One of the biggest healthcare issues in rural Alberta comes down to numbers.
“They don’t have nurses,” said Heather Smith, president of the United Nurses of Alberta.
Staffing is a concern in health care centres across the province, and the lack of nursing staff has contributed to closures and service disruptions in rural communities.
Recently the province announced programs to alleviate rural staffing woes, but some in the industry don’t believe the government is doing enough to address the issue.
Smith said she would like to see the province invest in long term growth strategies and show the workforce they are valued and that there is stability in the health care system.
“Look at the kinds of closures we've had, and service disruptions. Some of it is physician related. You can't keep an emergency department open if you don't have a physician, but you also can't keep an emergency department open if you don't have registered nurses. You can't promise maternity services in communities, if you don't have the physicians and the nurses to do it.
“Desperation is certainly a common adjective,” said Smith.
The UNA has had almost 3000 professional responsibility concerns over the last year, said Smith, which include concerns about staffing, workload, and equipment.
“They're heartbreaking. Almost all of them are about scenarios that unfolded because they, they just did not have the staff. And it's not just rural sites. It's also urban,” said Smith.
This month, the province has made two announcements that could lead to some easing of staffing issues in rural Alberta, and last year an announcement was made to give nurses cash incentives to move to rural locations.
In early 2022, the Rural Capacity Investment Fund which was negotiated and ratified as a part of the provincial collective bargaining agreement.
Smith said they have had $7.5 million to disperse this year and last year to try to address deficits in rural and remote sites. Nurses can get up to $10,000 to cover expenses to move to rural sites and $10,000 to $15,000 in cash – depending on location to move to various sites for a one-year commitment.
The UNA has done what they can to recruit nurses, said Smith, but retention and stabilization has to be the focus.
“(We need to) start growing our own now, right? If you don't put the seeds in the ground, you're never going to get a plant. If we don't open up nursing seats, and get people into programs, we're never going to grow our own workforce versus poaching,” said Smith.
On Oct. 17, the province announced they would be investing $11 million to fund internationally educated nurses to get the certification they need to become licensed to practice nursing in Alberta.
The funding has created 848 new registered nurse pathway seats and 373 new licensed practical nurse seats over the course of three years, a press release read, with eligible nurses being able to access up to $30,000 over five-years to offset costs of the program.
“The bursary is non-repayable for those who agree to live and work in rural Alberta as a nurse after graduation for a period of one year for every $6,000 in assistance provided,” the release read.
At the time of the interview, Smith was unable to comment directly on the funding, but she said it is imperative we don’t bring people into the province and set them up for failure.
“The really big issue was what are we doing to support them in practice?” she added.
In early October, Alberta Health Services announced they would be hiring around 70 internationally educated nurses from about 15 countries to strengthen AHS’s rural health workforces and services.
“The first cohort has already gone through their orientation and are starting their on-shift training at our sites,” said James Wood, a spokesperson for AHS in an email.
The first cohort of nurses will be spread across 30 sites in northern and central Alberta.
“The orientation is comprehensive, providing nurses with training that’s tailored to their individual skills and abilities. AHS supports IENs with the skills and knowledge to live and work in Alberta,” he said.
Wood said the nurses will also receive guidance on basic living requirements such as opening bank accounts, applying for IDs, healthcare cards, and Social Insurance Numbers.
Altogether, there will be 50 placements in the North Zone and 20 placements in the Central Zone with cites receiving one to three nurses or more as needed, with IEN’s going to sites deemed to have the greatest needs.
The exact sites the nurses are going to, nor which countries the nurses came from can’t be disclosed, said Wood, to maintain the employee privacy.
However, those details are being shared with permission “with sites and community members to support the successful integration of the new nurses.”
“While we can’t disclose country of origin of our employees due to privacy, we can share that we ran recruitment campaigns in countries with nursing degree programs that are comparable to Alberta, including the United States, United Kingdom, Australia, Jamaica, South Africa, India and the Philippines,” he added.
In an email, Thomas Edwards, vice president with Local 43 United Nurses of Alberta in Olds said while the 70 IEN are a needed step, they are insufficient to address the dire staffing challenges in the province.
“(The 70 internationally educated nurses are) just a drop in the bucket compared to what we need in terms of wholesale recruitment and retention for the nursing profession,” said Edwards.
The Ministry of Health did not respond to a request for comment on criticisms about the number of IENs.
Edwards said the UNA director of labour relations has reported the province is short 3000 nurses and position vacancies have doubles over 2022.
"Day in and day out I hear from my members that they are being asked to work excessive overtime, having vacation denied, having personal leave denied, having professional development time denied…Nurses continue to flee the profession at record numbers, feeling burnt out and that the pay is no longer worth the work asked of us,” said Edwards.
The first step in addressing the nursing shortfall, said Edwards is for nurses to be respected and their hard work acknowledged.
“At the end of the day,” Edwards continued, “the government of Alberta and our employers are going to need to address this retention and recruitment problem…it will not be solved by poaching nurses from other jurisdictions.
“We need to focus on home grown RNs and making the nursing profession a desirable job to enter and stay working in.”
Re-establishing a rural program for students to address education is also a real need, and, Smith continued, courses in the nursing program that are not a part of the nursing program include advanced life support and labour and delivery.
“You can't take a new grad and suggest that it's safe for her or anybody else, to be suddenly in an emergency department in rural Alberta. If you're the one person in a rural facility emergency, you better hope that the employer provided the time and the financial support for those men and women to get the courses they need to make them safe.
“I would suggest that has not been a priority in recent times. And if you don't support their entry, they leave. They leave the province, or they leave the profession,” she said.
