By Senthujan Senkaiahliyan, Queen’s University Smith School of Business

As Ontario begins to slowly enter a post COVID-19 world, we see priorities shifting from the health system to other avenues. Although on paper, COVID-19 may seem manageable, it remains a significant burden to our health system with a reported 0.4 hospitalization rate this past month. (Public Health Ontario, COVID-19 Data Tool)
As health systems shift priorities to resilience, research has begun to take place into assessing our current health workforce to help manage and better protect it from further shocks. However, as we fight one war, another one emerges and that is the increasing inflation within our province and nation. Statistics Canada recently reported that annual inflation rate has jumped to 7.7% in May, which is the fastest it has increased since 1983.

In our previous article, we highlighted how Bill 124 has effectively capped healthcare workers from compensation increases to 1% annually. This moderation period is to last for three years with some employer groups ending their moderation period in 2024. It was projected that due to these caps and increased workloads, we will see nurses leaving the bedside in favour of care-coordination or administrative roles that are less taxing mentally and physically. The currently released Health workforce Crisis report by the Canadian Nurses Association has confirmed that projection in which they highlighted that all three stages of the nursing profession (early, mid, and senior) have been critically impacted by the pandemic.

With inflation reaching almost 8% as of this month (and expected to be a lot higher by the end of the year) and nurses only receiving a 1% adjusted wage for this fiscal year, they are facing what amounts to more than an estimated 7% pay cut in our current economic situation. These effective reductions in salary for nurses and other healthcare workers send out a clear message that this is no longer a sufficiently compensated or valued profession. As certain industries are attempting to offset inflation by promising increases and bonuses to employees, Bill 124 bars hospital management from properly compensating their nurses for their services.

So, what does this mean? Already, the Ontario Nurses’ Association has noticed a “mass exodus” of nurses leaving the bedside but now with inflation we will see them leave the profession entirely. The clinical skills that nurses possess are highly valued in other industries, noticeably the technology sector. Clinical Informatics has been massively growing and mid to senior-level nurses have been utilizing their skills to build and serve growing IT infrastructure among healthcare practices. Another growing field is clinical research, in which nurses often can wear multiple hats such as coordinating studies as well performing many of the clinical duties required in clinical trials. Previously we reported a skills gap for entry-level nurses as they move towards care coordination and vaccination centre roles where they do not receive adequate bedside training but in a post-COVID world, we will see a training gap in which mid and senior level nurses who are often the backbones of preceptor training leaving their roles to pursue other avenues in which they are fairly compensated for their time and skills.

Among the public, healthcare workers have been hailed as heroes and many young students look at nursing as a career that is respected and a contribution to societal good. The Canadian Nurses Association has seen a rise in young people applying to nursing schools, but this trend has not translated into an increase in nursing school class sizes. With the lack of experienced nurses in the field, it will be very hard to support an increase in clinical placements to help support these new graduates. Without adequate clinical training, we can very well see many nurses graduating from school without establishing the core critical competencies.

We must look to innovative solutions to combat this national nursing shortage crisis. Pre-pandemic policies and health systems have been proven to be ineffective when faced with external shocks. To truly build resilience in our future healthcare system, an evaluation of all policies, including Bill 124 must be immediately conducted to ascertain if the short-term savings in health workforce dollars will translate into the long-term of effects of an inefficient and poorly staffed healthcare system.

Senkaiahliyan was a masters student in the Smith School of Business at Queen’s University. Image from Shutterstock.