New Brunswick faces severe nursing shortage during COVID-19

New Brunswick is facing a severe nursing shortage over the next five years. These are part of the findings of a report issued by the New Brunswick Nurses Union (NBNU), released October 15.

The report, The Forgotten Generation: An Urgent Call for Reform in New Brunswick’s Long-Term Care Sector, states that nursing numbers are slated to drop drastically in the early 2020s, as more than 800 Registered Nurses (RNs) retire from the active workforce.

The report highlights the shortages in the long-term care sector, a sector particularly hard hit in Canada during the COVID-19 pandemic.

The report’s findings echo previous statements by officials in New Brunswick’s health care system.

In June 2019, nine months before the COVID-19 pandemic hit the province, Horizon Health Board Chair John McGarry announced Horizon would have to hire 320 nurses every year for the next five years to keep up with staffing shortages.

However, New Brunswick universities have not received funding to allow them to train enough nurses for those positions.

According to the NBNU, the difference between the number of RNs entering the provincial workforce and those leaving could soon approach 400 nurses annually.

“To avoid the worst­-case scenario, […] New Brunswick must immediately implement comprehensive reform to the way it trains, recruits, and retains its nursing workforce,” the report says.

The report recommends that the government work with University of New Brunswick (UNB) and Université de Moncton to expand the number of nurses being trained in the province. Both universities have already made proposals to that effect, but so far, the Higgs government has ignored them.

Administrators at UNB have known of the nursing shortage problem for years and, according to documents obtained through Right-to-Information by the NBNU, pleaded with government officials to expand the number of seats in UNB’s nursing program, and in its LPN-RN (Licensed Practical Nurses—Registered Nurses) bridging program.

Not only did the request fall on deaf ears, but at the start of fiscal 2019-20, the Higgs government announced a cost saving measure, cutting $8.7 million in funding to the province’s nursing schools used to fund nursing grads.

Just this week, Higgs’s Finance Minister Ernie Steeves announced a $48.7 million budget surplus for the 2019-20 fiscal period.

The $8.7 million in provincial funding—or $3,300 per student—had helped defray the costs of clinical training for nurses (estimated at UNB to be $24,000 per year), which have steeply risen in part because of ongoing shortages of clinical staff in the province. Nursing tuition fees have also had to rise as a result, even as nursing seats have had to be restricted.

“Why would the number of seats be reduced when there is an immediate need that will continue long into the future? Don’t we want New Brunswickers to stay in our province and have well­ paying jobs,” McGarry of Horizon Health says in the report.

The nursing shortage is hitting the province hard in the midst of the pandemic. In the midst of an outbreak of COVID-19 in Moncton, 16 nurses were forced to self-isolate, creating scheduling havoc for nurses that will only get worse as the pandemic continues.

Nursing shortage in long-term care

The report particularly highlights the effects of the nursing shortage on long-term care facilities, where New Brunswick is now seeing acute shortages in the midst of a pandemic, which has severely affected Canadian nursing homes.

A memo from Horizon Health’s human resource officer, Maura MacKinnon on October 7 asked for LPN volunteers at the local Manoir Notre-Dame special care home, where at least 19 cases have been detected (as of October 15).

According the NBNU, there are only 540 nurses working in the province in long-term care homes (there are about 8,000 nurses in the provincial workforce).

Nursing homes have been routinely cited for breaking minimum staffing regulations, and for not having a registered nurse on duty—sometimes for weeks at a time. New Brunswick regulators have also relaxed oversight of nursing homes’ staffing levels, allowing the industry to voluntarily set levels based on their own assessment of residents’ needs.

“In recent years, some New Brunswick nursing homes have gone up to 43 days without a Registered Nurse on duty, without being written-up by the Department of Social Development, which is completely unacceptable,” said NBNU President Paula Doucet at the launch of the report October 15.

Staffing shortages are especially acute in northern and rural communities, where there is an even greater number of ageing adults in need of care.

Despite the acute nursing shortage in rural areas of the province, most nursing positions there are casual. Casual RNs at New Brunswick nursing homes outnumbered full-time permanent workers by a factor of 5 to 1. Full-time jobs, essential to retaining workers in rural and northern communities, require more public funding which was diverted last year towards debt repayment instead.

As the report points out, the casual workforce helps save money for private care homes.

“Because homes are constantly grappling with uncertain budgets, they try to buy themselves flexibility by maintaining a higher percentage of casual staff, to whom they don’t pay benefits or pension contributions,” the report says.

On top of attrition, the shortage in nurses also contributes to the high rates of burnout and turnover among existing staff.

The report recommends that the province’s nursing program implement more work placements in long-term care facilities, and that the province make ‘real efforts’ to recruit internationally—something they have so far failed to do.

In spring 2019, a year before the pandemic, the Higgs government used the courts to prevent 4,000 long-term care workers from striking for better wages and working conditions.

In December 2019, the province passed Bill 17, preventing nursing home workers from striking.

During the labour dispute, Premier Higgs suggested workers who were fighting for fairer wages should consider moving to Alberta.

Matthew Hayes is a professor of sociology and the Canada Research Chair in Global and International Studies at St. Thomas University.