Quebec Order of Nurses annual report reveals bleeding of staff to private sector

Many nurses report having left the front lines after the stress of COVID-19 made their jobs more difficult and less safe, creating a shortage of health-care workers in certain regions and even forcing rural areas to temporarily close hospital units.

Montreal — The number of practicing nurses in Quebec continued to grow in 2020-2021, but slowly.

The year's growth of 1.9 per cent was lower than that of the previous year's 2.2 per cent growth, which was the biggest staffing jump of the last ten years.

The Order of Nurses of Quebec (OIIQ) unveiled its annual statistical report on Monday, reporting that nearly 80,500 nurses had joined its registry as of March 31, 2021.

The profession remains overwhelmingly female, but the proportion of men in nurses' ranks reached its highest level in 10 years at 14.1 per cent.

Despite the overall increase, the proportion of those working in the public network fell slightly, from 84.8 per cent last year to 84.4 per cent this year.

At the same time, the number of nurses working in private agencies increased by 19 per cent.

The approximately 2,760 professionals who have turned to the private sector represent only a small proportion of the total, but the increase is nonetheless the largest, again, in a decade.

WORKPLACE ISSUES IN THE SPOTLIGHT

In its press release, the OIIQ also notes that "the shortage of nurses in the health and social services network has shone the spotlight on issues related to the organization of work."

In particular, they wrote, "the most recent report shows that more nurses are turning to the private sector to improve their working conditions."

The group's president, Luc Mathieu, added that "improving services to citizens will be possible through retaining and rehiring nurses, but also through three priorities: more efficient work organization, better clinical support, and university training to meet the more complex needs of the population."

These statistics also don't take into account more than 6,000 rights to practice the Order granted to allow people to participate in the effort to fight the pandemic.

These included former members who were no longer on the roll, nurses from the Armed Forces, students, and nurses who graduated outside Canada.

The rights to practice could be full or limited, depending on the case.

REGIONAL INEQUALITIES

One of the things to note is that Quebec has a nurse-to-population ratio significantly higher than the Canadian average: it has 7.62 nurses in direct care per 1,000 inhabitants, a slight increase compared to 7.53 last year.

Both compare very favourably to the 7.02 average of the rest of Canada. Ontario lags significantly behind Quebec, with a ratio of 6.32 nurses to 1,000 people.

On a regional basis, it's the Nord-du-Québec, Nunavik and James Bay region which has, by far, the best ratio in the province at 13.45 nurses per 1,000 inhabitants.

That's ahead of the regions of Quebec City (11.04), Montreal (10.33) and Gaspésie-Îles-de-la-Madeleine (9.33).

The ratio is lowest in the Lanaudière region, with 4.93 nurses per 1,000 inhabitants, just below the Outaouais (5.09), the Montérégie (5.18), the Laurentians (5.29) and Laval (5.49).

On the other hand, Quebec lags seriously behind in one area: the number of specialized nurses is low, though they are well qualified, with half having earned a university degree (44.5 per cent have a bachelor's degree and 5.4 per cent have a master's degree).

Overall, there are 842 specialized nurse practitioners in Quebec, a ratio of 9.3 per 100,000 inhabitants, compared to 18.4 in the rest of Canada and 22.2 in Ontario.

Specialized nurse practitioners specialize in one of several areas: primary care, adult care, neonatal care, pediatric care and mental health.

Another category, that of specialist clinical nurses, will be established. There are only 35 of these in Quebec and only one specialization has been recognized for them so far, namely infection prevention and control, but "the needs extend to other areas of practice," the Order says.

Finally, the Order's statistical report revealed a curiosity in the "rate of integration into the labor market."

It shows that this rate among those with a bachelor's degree reached 93.5 per cent, compared to 89.9 per cent among those with a college diploma.

Although these are both robust rates, it is still surprising that in times of a shortage of nurses, between 6.5 per cent and 10 per cent of them cannot find work.

This report by The Canadian Press was first published in French on Nov. 1, 2021.