Investing in Nurse Retention is Investing in the Future of Canadians

It takes a special type of person to pursue a career in nursing. Nurses have invaluable skills and competencies, and they are known for being strong, resilient, gritty, and powerful—in part because they have needed to be over the past few years but also because nursing is a demanding profession. This year’s National Nursing Week theme is “Changing Lives. Shaping Tomorrow.” In the past four years, we have all witnessed the critical role nurses play in health care. In hospitals, long-term care homes, primary care, and community and public health settings, nurses work day and night to support us in maintaining our health and the health of our loved ones. Without nurses and their professionalism and expertise, what would the future of our healthcare system look like?  

Canada’s Chief Nursing Officer

The role of the Chief Nursing Officer (CNO) was reinstated after being vacant for almost a decade – I was appointed to the position in August 2022, and my experience since then has been profoundly impactful, both personally and professionally. Since I took on the role of CNO, I made a commitment to visit every province and territory to hear first-hand from nurses about their experiences working in academic, clinical, and community settings. As of January 2024, I can officially say that I have visited nurses from coast to coast to coast, even reaching North of the Arctic Circle to engage with nurses in Inuvik, Northwest Territories. 

During all of those visits, and despite their challenging work environments, I observed nurses consistently delivering essential care with humanity, composure, and competence. It’s clear that nurses care deeply about their patients, but they also want to improve the current state of the health workforce, not only for themselves and their peers but for future generations of nurses in Canada. Investments in the future of our nurses are investments in the future of Canadians. I have been listening to nurses’ stories and diverse perspectives, and these have been critical to informing the solutions that we, as policymakers and decision-makers in Canada, are working towards. There is hope for the future, but the current and longstanding challenges, which were exacerbated by the pandemic, certainly don’t make things easy.

Challenges Faced by Canadian Nurses

Nurses are the largest group of regulated health professionals in Canada, but the size and capacity of the workforce have not kept pace with the growing demand for care. Collectively, they are currently facing increased workloads, high rates of burnout, stress, anxiety and depression, and, in some cases, abuse. 

The current health workforce challenges are complex and multifaceted, and they require innovative and comprehensive mitigation strategies. According to the 2024 Canadian Federation of Nurses Union (CFNU) member survey results, 4 in 10 nurses intend to leave the profession, leave their job, or retire within the next year. Additionally, the latest data published by the Canadian Institute for Health Information demonstrates that surges in healthcare job vacancies suggest demand for healthcare is outpacing the gains in supply.

Nurses want to stay in their jobs, but the working conditions are forcing them to choose between their profession and their well-being. While recruitment will remain an ongoing endeavour for any healthcare organization or health authority, we must shift our gaze to exploring how we are keeping nurses in the profession and encouraging the return of those who may have left. Stated simply, we cannot recruit our way out of the current crisis, but if we “fix” nursing by changing the way in which we value nurses’ contributions, we may actually fix health systems across the country. It is imperative that we think about the current health system’s challenges and constraints in an innovative manner and put forth concrete strategies that will initiate real change.

Solutions for the Retention of Nurses

My personal experience as a nurse for over 20 years and engaging with nurses from across the country has been a key contributing factor in the development of the Nursing Retention Toolkit. This toolkit is the result of a pan-Canadian collaboration with the Canadian nursing community and is a resource to help improve and optimize the working conditions of nurses in Canada. It was co-created by a diverse group of nurses brought together in June 2023 at the Nursing Retention Forum. The group comprised nursing experts, including point-of-care nurses, nurse-employers, decision-makers, nursing regulators, union representatives, and others. As a resource created by and for nurses, it draws on evidence-based practice, lived and living experiences of point-of-care nurses, and insights from nursing professionals at all career stages, including nursing students. The aim of the toolkit is to provide Canadian nurse employers, healthcare organizations, health systems, and health systems administrators with practical strategies and tools to improve the retention of nurses.

The toolkit focuses on eight core themes that impact a nurse’s day-to-day working life in the domain of clinical care and provides corresponding tools that Canadian employers can implement. The themes are:

• Inspired leadership
• Flexible and balanced ways of working
• Organizational mental health and wellness supports
• Professional development and mentorship
• Reduced administrative burden
• Strong management and communication
• Clinical governance and infrastructure
• Safe staffing practices

It is my hope that the toolkit will spark change in how we think about and value the work of nurses, and build on the work others have done to improve nursing retention in Canada. 

I believe that this toolkit provides a framework that can be utilized as a key resource for employers and organizations to enhance the working conditions of nurses. It also ensures the voices of the profession are woven into decision-making processes. Others must now step up and address the ongoing challenges. There is strength in numbers, and it is only by working together that we will be able to build a more equitable, robust, and sustainable healthcare system that values and respects the nursing community so they can continue to deliver care now and for future generations.