Hospital Reform and Nursing Labor Market Trends in Canada

Abstract

The ultimate outcomes of hospital retrenchment for the RN workforce remain unclear. Some speculate that the quality of care and working conditions will deteriorate in hospitals, as hospital administrators replace RN staff with lesser trained personnel to reduce costs. Others see change in the hospital sector as an opportunity for RNs to expand their scope of practice and responsibility in outpatient settings. The need for national and international research on the outcomes of hospital restructuring on patient care and the work of RNs is critical to sound policy making.

Toward evidence‐based policy decisions: a case study of nursing health human resources in Ontario, Canada

“…In teaching hospitals the number of nursing paid hours per patient day has steadily increased from an average of 6.2 hours in 1983 to 9.06 hours per patient day in 1997. Cost saving strategies since 1994 have included reductions in the paid hours of support personnel (housekeeping, patient transport, and dietary services) and the number of head nurse and management support positions has declined considerably by about 10% nationally ( Baumgart 1997; O’Brien‐Pallas et al 1998a).…”

Retaining nurses: The impact of Ontario's “70% Full-Time Commitment”

“…Ontario is the most populated province in Canada and employs approximately two-thirds of the country's regulated nurses [15]. As of 2009, the nurse profession in Ontario was comprised of approximately 94,000 registered nurses (RNs) and 28,000 licensed practical nurses (LPNs), also referred to as registered practical nurses (RPNs) [8].…”

Organisational change and quality of health care: an evolving international agenda

“…For example, in Canada, the nursing workforce is now much more highly qualified than in the past, although this has been associated with a smaller number of middle managers or specialist roles, and with a failure of wages to keep pace with those in other sectors. 32 In general, however, there is much less research in countries outside the United States. 33 34 In summary, the available literature on the impact of organisational change in hospitals is largely from the United States.…”