Statistics Canada says there is a shortage of 4,265 nurses in British Columbia. The results are closed emergency rooms and stressed patients and staff.
Aashna Thapar grew up wanting to be a nurse, inspired by her father, a nurse in Surrey. But her recent student internships brought a dose of real medicine: while they strengthened her love for the profession, they also revealed the extent of the nursing shortage in British Columbia
“Being able to work with patients was such a rewarding experience. But at the same time, you can see how busy it is in the hospital and how much the nursing shortage is really affecting everyone as well as patient care,” said Thapar, who was a student intern at the University Hospital of Northern BC in Prince George.
“It really opened my eyes to the reality of breastfeeding.”
There is a severe nursing shortage, and it goes beyond Prince George. It extends throughout British Columbia, into Canada and into many other countries. And it comes at a time when demand for health care is growing in this province, mainly due to an aging population, more people moving here and the COVID-19 pandemic.
Shortages of health care workers, as well as rising sick calls during this seventh wave of COVID-19, have hurt British Columbia’s primary care system. Over the past few months, several emergency rooms in rural communities have been temporarily closed, including in Port Hardy and Port McNeil.
Island Health announced Friday that the Cormorant Island Community Health Center will be closed at night for two weeks starting August 2 due to a nursing shortage.
At Lions Gate in North Vancouver, a patient died on July 11 after waiting on a stretcher for about two days in an overcrowded, understaffed emergency room. That death, which distraught staff described as avoidable if there were more nurses and beds, is being looked into by Vancouver Coastal Health.
Thapar, who is halfway through a four-year nursing degree at the College of New Caledonia and the University of Northern British Columbia, said during her studies she witnessed nurses working their hardest to care for as many as possible patients. She hopes governments will do more to help.
“We need more mental health support, we need more funding, we need more nursing staff. We have to find a way to have better working conditions for nurses and students,” said Thapar, who is on the executive director of the British Columbia Federation of Students.
“For me, the reason I got into nursing is because of how rewarding the career is. When you go to the hospital and put a smile on a patient’s face just for the smallest things, you definitely want to keep going.”
The provincial and federal governments have responded to this crisis, but much more needs to be done to address the “really urgent” nursing shortage, said Elizabeth Seivik, director of the University of British Columbia’s School of Nursing.
“Sometimes it feels like the system is ready to just keep squeezing and squeezing and squeezing until there aren’t enough health professionals — nurses, doctors, health aides, respiratory technicians — to meet the need. And when that happens, the quality of health care suffers and tragedies happen,” she said.
“When the system is so stretched that we can’t actually meet the health care needs of British Columbians, that’s a real concern.
BC is hiring as fast as it can, Dix says
Health Minister Adrian Dix said his government was recruiting staff as quickly as possible. That’s critical, he said, “not only because we need more staff in places, but because the existing staff are worn out” after 2 1/2 years of the pandemic.
“The overall impact of COVID has been challenging for people and people’s health. So we’re dealing with that and responding with a massive addition of health care staff, which in some cases has proven to be insufficient to [meet] search. And we have to continue to work on that,” Dix said.
As of March 31, according to the most recent data available from Statistics Canada, British Columbia had 4,265 nursing job vacancies — three-quarters of them for registered nurses, 20 percent for licensed nurses and a small number for nursing supervisors. Nearly two-thirds of these vacancies are in Metro Vancouver, the Fraser Valley, the Squamish to Lillooet corridor and the Sunshine Coast. The rest are scattered in other parts of the province.
This number of vacancies is down from the 5,875 recorded on the same date in 2021, when we were one year into the pandemic. But that’s still much higher than the 3,230 nursing vacancies at the end of March 2020, when the pandemic had just begun, and 2½ times the 1,715 open positions on March 31, 2019, before the arrival of the pandemic.
Healthcare job vacancies hit an all-time high
Nationally, a StatCan report released in June said health care job vacancies had reached an “all-time high.” It found that there is a shortfall of more than 34,000 registered nurses and licensed practical nurses in Canada, accounting for two-thirds of the vacancies in the health professions.
The crisis is growing worldwide. A report released in January by the International Council of Nurses found that about 13 million new nurses are needed worldwide “due to existing nursing shortages, an aging nursing workforce and the growing impact of COVID-19.”
Dix said the provincial government is trying to address that problem by adding 602 more public post-secondary nursing positions: 362 for registered nurses, 40 for psychiatric registered nurses, 20 for nurse practitioners and 180 for licensed nurses. This will result in approximately 2,600 nurse training positions in British Columbia.
When the NDP was elected in 2017, ending 16 years of Liberal rule, Dix said British Columbia had the lowest number of nurses per capita of the 10 provinces. His government has since “led the country in adding registered nurses” — there were 43,985 in 2018 and 51,575 by 2022 — but there is more work to do.
“When you’ve started last, there’s still room to move forward,” he said. “We have to lead the country for a few more years.”
The latest data from the Canadian Institute for Health Information shows that British Columbia has climbed to only ninth place by 2020 in terms of registered nurses per capita.
‘Incredible stressors’ on the health care system
The nursing shortage is being exacerbated by healthcare workers infected with the latest strain of COVID. For example, more than 8,300 health authority employees were sick between July 11 and 13, the time frame that included the North Vancouver patient’s death, representing five percent of B.C.’s health workforce, the Ministry of Health said.
And that number of people not sick is higher than for the same three-day period in 2020 and 2021, Dix said.
Not having enough nurses to treat patients “has created incredible stressors on the health care system,” said UBC’s Saewyc.
“So we’ve seen what was already a shortage to begin with get worse. There are also early retirements, there are people who leave the profession because of the work environment, the intensity, the serious concerns,” she said. “It’s stressful when you worry that your patients aren’t going to get the care they need.”
The solution isn’t just to hire new nurses, but to retain existing ones, said Saewyc and Adriane Gear, vice-president of the 48,000-member British Columbia Nurses Union.
Wages could be increased, their work environment could be improved to deal with the documented rise in verbal and physical abuse from stressed patients, and 12-hour shifts could be adjusted to make it more appealing to older people nurses to continue working.
While breastfeeding has never been “glamorous,” it’s usually satisfying, Geer said. Except when nurses are understaffed—and they’re left to worry about what they missed, whether they helped someone quickly enough, and whether they paid enough attention to patients and families.
“This constant witness to human suffering takes its toll,” Geer said. “If nurses can’t be supported to do a good job, then people have no interest in staying.”
In response to questions about the retention, the ministry’s statement said the nurses’ contract expired on March 31 and collective bargaining had not yet begun, and said several online tools had been set up to support nurses’ mental health.
The ministry also said it is trying to speed up the accreditation process for foreign-trained nurses in British Columbia, which could help 1,500 applicants next year.
While it’s laudable that the province has created 602 new nurse training positions, Saewyc said they will be difficult to fill in the short term. That’s because most of the province’s 17 post-secondary institutions that offer nursing degrees are experiencing a shortage of instructors either due to retirements or an inability to hire new staff, said Saewyc, the incoming chair of the Board of Nursing Education. sisters of British Columbia
Also, she said, there aren’t enough clinical placements even for the current batch of nursing students because if veteran nurses are already overworked, they don’t have time to teach students either.
The Department of Health did not respond to a question about nursing instructors and student clinical placements, but said it expected all 602 new places to be filled.
Dana Domasig was caught in the under-resourced nursing education system. After completing a recommended nursing course at Douglas College, she had to apply and reapply for two years before she was finally accepted for this September.
“I’ve thought about it for a long time and it’s the career I want to pursue. I stuck with it because I thought I would be really good at it, but the two-year waiting list is crazy,” said Domasig, 26, whose mother is a nurse.
She wonders, however, whether other young people facing these delays will choose different career paths. And she worries about the expectations for new nurses when they graduate from…
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