A new Montreal Economic Institute report shows nearly half of all new Canadian nurses under the age of 35 are leaving the profession.
But nursing organizations and unions say this figure overstates the problem — highlighting the need for better, centralized data to inform Canada’s nursing shortage.
“There is no uniform collection of nursing shortage data across the country, and there’s no standardized approach to measuring what a nursing shortage looks like,” says Angela Wignall, chief executive of the Nurses and Nurse Practitioners of B.C.
“There are [about] 470,000 [nurses] in the country, and to not have good data collection about what functionally ends up being more than 50 per cent of your entire health workforce seems foolish.”
Young nurses are “the senior nurses of tomorrow,” says Emmanuelle Faubert, author of the Montreal Economic Institute report and an economist at the public policy research institute. “If we don’t retain younger ones, not only are we increasing the shortage, but we’re also affecting the quality of care in the long run.”
The nursing shortage — which is projected to rise to 117,000 nurses by 2030 — imperils patient care.
“If you feel you could safely provide care [to] four patients and you’re assigned eight patients … your entire shift, you’re not feeling safe yourself or that you can provide the best quality of care,” says Valerie Grdisa, CEO of the advocacy organization Canadian Nursing Association.
‘Staggering’ number leaving
The Montreal Economic Institute report, published in September, measures how many nurses under 35 did not renew their licenses in 2022 compared to the number who received a license for the first time.
A “staggering number of nurses are leaving [the profession], whether that is temporarily or permanently,” said Faubert, who based her report on datasets from the Canadian Institute for Health Information, a research organization.
The report shows the highest attrition rates in the Atlantic provinces. In Nova Scotia, for example, 624 nurses under 35 did not renew their licenses while 1,033 requested a license for the first time.
“We can’t really know exactly why, but … it might be the case that nurses are less attracted to working in these provinces — they’d rather work in denser cities,” said Faubert.
But Janet Hazelton, president of the Nova Scotia Nurses’ Union, disagrees with the report’s findings. While she agrees there is a nationwide nursing shortage, she says the province is “not seeing many of our younger nurses leaving.”
The province had 12,738 registered nurses in 2023, up 18 per cent from 2022, according to the Nova Scotia College of Nursing.
Since April 2022, the largest provider of health services in the province, Nova Scotia Health, has added 372 nurses under 35, the organization said in an emailed statement.
In B.C., which has one of the better attrition rates, the report says 32 young nurses exited for every 100 new nurses who registered.
But Wignall, of the Nurses and Nurse Practitioners of B.C., also disagrees with the report’s findings. “[W]hat I can say is, according to data that we do have, we do not appear to be losing that degree of nurses in B.C.,” she said.
Faubert says one possible explanation for the discrepancy between the report and Hazleton and Wignall’s numbers is that the total number of registered nurses entering the profession has increased.
“When you look at [the number of new registered nurses] in most provinces, [the number] still goes up, simply because there’s more people — there’s a lot of graduating nurses,” she said. “There’s a lot of inflow — there’s a lot of new blood in the profession, but there’s a lot of people that also leave.”
Guesstimating
It is not known exactly how many registered nurses there are in all of Canada — making it difficult to understand whether professionals are staying in the field, says Grdisa.
Grdisa estimates there are about 470,000 registered nurses in the country. But, “there’s actually a belief that we might even be double or triple counting nurses that have licensure in different jurisdictions,” she adds.
Some nurses relocate to new provinces for work, while others choose to work in long-term care or teaching. In addition, at any given moment, “probably 20 per cent of nurses are leaving … because they’re retiring,” Grdisa said.
Wignall says better representation at the provincial level can play a big role in retaining nurses. B.C.’s chief nursing officer has created more funding opportunities for nurses to work in sectors outside public hospitals, such as nonprofits that aid the homeless. B.C. is also the first province to implement minimum nurse-to-patient ratios.
But absent broader change, Canada’s nursing shortage — and the lack of data on it — will remain problems.
“When we look at nursing shortage, we’re starting from … behind the starting line,” said Wignall. “We know that there’s a shortage, [and] we know that in the next 10 years, our population is going to demand significantly higher care with significantly more complexity. And we don’t have the nurses today to meet demand.”
