The stress and strain of working during the past 14 months has taken its toll on the mental health and wellbeing of nurses, prompting a significant number of them to consider leaving the profession after the pandemic ends. That’s the primary finding of a survey carried out by the Registered Nurses’ Association of Ontario (RNAO).
The survey was conducted between Jan. 29 and Feb. 22 and captured responses from more than 2,100 registered nurses (RN), nurse practitioners (NP) and nursing students working in Ontario and in all domains of practice and across all sectors of the health system, including hospitals and long-term care.
Virtually all respondents (95.7 per cent) said the pandemic affected their work, with a majority of nurses reporting high or very high stress levels.
One of the most alarming findings coming out of the survey was that at least 13 per cent of RNs aged 26-35 reported they were very likely to leave the profession after the pandemic. RNAO says the number should serve as a wake-up call to employers, policy-makers and the government because the figure is four times the normal rate of attrition for that age cohort.
“Losing so many nurses at an early stage in their career would have a profound and lasting effect on how our health system functions so we need to take this very seriously and act immediately,” says Dr. Doris Grinspun, RNAO’s CEO. “I am extremely worried and more determined than ever to advocate for the retention of nurses who are early in their career.”
Added to those planning to exit the profession at a significantly higher rate than usual are late career nurses. A total of 4.5 per cent of respondents say they plan to retire now or immediately after the pandemic. Within that 4.5 per cent of respondents, nurses in the following roles are most likely to exit the workforce: nurse executives (13.8 per cent), advance practice nurses (13.3 per cent) and college faculty (10 per cent). Three per cent of staff nurses also say they plan to retire immediately or after the pandemic.
Grinspun says the results paint a sobering picture of Ontario’s nursing landscape and are even more concerning given that the province has the worst RN-to-population ratio in the country. “The kind of nursing exodus that our survey suggests threatens people’s health and our health system. We must take immediate steps to address that risk.”
The association has five recommendations it says the provincial government and employers must implement to improve workforce planning and retention strategies:

  • increase support for early and mid-career nurses
  • increase staffing levels
  • bolster admissions to nursing baccalaureate programs by 10 per cent in each of the next four years
  • increase the supply of NPs as outlined in RNAO’s recent Vision for Tomorrow report
  • implement succession planning for management, senior management and faculty positions

RNAO president Morgan Hoffarth says Premier Doug Ford and Health Minister Christine Elliott have lauded the efforts and dedication of nurses, even calling them heroes during the past year. And yet, Hoffarth says, “accolades alone will not help nurses as they valiantly care for patients during this fast escalating third wave. Our colleagues are exhausted, some are even at the breaking point and what they want is a government that gives them the help they need: more staffing and more supports. As one nurse in our survey put it succinctly: ‘I don’t need more pizza, I need more people in here’ referring to her unit.”
Hoffarth says “RNAO’s recommendations — if acted on quickly — will soften the post-pandemic hemorrhage of the nursing workforce. RNs and NPs have given their all to Ontarians and to our province, leaving their families and themselves shorthanded since the pandemic began. They have faced job-related risks, excessive workloads and cancelled vacations and yet, they have carried on with the resilience nurses are known for. However, there are limits to what nurses can endure. Premier Ford must act immediately.”
RNAO plans to conduct a series of focus groups to examine potential retention strategies such as reducing workload, limiting overtime and increasing mentorship opportunities in the workplace.
The association will continue holding its regular open forums for nurses so they can talk openly about how they are coping during the pandemic.