As staffing crunch looms, small northern hospitals turning to private nurses

As hospitals across the province continue to grapple with staffing pressures, a union representing Ontario nurses says that several northern hospitals are turning to private agencies to fill staffing needs.

But the Northern Ontario representative with the Ontario Nurses Association (ONA) says that's not a viable solution to the problem.

Dawn Armstrong, vice president of ONA Region 1, which represents 9,000 nurses across northern Ontario, said outside of the three largest hospitals in the region –  Health Sciences North in Sudbury, Sault Area Hospital and Thunder Bay Regional Health Sciences Centre –  most smaller hospitals are filling staffing gaps through agency nurses.

"A small community about an hour from [Dryden] currently is using 70 per cent agency nurses, and that is not sustainable," Armstrong said.

"That is a huge drain on our public system because as we know, agency nurses get paid a higher wage than the regular nurses working in that facility," she said. 

The agency also is paid a fee, and some of these communities are also providing housing, food and travel expenses, Armstrong said.

"We need to start stabilizing the workforce that we have and bringing more registered nurses back into the facilities as regular, full-time staff," Armstrong said.

Cathryn Hoy, the union's president, called it a "gross abuse of health care dollars."

"Say I'm a senior nurse. I make $50 an hour," Hoy said. "If you're an agency nurse, you're going to get paid $100 an hour."

"We're working side by side. But you don't know my hospital. You don't know how the flow goes. You don't know the patients," she said.

Agencies also bill hospitals double what each nurse makes, Hoy estimates.

"Hospitals are paying $200 an hour for a nurse that if they paid them, say, $60 an hour, they could have. So this is abusing health care dollars, but yet the hospitals are paying them over and over and over."

Hoy added that the pressures on nurses, not to mention the financial benefits of working for a private agency, are putting even more strain on the nursing shortage.

"Agency nurses are actually adding to the shortage because they can work less and make the same amount of money," Hoy said. "If I'm making $100 an hour, I only need to go in and work half the time for the same amount of money."

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Mike Baker, CEO of Temiskaming Hospital, said it's been challenging making sure the emergency room stays open and functioning. Agency nurses, he said, become a necessary part of keeping patients cared for.

"It's an expensive alternative and in a perfect world you wouldn't use those resources," Baker said.

"But when you're talking about emergency medicine and keeping a hospital open when there's already shortages in other sectors of the health care, and you're carrying that load, for example, of long term care, then you really have no choice."

International nurses the solution?

A 2020 report from Ontario's fairness commissioner showed that 14,633 internationally educated nurses were actively pursuing a licence through the College of Nurses of Ontario. That same year, just over 2,000 international applicants became fully registered members.

The registered nurses' association says the past decade has seen a growing backlog of internationally educated applicants and estimates the queue is near 26,000.

The nurses' college has recently taken steps to speed up the process, including changes to language proficiency requirements and a partnership with the province to create more supervised practice opportunities, a spokeswoman has said.

It has registered a record number of nurses this year, including more international nurses than in previous years, with 4,728 registrations by the beginning of August. The college also says it's looking at ways to streamline the process.

In order to practice in Ontario, internationally educated nurses have to show that they have recent experience, pass exams, and demonstrate English or French proficiency.

Ontario's Ministry of Health responds to shortages

Meanwhile, Ontario's health minister is giving the regulatory colleges for nurses and doctors two weeks to develop plans to more quickly register internationally educated professionals.

On August 4, Sylvia Jones sent directives to the College of Nurses of Ontario and the College of Physicians and Surgeons of Ontario directing them to make every effort to register those nurses and doctors "as expeditiously as possible."

The minister also directed the nursing college to develop supports for the internationally trained nurses — for example to bring their skills to Ontario standards — to allow them to practice "in a timely way."

Jones has asked for reports from the colleges in two weeks on how they will accomplish that.