Colleges can now offer four-year nursing degrees. But, in many cases, everyone is still competing for the same number of program seats.
Nurses have always been the front lines of health care but never more critical than during the COVID-19 crisis. In this ongoing series, we explore the many issues affecting nursing.
For Marijana Loncar, it was a 91 per cent average in high school that gained her admission to Brock University’s four-year degree program for registered nurses.
It’s the kind of average that’s commonplace in the programs, which are so sought after that Queen’s University in Kingston, for instance, received nearly 1,900 applications from students who were vying for one of the program’s 124 seats last fall.
That means a lot of people who want to get into the field are being left on the career sidelines as Ontario faces a nursing shortage that’s been both brought into the spotlight and worsened by the ongoing COVID-19 pandemic.
The Registered Nurses’ Association of Ontario pegs the current shortfall of registered nurses at 22,022. Ontario saw only 4,595 nurses graduate from an RN degree program in 2020, according to the government. While that is more than double the number who graduated in 2006, critics say the province needs a targeted plan that brings much faster results. And many doubt that changes to legislation and new programs tied to educating nurses will come anywhere near filling the gap.
“An evidence-informed strategy engaging multiple stakeholders, including acute, long-term and community care, professional associations and nursing education providers, is urgently needed to assess current needs and plan for the future of the nursing workforce,” said Linda Johnston, dean of the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto.
One of the biggest shifts in nursing education came in February 2020 — just a month before the pandemic hit Canada in full force — when the province announced colleges could have their own four-year stand-alone programs for RNs without having to partner with a university, which many had done since the early 2000s, when RNs were required to get a degree instead of a diploma.
Humber College, St. Lawrence College, Georgian College, Seneca College and York University, which until now partnered with Georgian, had all received approval from the ministry to offer stand-alone bachelor’s degree programs in nursing as of early December 2021, according to a spokesperson with the Ministry of Colleges and Universities.
But it may not make getting into a nursing degree program any easier for the thousands of students vying for the spots, for which demand has doubled in recent years.
Enrolment in bachelor of science in nursing programs at Ontario universities, and collaborative programs with colleges, was upped by 630 spots last fall, adding to the previous year’s first-year enrolment of 4,400, according to the Council of Ontario Universities.
Steve Orsini, president and CEO of the council, says Ontario universities are continuing to work with the government to ensure they can meet the demand for RNs, “including supporting the government’s commitment announced in the Fall Economic Statement to create an additional 1,000 new registered nursing positions for Fall 2022.”
Though the new four-year college programs may increase the overall number of spaces, experts say the greater impact will be in boosting the number of RNs in rural areas, who will be able to attend local schools and who are then more likely to live and work in those communities.
Georgian College, for example, loses about half the graduates of its collaborative RN degree program with York University, where students complete their final two years, to the GTA.
“In our experience, almost 50 per cent of the students did not return to their local communities upon graduation. They stayed in the city,” said Sara Lankshear, Georgian’s associate dean for health, wellness and sciences.
“That has a significant impact then on the availability of registered nurses in our local communities.”
Georgian has a campus in Barrie as well as Owen Sound, which means RNs can now do their clinical practices in communities where they may later be employed, and where it’s particularly difficult to recruit nurses.
“That’s huge for a nursing crisis, particularly in smaller cities and rural cities as well,” said Lankshear.
It will also eliminate the economic hardship of having to move or commute.
Georgian wasn’t the only college that partnered with a university in another city. Humber College previously partnered with the University of New Brunswick and St. Lawrence College, which has campuses in Kingston, Brockville and Cornwall, partnered with Laurentian University.
“There are some individuals whose dream perhaps to be a registered nurse was just out of their reach because they simply could not afford to then have to either move or to drive back and forth down to the GTA for the last two years of their (degree),” said Lankshear. “And for the students that were in our programs, they did find it to be quite a hardship.”
Applications to Georgian’s program, which starts in 2022, have already gone up.
While bringing new nurses in is, of course important, keeping the ones already in the field is just as much of a challenge and something that’s seen less attention from official government channels.
Loncar, who now works at Credit Valley Hospital in Mississauga as a float nurse, which means she’s assigned to units that are understaffed, said a number of factors are impacting the retention of nurses.
“The burnout is No. 1,” she said.
But also, “higher patient loads and the acuity of patients now are much more extreme because people have been scared to go to the hospital to focus on their health,” she added. “So they are a lot more sick.”
Loncar spent the night before talking to the Star on the COVID floor, tending to patients who needed total care, which means they required assistance with turning, feeding and changes.
“We have more patients who require full-on, one-on-one care,” she said. “And when you have six to seven patients a night, it is very difficult to be able to connect with your patients.”
Another factor affecting retention is Ontario’s Bill 124, which caps wage increases for nurses and other public workers at one per cent.
“We aren’t being financially compensated in the way that we should,” Loncar said. “It has impacted a lot of senior nurses who feel that it is too hard for them to stay given the acuity of some of these patients.”
The bill also feeds into the notion that nurses aren’t worth compensating, said Dianne Martin, CEO of the Registered Practical Nurses Association of Ontario.
“I think there’s also the issue of being sort of categorized as ‘We’re not going to worry about your pay. We might worry about the police officers or whoever, but we’re not going to worry about yours,’ ” she said.
“And I think that at a time when you’re giving more than you can really give, I think that’s just disheartening to a point where people become so readily disillusioned.
“It’s a bitter pill to swallow.”
Forty years ago, when Martin joined the profession, the education and expectations were vastly different.
“When I became a nurse, we did not do a lot of synthesis,” she said. “We kind of were told the answers and we carried out what we were supposed to do.
“But now we’re expected to problem solve at a very high level.”
As nursing gained professionalism and the skills and knowledge of nurses were being utilized to a greater extent, the education requirements changed as well. By 2005, RNs were required to get a degree from a university, and diploma programs for practical nurses changed from 10 months to at a minimum of two years.
“As people realized that nurses could do a lot of things that have previously been done by others, the education that needed to happen moved forward — our knowledge of chronic disease, the technology, all of those aspects, particularly research. The knowledge needed to evaluate all of that moved to being much greater,” said Martin, who graduated as an RPN and later became an RN.
And with that came another big change — nurses leaving the profession.
“We didn’t used to have that issue in nursing. Nurses became nurses and were nurses for life,” Martin said. “And now we’ve got a problem where nursing has changed. And we’ve been expecting things of nurses that are really far beyond what a human can sustain.”
“And so what we’ve got to do is solve those problems because we can just keep adding nurses to the system,” says Martin. “But if we’re not retaining them, we’re not ready to move forward in solving this crisis at all.”
Article From: The Star
Author: Patty Winsa
