Sustaining the Canadian Nursing Workforce

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Houssem Eddine Ben Ahmed discusses the recruitment and retention of Canadian nurses.

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Houssem Eddine Ben-Ahmed discusses the recruitment and retention of Canadian nurses.

Image courtesy of interviewee. March 22, 2024

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This video video is a transcription of a presentation discussing an article published in a nursing leadership journal, which highlights complex issues facing the nursing and healthcare workforce in Canada, such as staffing shortages, excessive workloads, and toxic workplace environments. These challenges negatively affect nurses' psychological well-being, contribute to burnout, and potentially lead to a decline in the quality of patient care.

The speaker outlines a comprehensive review aimed at identifying evidence-based solutions to these issues. The methodologies employed included a literature review, consultations with experts, and interviews with key stakeholders. The review identified over 1,000 articles, ultimately focusing on 1,176 relevant ones.

Key findings were categorized into reactive and long-term solutions, with emphasis placed on three main approaches: "Retain and Support," "Return and Integrate," and "Recruit and Mentor." Specific suggestions include reducing nursing workloads, creating supportive workplaces, integrating internationally educated nurses, and focusing on local recruitment initiatives.

In conclusion, the presentation stresses the urgent need for coordinated, evidence-based solutions to address the persistent challenges faced by healthcare workers and ensure high-quality care for patients. The speaker calls for immediate action from policymakers and a comprehensive implementation of the proposed solutions to avert a future crisis in the healthcare system.

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X-TIMESTAMP-MAP:LOCAL=00:00:00.000,MPEGTS=900000

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We have published it, this,

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article on the nursing, leadership journal,

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the Canadian Journal, and, one, like nursing

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and healthcare workforce, have been facing a number

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of complex issues, including staffing shortages, heavy

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and excessive workloads, mandatory over time,

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toxic workplaces, emic, violence, et cetera, et cetera.

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And this, all these issues,

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may have a negative impact on the nurses

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and the he healthcare workforce, for example,

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they may have impact on their, psychological wellbeing,

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on their progression, during,

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you know, in, in their pathway.

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And also many, they may leave the, their positions

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and also the profession altogether.

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And also, this may have an impact on the, quality

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of care and healthcare services offered

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to the clients, resident and patients.

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For example, we may, we have heard a lot about,

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missing nursing care.

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We have heard a lot about burnout, like, the people

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that can also like die when they don't have,

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receive a high quality care.

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So in, when nurses don't feel good, don't feel,

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or they feel burned out, of course,

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this have negative impact on the patients and, and,

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and the quality of care to identify the different,

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solutions or evidence based solutions

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and initiatives that have been implemented in Canada,

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or even at the, at the international level,

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we have conducted a comprehensive product review.

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Uh, so this is a type of, knowledge synthesis,

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which is like a designed to offer, policy,

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healthcare, or decision makers with rapid informations.

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Uh, because you, like, within a time of crisis, we need

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to provide psychologists in evidence to,

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implement some initiatives.

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So this is a feasible in this kind, in this kind of, of,

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in, in, in this context.

01:51.465 --> 01:53.605
So for the comprehensive level review,

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we have used different methodologies.

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Like, we have conducted peer reviewed, literature.

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We have consulted the literature,

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and also with the asserts of two, librarians from the,

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from the University of Ottawa.

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And we have identified more than 1000 articles.

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And, we have included only 1, 176

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articles within this review.

02:15.265 --> 02:17.605
And to do that, we have used the confidence,

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which is a platform, to, that supported us

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to screen, to extract the data

02:23.825 --> 02:27.805
and synthesize the data, into, different teams.

02:29.075 --> 02:30.845
Also, we have,

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used like different databases like Al PubMed midline to look

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for the, for this literature

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and the second method that we have used to collect data.

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We have, used interviews

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and group discussions with, 42 stakeholders

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that are representatives of unions, representatives of,

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of regulated bodies, and other key nursing,

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and healthcare organizations to do that.

02:54.665 --> 02:57.405
So for these interviews, we have,

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also like we have individual

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Interviews and also focus groups.

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So for the focus groups.

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So we have,

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divided the groups into break rooms, breakout rooms,

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for the, for the each room, we have targeted three themes.

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First team, like the, the are retention, then the return,

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and then recruit recruitment of, of nurses.

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And for each team, there were like groups.

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And these groups have, ranked the different initiative

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that we have identified in the re review according

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to their importance.

03:29.545 --> 03:33.205
And, here, like we have invited an expert, of x,

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of cross lead, cross C, which is like a software that use it

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to, to show, the process with the transparency

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for these stakeholders, how, what are the most impactful,

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initiatives, to implement.

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And then we have, conducted the surveys

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with the 11 key, negotiators that are members also

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to CFNU, the Canadian Federation Officer Unions,

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in case if we did not capture all the initiatives.

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So this, service have augmented the data.

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And, just wanted to be sure

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that we have covered all these initiatives.

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So those are the different

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methodologies that we have conducted.

04:14.525 --> 04:18.225
Uh, for this rapid review, our findings, we have,

04:18.685 --> 04:21.505
so we have like two big parts, themes of the findings.

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One theme about reactive solutions,

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that solutions should be implemented in the

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medium and short term.

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And also we have identified, long term solutions.

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Like in this article that we have published,

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we have focused only on the reactive solutions

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that we're gonna talk about today.

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For reactive solutions,

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we have identified like three Rs, the approach.

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So the first r, which is like retain and support.

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Uh, we have focused on different, measure folks,

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and then there is return and grade.

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And the third are recruit and mentor for.

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So for the first R we have focused on the issue

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that have identified at the beginning.

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So, for example, we have focused like on initiative

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to reduce nursing workloads, both in acute

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and non-acute settings.

05:04.655 --> 05:07.465
Also, we have identified solutions that to create safe

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and healthy and more supportive workplaces.

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Uh, you know, like, because there is uncivility

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and many, many nursing have been facing this kind

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of demonizing practices.

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And also, we, suggest a solution

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to embed mental health days.

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So this may let nurses

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to energize themselves when they take, one

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or two days of, of break.

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Also for the to retain nurses, we have implemented target

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and retention solutions across their career continuum.

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So when nurses, they graduate, they need to,

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be supported and also throughout their career, of course,

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until their retirement.

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For the, for the second R, which is return and integrate.

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Here we have focused on how we can return nurses

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who have left the profession or the public sector,

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because many, they have, they, they went

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to the private sector to work

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because the conditions are better

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than in the, in the public sector.

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Also, we have suggested

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to develop magnet like working conditions

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and organizational culture.

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You know, like in USA, they have implemented,

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a magnet hospitals, which is one of the gold standard,

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for excellence in nursing.

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So we, our experts have highlighted

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that this is very important to implement it in Canada,

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to, improve, work, working conditions

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of, of, of healthcare workers.

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And also to return

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and integrate, this, this workforce.

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We suggest facilitating the integration

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of internationally educated nurses within Canada.

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You know, like we have many international educated nurses

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that are in Canada, and they're,

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that are unemployed or underutilized.

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They don't work here.

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Most of them are, struggling

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with the registration process.

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So we need to streamline the registration process

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and to, ate their integration within the healthcare,

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the Canadian healthcare workforce,

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and the third R, which is recruit and mentor.

06:59.625 --> 07:03.525
And this, we have focused how we can, recruit nurse

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and focus on the local recruitment.

07:05.745 --> 07:07.565
And instead of recruiting overseas,

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because the shortage is global.

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So we need like to focus on nurses that are here in Canada

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by fostering pathways into nurse training, through

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and tuition free for the following years.

07:18.505 --> 07:22.645
And also, student loan forgiveness programs to, and,

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and target trainee diversification.

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You know, like we are serving diverse populations.

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So we need to focus on,

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diversifying this, workforce.

07:31.345 --> 07:34.565
And also, of course, support expansion of training programs

07:34.565 --> 07:36.525
through employer funded secondments

07:36.745 --> 07:39.405
of the clinical nursing faculty in academic institutions.

07:39.785 --> 07:41.565
We have added to the three hours,

07:41.625 --> 07:43.485
we have the fourth hour, which is respect.

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Nurses and healthcare workers need to feel respected

07:47.385 --> 07:52.205
by the policy, makers to work within healthcare

07:52.205 --> 07:54.165
and to provide high quality services.

07:54.785 --> 07:59.605
So this generally, what are our, data showed,

07:59.605 --> 08:01.845
after conducting, contacting this, the,

08:01.845 --> 08:04.765
this review here, like what we can take home,

08:05.275 --> 08:07.605
like messages from this rapid review

08:07.605 --> 08:10.965
and from this, research that first, we need

08:10.965 --> 08:13.885
to support nurses because they are the largest group

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of healthcare workers, which is the most priority

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for health policy decision maker to take action, we need

08:20.285 --> 08:21.885
to take action to support nurses.

08:21.995 --> 08:23.085
This is not a new call.

08:23.595 --> 08:26.565
This nurses have been facing this problem.

08:27.065 --> 08:30.005
Uh, this issues more for more than decades.

08:30.665 --> 08:31.845
Uh, you know, like a report

08:31.845 --> 08:34.045
after report, we are, we are suggesting the same

08:34.045 --> 08:37.125
recommendations, but there is no action, I can say,

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or few actions that have been undertaken,

08:39.945 --> 08:43.205
to support healthcare workers, which is important also

08:43.205 --> 08:45.725
that we need to implement evidence-based solutions

08:46.265 --> 08:49.125
to support first the nursing cook force, that the,

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that requires urgent reactive solutions

08:51.325 --> 08:54.205
and also proactive solutions in the medium term

08:54.305 --> 08:55.895
to avoid the future crisis.

08:56.675 --> 09:01.215
So, the solution that I have presented,

09:01.285 --> 09:04.015
earlier, there are different solutions,

09:04.115 --> 09:08.295
but we should not pick up, it's not a cafeteria just

09:08.295 --> 09:10.415
to pick up and choose from, from the solution,

09:10.415 --> 09:13.535
but it should be, implemented as a set

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of solutions are coordinated planet

09:15.835 --> 09:18.215
and sequenced solutions that all levels

09:18.235 --> 09:20.055
of government governments need to undertake.

09:20.515 --> 09:22.695
So this is what we need,

09:22.835 --> 09:26.415
or watch, the, unit contributions of,

09:26.435 --> 09:29.535
of our review, that all the solutions should be implemented

09:29.595 --> 09:32.415
by, you know, planet.

09:32.835 --> 09:36.775
So that's why we have suggested, such subject plans for

09:37.615 --> 09:40.415
employers, stakeholders, and the federal government.

09:40.675 --> 09:44.845
And I think this is like, like to avoid the future crisis,

09:44.845 --> 09:46.885
you know, like the CVID 19 have,

09:47.215 --> 09:49.725
exacerbate the situation of,

09:49.725 --> 09:50.885
nurses and healthcare workers.

09:51.425 --> 09:53.845
So if you would like to have better services in Canada

09:53.985 --> 09:55.445
and even in other countries,

09:55.445 --> 09:57.565
because the global is crisis, we need

09:57.565 --> 09:58.805
to support healthcare workers.

09:59.745 --> 10:03.965
So this is what we can, take from this, the,

10:04.025 --> 10:05.125
the, this, this review.

10:05.125 --> 10:07.245
But we still need more other researchers

10:07.385 --> 10:09.325
to sustain our healthcare workers.

Nursing Workforce Challenges and Solutions

00:00:00 - We have published it, this, article on the nursing, leadership journal, the Canadian Journal, and, one, like nursing and healthcare workforce, have been facing a number of complex issues, including staffing shortages, heavy and excessive workloads, mandatory over time, toxic workplaces, emic, violence, et cetera, et cetera. And this, all these issues, may have a negative impact on the nurses and the he healthcare workforce, for example,
00:00:34 - on their progression, during, you know, in, in their pathway. And also many, they may leave the, their positions and also the profession altogether. And also, this may have an impact on the, quality of care and healthcare services offered to the clients, resident and patients. For example, we may, we have heard a lot about, missing nursing care. We have heard a lot about burnout, like, the people
00:01:04 - receive a high quality care. So in, when nurses don't feel good, don't feel, or they feel burned out, of course, this have negative impact on the patients and, and, and the quality of care to identify the different, solutions or evidence based solutions and initiatives that have been implemented in Canada, or even at the, at the international level, we have conducted a comprehensive product review. so this is a type of, knowledge synthesis, which is like a designed to offer, policy,
00:01:39 - because you, like, within a time of crisis, we need to provide psychologists in evidence to, implement some initiatives. So this is a feasible in this kind, in this kind of, of, in, in, in this context. So for the comprehensive level review, we have used different methodologies. Like, we have conducted peer reviewed, literature. We have consulted the literature, and also with the asserts of two, librarians from the, from the University of Ottawa.
00:02:10 - And, we have included only 1, 176 articles within this review. And to do that, we have used the confidence, which is a platform, to, that supported us to screen, to extract the data and synthesize the data, into, different teams. Also, we have, used like different databases like Al PubMed midline to look for the, for this literature
00:02:40 - We have, used interviews and group discussions with, 42 stakeholders that are representatives of unions, representatives of, of regulated bodies, and other key nursing, and healthcare organizations to do that. So for these interviews, we have, also like we have individual Interviews and also focus groups. So for the focus groups. So we have, divided the groups into break rooms, breakout rooms,

Nursing Recruitment and Retention Strategies

00:03:11 - First team, like the, the are retention, then the return, and then recruit recruitment of, of nurses. And for each team, there were like groups. And these groups have, ranked the different initiative that we have identified in the re review according to their importance. And, here, like we have invited an expert, of x, of cross lead, cross C, which is like a software that use it to, to show, the process with the transparency
00:03:45 - initiatives, to implement. And then we have, conducted the surveys with the 11 key, negotiators that are members also to CFNU, the Canadian Federation Officer Unions, in case if we did not capture all the initiatives. So this, service have augmented the data. And, just wanted to be sure that we have covered all these initiatives. So those are the different
00:04:14 - for this rapid review, our findings, we have, so we have like two big parts, themes of the findings. One theme about reactive solutions, that solutions should be implemented in the medium and short term. And also we have identified, long term solutions. Like in this article that we have published, we have focused only on the reactive solutions that we're gonna talk about today. For reactive solutions, we have identified like three Rs, the approach. So the first r, which is like retain and support.
00:04:48 - and then there is return and grade. And the third are recruit and mentor for. So for the first R we have focused on the issue that have identified at the beginning. So, for example, we have focused like on initiative to reduce nursing workloads, both in acute and non-acute settings. Also, we have identified solutions that to create safe and healthy and more supportive workplaces. you know, like, because there is uncivility and many, many nursing have been facing this kind
00:05:17 - And also, we, suggest a solution to embed mental health days. So this may let nurses to energize themselves when they take, one or two days of, of break. Also for the to retain nurses, we have implemented target and retention solutions across their career continuum. So when nurses, they graduate, they need to, be supported and also throughout their career, of course, until their retirement. For the, for the second R, which is return and integrate.
00:05:50 - who have left the profession or the public sector, because many, they have, they, they went to the private sector to work because the conditions are better than in the, in the public sector. Also, we have suggested to develop magnet like working conditions and organizational culture. You know, like in USA, they have implemented, a magnet hospitals, which is one of the gold standard, for excellence in nursing. So we, our experts have highlighted

Integrating Internationally Educated Nurses in Canada

00:06:21 - to, improve, work, working conditions of, of, of healthcare workers. And also to return and integrate, this, this workforce. We suggest facilitating the integration of internationally educated nurses within Canada. You know, like we have many international educated nurses that are in Canada, and they're, that are unemployed or underutilized. They don't work here. Most of them are, struggling with the registration process.
00:06:51 - and to, ate their integration within the healthcare, the Canadian healthcare workforce, and the third R, which is recruit and mentor. And this, we have focused how we can, recruit nurse and focus on the local recruitment. And instead of recruiting overseas, because the shortage is global. So we need like to focus on nurses that are here in Canada by fostering pathways into nurse training, through and tuition free for the following years.
00:07:22 - and target trainee diversification. You know, like we are serving diverse populations. So we need to focus on, diversifying this, workforce. And also, of course, support expansion of training programs through employer funded secondments of the clinical nursing faculty in academic institutions. We have added to the three hours, we have the fourth hour, which is respect. Nurses and healthcare workers need to feel respected by the policy, makers to work within healthcare
00:07:54 - So this generally, what are our, data showed, after conducting, contacting this, the, this review here, like what we can take home, like messages from this rapid review and from this, research that first, we need to support nurses because they are the largest group of healthcare workers, which is the most priority for health policy decision maker to take action, we need to take action to support nurses. This is not a new call.
00:08:27 - this issues more for more than decades. you know, like a report after report, we are, we are suggesting the same recommendations, but there is no action, I can say, or few actions that have been undertaken, to support healthcare workers, which is important also that we need to implement evidence-based solutions to support first the nursing cook force, that the, that requires urgent reactive solutions and also proactive solutions in the medium term
00:08:56 - So, the solution that I have presented, earlier, there are different solutions, but we should not pick up, it's not a cafeteria just to pick up and choose from, from the solution, but it should be, implemented as a set of solutions are coordinated planet and sequenced solutions that all levels of government governments need to undertake. So this is what we need, or watch, the, unit contributions of,

Addressing Healthcare Workers' Crisis Post-COVID

00:09:29 - by, you know, planet. So that's why we have suggested, such subject plans for employers, stakeholders, and the federal government. And I think this is like, like to avoid the future crisis, you know, like the CVID 19 have, exacerbate the situation of, nurses and healthcare workers. So if you would like to have better services in Canada and even in other countries, because the global is crisis, we need
00:10:07 - So this is what we can, take from this, the, the, this, this review. But we still need more other researchers to sustain our healthcare workers.

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Sustaining the Canadian Nursing Workforce

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