and available hospital beds, current working RNs may be subject to an increase patient workload that will result in increased patient mortality and outcomes potentially sensitive to nursing. For future RNs, if government funding is not provided, overtime and increased patient loads will continue to be present in hospitals. Luckily, the CNO has established six policy scenarios that will help deal with the nursing shortage. Among the six is a plan to increase RNS productivity. This will be done by eliminating non-nursing tasks by providing support staff and by providing appropriate equipment and technology allowing RNs to focus more on registered nursing care (Murphy et al., 2009).

Untenable Work Situations for RNs

The present nursing shortage is negatively impacting delivery of care to Canadians as it produces untenable work situations for RNs. The past president of the Canadian Nurses Association, Judith Shamian, was interviewed in 2011 and talked about the current concerns about nursing shortages. She explains that the shortage is being compensated by a lot of nurses working overtime (Winston, 2011). In 2010, nurses worked 20,627,800 hours of overtime costing $891 million/year (Canadian Federation of Nurses Unions, 2013). Furthermore, Shamian goes on about how the overtime causes an increase in absentee days for RNs compared to the rest of the public; a result of working very long shifts to the point of exhaustion (Winston, 2011). These untenable working conditions have a direct association on the delivery of patient care because it is highly associated with medication errors which can have significant impact on patient mortality. Statistics Canada (2008) found that there was an increase in medication errors when nurses worked a 12-hour shift, compared to shorter shifts, and when nurses worked overtime. If this current problem isn’t dealt with, future nurses will be experiencing the same problem. There have already been moves which focus on workplace quality. The government of the Northwest Territories was the first to sign the Healthy Healthcare Leadership Charter which ensures that the government makes workplace quality a priority (Anonymous, 2008). Additionally, if this charter is signed by every province and territory, it will positively impact the RNs workplace by reducing turnover rates and increasing job satisfaction, which will
consequently decrease the number of medication errors.

Conclusion

With all things considered, it is evident that the nursing shortage is a national epidemic that is currently impacting the delivery of health care to Canadians as it produces long wait times in hospitals, adverse effects for patients, and an untenable work environment for RNs. Although, the nursing shortage is not the only factor affecting the delivery of health care to Canadians, it is a significant one. Among the other issues affecting the delivery of health care to Canadians is lack of funding and inappropriate use of funding. The federal and provincial government must work through many of these issues in order to deliver optimum health care to Canadians and to ensure RNs are in place when and where Canadians need them.

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