My name is Linda Silas. I'm the president of the Canadian Federation of Nurses Unions and a proud nurse from New Brunswick. We represent nine nurses' unions across the country, and we have excellent working relationships with the Fédération interprofessionnelle de la santé du Québec. As you know, over 80% of nurses in Canada are unionized. We thank the Standing Committee on Health for the opportunity to share our views.
I realized this morning when preparing my notes that I've been in this job for six years and have presented more or less the same recommendations and more or less the same data on a yearly basis to more or less the same committee or committee members. The federal government itself has spent millions on HHR sector studies. The evidence is clear: there is a nursing shortage and it's not getting any better. Nurses across the continuum of care, in hospitals, long-term care, home care, and in our communities, are living the symptoms of the shortage every day, and we need action on a long-term basis.
CFNU's first recommendation is the creation of a national observatory on HHR. Provinces are spending health care dollars competing with each other to attract nurses and other health care workers from one jurisdiction to the other. There's not one jurisdiction in Canada that's currently producing a nursing surplus. The existing federal-provincial-territorial Advisory Committee on Health Delivery and Human Resources would need to have its mandate expanded and membership expanded to include active participation from stakeholders in order to have realistic and attainable goals. Or maybe a better idea is to start afresh with the national observatory on HHR that stakeholders have been requesting for a number of years.
We stress again the engagement of stakeholders, the only way to ensure appropriate and accountable actions, targets, and timeframes. We have to remind ourselves once again that health care is not only a government issue, it's everyone's issue.
Our second recommendation is to continue and increase the data collection and reporting on HHR. This role must be filled by the federal government. Repeating the national survey of work and health of nurses conducted by CIHI and Statistics Canada and expanding it to other health care professionals is a must. It will also measure the impact of change in policy and practice from the perspective of the workforce.
Third, fund innovative projects related to retention and recruitment in HHR in Canada and across the continuum of care. Forty-nine per cent of nurses retire before the age of 65. That's compared to 43% of any other field. We cannot afford to lose this experience in patient care. For example, CFNU receives support from HRSDC for a project in Cape Breton to provide an opportunity for nurses to upgrade their skill set and meet a serious nursing shortage in critical care while remaining in the rural region. We also had a project in Saskatchewan where valued, experienced, and seasoned nurses were allowed to work on a mentorship program. This year we received funding from Health Canada for nine pilot projects to apply evidence-based retention recruitment strategies. This is a start.
This kind of innovation in the workplace, supported by macro-level resources, will ensure retention of a skilled workforce. How often do you hear and see federal funding applied and evaluated directly in the workplace? This is the only way to make real and sustainable change.
Of course we have to talk about child care. Most of our population are women and child-bearing, so we have a fourth recommendation on supporting the creation of a child care program that addresses the need for shift work.
Our fifth and last recommendation is the creation of a federal HHR fund to support education and lifelong learning. As CFNU mentioned before, the federal government can use the EI program to provide educational support to health care workers entering nursing and for nurses to expand their scope of practice through job laddering and specialty training. This would complement support given to the building trades apprenticeship program that already exists under EI. These strategies would help attract more aboriginal Canadians to the health care workforce and would help underserved communities, supporting local residents to enter and progress in the health care profession, and would bring best investments to build sustainable services in those regions.
As a conclusion, what is the price of inaction? A high workload leads to a high turnover rate, and turnover is really expensive in our profession. It can be up to $64,000 per nurse. A shortage means the present workforce is doing a large amount of overtime, a costly solution for an inadequate supply of nurses. In 2005 it was 18 million hours of overtime, 144% more overtime than was worked in 1987.
Currently, CFNU is updating this study, but the preliminary reports are suggesting that the numbers are even worse. Let's remember that 66% of young nurses are showing signs of burn-out.
The extensive and growing body of research showing the relationship between nurse staffing levels and patient outcomes should be the most compelling reason for government and policy-makers to address the nursing shortage. But using the shortage as an excuse to bring in less skilled, less knowledgeable workers—similar to what the Canadian Blood Services is trying to do today—is plainly dangerous and should not be supported by any policy-maker concerned about public policy.
We thank the committee for undertaking this important study. Hopefully, we will meet again next year to provide you with a progress report and not a whole bunch of further recommendations. This problem is ongoing, and we all need to stay very focused on this issue.
Merci beaucoup.