A huge exodus of nurses choosing to take early retirement at the same time that newly graduating nurses are juggling a career and a family is creating a “double whammy” in nursing supply.
This shortage is not temporary and is likely to worsen as the increasing demands put upon the remaining nurses pushes them into further exhaustion.
Johanne Rust is a Nurse Practitioner, who spoke about what she has witnessed in the field. She started as a nurse in 1997 and has worked as a Nurse Practitioner since 2004.
“When I started out as an RN, there was a lack of permanent positions. There was no guarantee of hours, or predictable income.” The only permanent position Rust was able to get as an RN was a permanent weekend night rotation.
In order to make an income, it is commonplace for a nurse to be casual in two or three locations.
“The shift offers would come for the same days from more than one location, but you could only pick up one shift at a time. Things are still like that in many workplaces. You might have casual staff, but that might not mean that they are available to pick up shifts or fill in when nursing rotations become vacant due to leaves. We are plagued by a system that never has enough nurses, but is not structured to offer reliable employment.”
“I decided to complete my Nurse Practitioner education because my current employment opportunities as an RN lacked security. I wanted something better for myself, and my family,” said Rust.
“I have seen many of my co-workers take early retirement, creating this huge exodus of very experienced and valuable nurses out of our hospitals and care facilities. One of the reasons many nurses consider retirement is fatigue. Nurses are exhausted,” explained Rust. “Working conditions have made them so exhausted, that they can’t see any other feasible way to get some rest.”
Another trend right now is that many of the nurses who have finished their four-year degree program are women who want to start having families. Nursing remains a predominantly female workforce, and many of these young graduates have put off having a family for a long time.
“Both female and male nurses look forward to taking time off when those children arrive. They have worked hard and are deserving of the precious years with their families just as anyone else is. So we have a very dire situation where much of the work is falling on the remaining staff on the floors. These nurses are trying to manage looking after increasingly acute patients, and doing it day in and day out with less help.”
“When I worked on the wards, I found that there was increasing expectations being pushed onto nurses. We didn’t have housekeeping on some shifts; you had to run meal trays to and from patient rooms. There was no ward clerk to catch the phones. The charting was taking more and more time away from patients. All of these obligations diluted the ability of a nurse to be able to provide bedside nursing,” explained Rust.
“I find that there is also a lack of mentorship in nursing, and new graduates don’t have a very long time to learn from an experienced colleague before they are thrown into the fire. In the city, if you are understaffed on a ward, you might be able to pull staffing from another clinical area. Commonly, a rural unit may only have one RN, RPN or LPN on shift. If that one nurse is not available, there is no other unit to pull a nurse from. As a last resort, the solution might be to reduce services, or close the unit,” explained Rust.
“I love what I do, and being a Nurse Practitioner has given me back the chance to work directly with the patients and their families. This is the part that draws so many of us into nursing as a vocation. I am disappointed that we have had to witness closures and cutbacks in our communities.”
“I am not aware of any new initiatives to address the nursing shortage, and the factors that have contributed to this mess have been going on for years. I would like to see creation of enough permanent full time positions to ensure we can replace all of our retirees, support nurses through prolonged leaves like maternity/paternity leaves, as well as sick time or other unpredictable leaves. On a unit, you can calculate how many days of vacation leave your combined staff is entitled to.”
“I wish that we could work that into a new ‘supernumerary’ nursing position, and put it in the budget. As a potential patient myself, and a taxpayer, I would like to see those hours filled by someone who is not exhausted and pulling another overtime (expensive) shift. It’s time we start doing some upstream work on our staffing instead of trying to put a band-aid on it when we have no other choice.”
