This research was funded by grants from the Government of Ontario and the Canadian Health Services Research Foundation REISS through the Community Health Nursing study.
Tag Archives: nursing workforce
Employer Perspectives on Implementing an Employment Strategy
Authors: Hunsberger, M., Baumann, A., Idriss, D. and Alameddine, M.
In 2007 the Nursing Graduate Guarantee (NGG) was launched to ensure that every Ontario RN and RPN graduate would have the opportunity to work fulltime hours (MOHLTC, 2007). An evaluation of the NGG is reported in Employment of Nursing Graduates: Evaluation of a Provincial Policy Strategy (2008). This fact sheet presents the perspectives of employers who participated in the NGG initiative.
Sector Specific Components that Contribute to Positive Work Environments & Job Satisfaction For Nurses (SSC)
These summaries highlight findings from the research study entitled “Sector Specific Components that Contribute to Positive Work Environments & Job Satisfaction For Nurses (SSC)”. This series of summaries present selected content from a report produced for the Ontario Ministry of Health & Long Term Care (MOHLTC).
View PDF Summary Factsheet 1 of 2
View PDF Summary Factsheet 2 of 2
Ontario’s Web-based Employment Portal for Nursing Graduates: Best Practices
Authors: Alameddine, M., Baumann, A., Idriss, D. and Hunsberger, M.
This summary highlights the findings from the research study entitled “Employment of Nursing Graduates: Evaluation of a Provincial Policy Strategy”. The purpose of the Nursing Graduate Guarantee (NNG) was to ease the transition of new graduates into full-time employment by funding six-month supernumerary (above staff complement) full-time nursing positions for all 2007 nursing graduates (MOHLTC, 2007).
70% FT Nursing Local Health Integration Network (LHINs) Initiative
This summary highlights findings from the research study examining the 70% FT Nursing Local Health Integration Network (LHINs) Initiative.
Canadian Community Health Nursing Study: Toward an Effective Sustainable Workforce
Research Team: Underwood, J., Baumann, A., Mowat, D., Meagher-Stewart, D., Ciliska, D., & Deber, R.
This summary highlights findings about the community health nursing and suggests policy recommendations to optimally utilize the CHN workforce.
Nursing Graduate Guarantee (NGG)
This summary highlights findings from a study examining the Nursing Graduate Guarantee initiative in Ontario. This research has been generously funded by a grant from the Government of Ontario.
Educated and Underemployed: The Paradox for Nursing Graduates
Authors: Baumann, A., Blythe, J., Cleverley, K., Grinspun, D., & Tompkins, C.
Executive Summary:
There are three sources of nursing supply: new graduates, internationally educated nurses, and nurses returning to the workforce. This report focuses on the supply and employment of new nursing graduates in Ontario and their absorption into the workforce during the two-year period covering 2003/4 to 2004/5. Historically, economic cycles have created fluctuations in supply and demand. Between 1993 and 1999, Ontario lost 7275 nurses from the system. This was largely in the hospital sector which lost 9.8% of its nursing workforce. The loss was fi nally recouped by 2003, mainly through growth in the community sector (Alameddine et al., 2006, in press).
There are currently 89,054 registered nurses (RNs) and 24,482 registered practical nurses (RPNs) working in Ontario (College of Nurses of Ontario, 2005). The largest potential employer of new nurses is the hospital sector with 24/7 service and over 31,000 patient beds. Other sectors such as community and public health are much smaller. The uptake of new graduates in Ontario is good. However, some concerns arise from market conditions and the availability of receptor sites (i.e., sites where jobs are available at a given point in time). Job opportunities are unpredictable in areas with few health care institutions. Organizations should have suffi cient annual turnover and a relatively large system to absorb new employees (Baumann, Keatings, Holmes, Oreschina, & Fortier, 2006). Employment opportunities are aff ected by economic booms and turnover resulting from retirement, job change, and workers leaving the profession or moving between sectors. Th e education system functions with relative independence from the employment market. There are no projections of required supply. From 1999 to 2004, the number of graduates in Ontario doubled, but the supply was dramatically reduced by more than half in 2005.
A survey of RN and RPN graduates in Ontario was conducted in 2004 and 2005.
The majority who responded to the surveys indicated they wanted full-time work. However, most of the contract off ers they received were part-time, casual, or temporary. Although there was a 9% increase in employed nurses with full-time status between 2004 and 2005, this may have been due to the small number of students graduating that year rather than the greater availability of fulltime work. The majority of new graduates sought employment in the central region and preferred employment in large teaching hospitals. Fewer favoured the community and public health sectors. Actual employment corresponded with these preferences.
Resurveys at six months and two years after graduation indicated that few graduates had left Ontario for employment, despite their stated intent or willingness to do so. Just over half of those who replied to the two-year follow-up of 2004 graduates had full-time contracts. Over half indicated that their employment had changed since graduation (usually from casual to full-time), suggesting that new graduates experience considerable job mobility in their first years of employment. The government of Ontario has implemented a targeted employer incentive to increase the number of full-time nurses. In addition, on May 8, 2006, a new provincial task force was created to examine the issue of full-time positions for new graduands. Other provinces have strategies to improve uptake and increase retention such as bursaries, loan forgiveness, and mentorship.
Registered Nurse and Registered Practical Nurse Decision Making
Authors: Boblin, S., Baxter, P., Alvarado, K., Baumann, & Akhtar-Danesh, N.
Executive Summary:
Nursing is the largest human resource expenditure for many departments, and the necessity for articulating nursing work and differentiating between levels of knowledge and skills required has become paramount. In Ontario, nursing is one profession with two categories of registration in the general class – the Registered Nurse (RN) and the Registered Practical Nurse (RPN). Both the RN and RPN are governed by the same regulatory body – the College of Nurses of Ontario (CNO), practice within the same Scope of Practice, and frequently work in similar settings. In some aspects, the roles and responsibilities of these nurses are shared; in other circumstances, they are considered distinct. One differentiation between RNs and RPNs is in the nature of the client population for whom care is provided: the RN cares for acute clients with unpredictable outcomes; the RPN cares for stable clients with predictable outcomes. The CNO has established standards of practice for nurses and competencies for entry-level practitioners, which may be interpreted differently by agencies and by individual nurses. The profession, regulatory bodies, and employers are struggling to differentiate between these nurse categories in their attempts to respond to changing client demographics, fiscal restraints, and shortages in nursing resources. Nursing decision making has been identified as one of the ways to differentiate between categories of nurses; this assumption, however, has not been thoroughly tested empirically. Work by Boblin, Baumann and colleagues (Baumann, Boblin & Deber, 2002; Baumann, Deber, O’Brien-Pallas, Donner, Mitchell, Boblin-Cummings & Mulkins, 1992; Baumann, Deber, Silverman & Mallette, 1998; Boblin-Cummings, Baumann, Deber, 1999; Boblin-Cummings, 1996) suggests ways that this might happen. Boblin’s work on implementation decisions and Baumann’s work on the development of an instrument to measure nursing decision making were combined within this study. This study identified and described nursing decision making. Nursing decision making, for the purposes of this study, included a) the Decision Making Process (how nurses make decisions); b) Nursing Interventions and Clinical Activities (what they make decisions about); c) Considerations Prior to Implementation (decisions about how to implement selected interventions); and d) Factors Influencing Decision Making. A combination of quantitative (survey), and qualitative (focus groups and document analysis) approaches were used. The survey identified and described decisions made by RNs and RPNs, determined the frequency that RNs and RPNs made these decisions, and described the difficulty perceived when so doing. It also investigated the influence of variables such as education, experience, and setting on these decisions. Similarities in and differences between RN and RPN decision making were revealed. The results of the survey were further explored through focus groups with nurses. Documents were reviewed to determine whether they captured the components of nursing decision making.
Better Data, Better Decisions A Profile of the Nursing Workforce
Authors: Baumann, A., Keatings, M., Holmes, G., Oreschina, E., & Fortier, V.
Executive Summary:Human resource data routinely collected by hospitals can be utilized in workforce planning, and for comparisons to provincial/territorial and national work forces. Of the various workforces in hospitals, nursing has the largest number of employees. The development and maintenance of hospital databases help planners monitor their workforces by better understanding their characteristics and dynamics.
The study of the Hamilton Health Sciences (HHS) human resource database revealed an interesting profile of the nursing workforce. On average, nurses at HHS were younger compared to those in the Ontario and Canadian workforces. Over the period of fiscal year 2002–03, the average age of the nurses decreased from 44 to 43 years of age. Recruitment of the younger age category (22–29) increased, but the majority of the new recruits worked part-time. The age profile differed across programs and services. Most nurses lived close to the hospital.
The overall number of nurses increased in all employment categories by over 9% in the fiscal year. The amount of overtime also increased, reflecting increased work intensity and absenteeism. An interesting finding was that there were low annual external turnovers coupled with a high retention rate. The vacancy rates decreased over the year, which supports the latter finding. Internal turnover rates were high due to job advancement or job changes available within the hospitals. Retention within the hospitals is good, with the average nurse being employed for approximately 14 years. The amount of overtime and absenteeism is high. Studies have attributed these findings as being a measure of the increased work intensity and historical staff reductions. In response, the overall nursing work force growth was twenty five percent over a period of a year with a nine percent increase in full time staff. Another interesting finding is the number of staff on unpaid leave. This is the type of data that is worth exploring further in order to develop an understanding of the characteristics of this group.
This data creates a profile of the nursing workforce, which is useful for projecting trends and estimating future requirements. At the corporate level, longitudinal examination over a series of years would demonstrate the relationship between the characteristics of the nursing workforce and the overall requirements for patient care. At the unit level, the data is helpful to examine human resource needs and fluctuations in the workforce characteristics. A human resource profile has many data elements and results from the input of a variety of sources and requires high standards of data entry and management. It is an important element of workforce planning, especially when it is supported by an information system with accurate statistical and research information.
Decision makers today have more data about the workforce than was available in the past. The main recommendation would be to produce a template that would provide a basis for comparison of the workforce for planning purposes. The required variables would have to be identified and analyzed both at the department and organization level on an annual basis. This data should be enhanced by comparing it to provincial and national data to provide insight into workforce trends. The collection and analysis of baseline data on workforce is an essential component of planning change. Ultimately this approach will facilitate planning, increase forecasting accuracy and strengthen recruitment and retention strategies.