Mr. Houston, we have a health-care problem

When Nova Scotians need access to their health system, they know they’re in for a long slog.

Indeed, long wait times at the emergency room or for elective surgery are nothing new. They have been the norm in Canada’s health systems for as long as most people can remember.

Part of the reason why this issue remains unresolved today is a shortage of nurses and other health professionals. For instance, back in May, it was estimated that Nova Scotia’s health establishment had 1,000 open nursing positions in hospitals and home care divisions.

This understaffing increases the workload on the remaining nursing staff, which further contributes to burning out those who remain in the profession, thus setting up a vicious cycle.

This can be seen in the increasing number of nurses—especially younger ones—who choose not to renew their license.

The most recent data show that for every 100 nurses below the age of 35 who get a new license to practise, another 60 young nurses choose not to renew theirs, and leave the profession, either temporarily or for good.

This is the second worst ratio of nurses leaving to nurses entering the field in the country, ahead of only New Brunswick.

Things weren’t always this bad. Just 10 years ago, it was roughly 43 young nurses leaving for every 100 that started practising. In other words, Nova Scotia was losing nearly 30 per cent fewer nurses a decade ago than it is today.

So, what happened over the past decade to bring about this situation?

It’s clear that the pandemic didn’t help. It intensified the pressure we put on our health professionals and contributed to worsening the backlog in elective surgeries, further increasing the workload once the worst of the public health crisis was behind us.

But the problem dates from further back. Already in 2019, the ratio of young nurses leaving to young nurses entering the profession was up 18 per cent from 2013.

So, while the pandemic exacerbated the trend, it can’t fully explain the surge in nurses leaving the field.

For a premier like Tim Houston, who campaigned on fixing the province’s healthcare system, tackling this issue should be at the top of the policy agenda.

The good news is that nurses have been quite vocal about the issues that lead them to leave the profession.

In a recent survey of over 5,500 nurses across the country, seven in 10 mentioned problems with staffing, workload, and a lack of work-life balance as extremely important factors that make them think about leaving the field.

And while compensation was an important factor, it came in fifth, behind staffing, scheduling, and workload issues.

It must also be said that nurses who are in the early stages of their careers were the most likely to consider leaving their current job, according to this same survey. They were also the most likely to be interested in travel nursing positions.

This is understandable when we consider that those are the same nurses who have the least seniority. This means they are often stuck with the worst shifts and the last picks for vacations.

As they’re getting started in their careers and might be looking to start a family, they’re condemned to doing frequent overtime and lots of evening, night, and weekend shifts, and to having little predictability in their work schedule.

It shouldn’t come as a surprise that they’re looking for alternatives that would allow them some level of work-life balance, whether in the field of nursing or outside of it.

Until the government-run health establishments can address these issues, nurses will continue to leave in droves either for travel nursing positions or for a completely different career.

It needs to be said: while travel nursing agencies are costly, they are not the problem, so much as they are a symptom of the way our health system is run.

And until the government of Nova Scotia tackles this personnel retention problem, the province’s healthcare woes will remain.

Emmanuelle B. Faubert is an Economist with the MEI and the author of “Which Provinces Struggle the Most to Keep Young Nurses?” and Renaud Brossard is Vice President, Communications at the MEI. The views reflected in this opinion piece are their own.