Nurse practitioners an emerging specialty: Report
Between 2005 and 2009, Canada gained just more than 27,000 nurses, bringing the total regulated nursing workforce to about 348,500, according to a report by the Canadian Institute for Health Information (CIHI). This represents an increase of nine per cent when the Canadian population grew by five per cent over the same period.
Over the past five years, growth among registered nurses (RNs) and practical nurses (LPNs) has exceeded the rate of growth of the Canadian population, while growth in the registered psychiatric nurses (RPNs) workforce has kept pace with population growth in the western provinces they serve. However, there are actually fewer registered nurses today relative to the size of the population than there were 20 years ago, according to CIHI's report Regulated Nurses: Canadian Trends, 2005 to 2009. In 1992, there were 824 RNs for every 100,000 Canadians, compared to 789 per 100,000 in 2009.
"In the mid-1990s, with cuts to health-care budgets across Canada, we saw reductions in the numbers of nurses and other health-care professionals working in this country, as governments implemented hiring freezes and early retirement packages," said Michael Hunt, CIHI's director of pharmaceuticals and health workforce information services. "Despite reinvestments in health care over the past 10 years, the ratio of nurses to the Canadian population has still not returned to what it was in the early '90s. In contrast, the number of physicians relative to the size of the population is now at an all-time high."
Age of nurses stabilizing, education level rising
Between 2005 and 2009, the average age of a Canadian nurse remained stable at 45. LPNs were the youngest, with their average age dropping from 44 to 43, while the average age of RNs remained stable at 45. RPNs had the highest average age in the nursing workforce, at 48.
In 2009, 37 per cent of RNs in the workforce had attained a university baccalaureate degree as their highest level of education in nursing, compared to 32 per cent in 2005. The number of RNs who had obtained a college diploma as their highest level of education in nursing decreased from 66 per cent in 2005 to 60 per cent in 2009.
In 2009, registered nurses continued to represent the largest proportion of the nursing workforce (76 per cent), although their share of the total workforce has decreased since 2005 (when it was 78 per cent). Conversely, the proportion of licensed practical nurses has been increasing. In 2009, there were 228 LPNs for every 100,000 Canadians, up from 201 in 2005. Over the past five years, LPNs experienced the highest growth rate—more than 18 per cent, or double the growth of the overall nursing workforce.
The number of nurse practitioners (NPs) in Canada also experienced a boost, more than doubling over the past five years and increasing by 22 per cent between 2008 and 2009. Nurse practitioners now represent 0.7 per cent of the total registered nursing workforce.
"Nurse practitioners are an emerging specialty," said Carol Brulé, CIHI's manager of health human resources. "They receive an education in health assessment, diagnosis and management of illness and injuries, and they have responsibilities that include ordering tests and prescribing medication — they are a small but increasingly important group."
The report highlights the importance of investing in nursing education in Alberta and dispels some myths about registered nurses, according to the College and Association of Registered Nurses of Alberta (CARNA).
"In Alberta, we need to increase the number of nursing graduates while the baby boomer nurses are still working in the health system, providing care and mentoring new graduates and internationally educated nurses," said Joan Petruk, CARNA president. "As the report shows, 24 per cent of Alberta's registered nurses are age 55 and older, giving us just a few years before the demographic profile changes significantly for registered nurses in this province."
"The most effective approach to the nursing shortage is to increase the number of nursing education spaces and then hire most of the new graduates each year," said Petruk. "Education, effective retention strategies and targeted international recruitment will all be needed to address the nursing shortage. New hospital beds cannot open without nursing staff to provide care for the people who are admitted into them."
