Human Resources Committee on May 7th, 2013

[Linda Silas]

We did that. From about 2002 to 2005-06, you saw a big increase in nursing graduates. We went from about 4,500 to 9,000. There was a big influx.

The problem is that we're not finding jobs for them, so they go into another program. All nursing graduates, except a few courses in Quebec, go through university programs now, and they will go somewhere else.

It is also a different generation, right? They will not accept what the graduates of 20, 25, 30 years ago accepted in their working conditions.

[Ryan Cleary, NDP, St. John's South—Mount Pearl, NL]

You mentioned that nursing programs now are all offered through the universities. You also mentioned, though, that the federal government could help—realizing that health care is mostly a provincial jurisdiction—with EI apprenticeships, whereby licensed practical nurses would do apprenticeships with registered nurses.

Has there been much reaction to that idea?

[Linda Silas]

Yes. Honestly, that's how our workplace skills and development program or initiative was created about seven years ago. We got funding from there.

You know, in this country, if you're a plumber, you can go for different apprenticeship programs with the help of the federal government under EI and the help of your employer. But if you are a professional, and I'm talking about nurses, you don't have those opportunities.

It's time we opened the door. It's about changing our culture and making sure it's always a step ahead and we help them through it.

[Ryan Cleary, NDP, St. John's South—Mount Pearl, NL]

How many licensed practical nurses are there out there right now who could theoretically take part in a program like this? What kind of pool could you tap into to tackle that nursing shortage?

[Linda Silas]

You need LPNs, licensed practical nurses, in the system. There are about 15,000 in the country. How many of them could go and take the RN program? That's a great question. We hear a lot of hearsay that they would be a strong component of it, but it wouldn't be an overflux. One, you need the education criteria to join it.

[Ryan Cleary, NDP, St. John's South—Mount Pearl, NL]

On the percentage of nurses who work past the age of 55, considering you mentioned how nurses are twice as likely to be off sick, or off due to injury.... I know a lot of nurses, and I know how hard physically the profession is.

How many work past 55? Is it possible to extend the working life of a nurse?

[Linda Silas]

Yes, it is. We used to have an average age of retirement of 58, and we did many predictions that we were going to have a humongous shortage because of that retirement age. But they are staying much longer.

I met a chief nurse just last week—this is nurses week, by the way, in case you know any nurses—and she is 70 years old, still working, and she'll be there for a while. I meet practising nurses who are way in their 60s, but their work environment needs to be changed.

That's where the mentoring program has to change. We saw programs here in Ottawa where after 60 they brought them back, working days, but just training the new ones coming in. That's of great value in terms of experience, and they feel very good doing it. Sometimes it's as simple as wearing civilian clothes instead of your nursing scrubs.

[Ryan Cleary, NDP, St. John's South—Mount Pearl, NL]

As a last question, you mentioned that the federal government could take a leadership role—realizing, again, that health care is mostly a provincial jurisdiction—in workforce planning. Can you elaborate on that?

[Linda Silas]

Right now the federal government provides all the statistics—from CIHI, from Statistics Canada; all the statistics are there.

What the federal government did before, and we did it through WSIB and through Health Canada, is bring that flexibility to employers, bring the researchers to the table, national researchers, evaluation companies, to make sure that what they're doing is effective and will bring a return on investment.

That's where we see the federal government. Right now the provinces and territories are strapped for money in health care. That's why there are no jobs. But there's a role to do it without administrating care.

[Ryan Cleary, NDP, St. John's South—Mount Pearl, NL]

You mentioned too that $5 million to $6 million a day is spent on patients who should not be in hospital but at home. How does the nursing profession address that?

[Linda Silas]

Sadly, you've heard—

[The Chair, Conservative, Ed Komarnicki]

Mr. Cleary, your time will conclude with this response, as your time is up.

Go ahead.

[Linda Silas]

You've heard a lot about “bed blockers”, which is a sad term to define clients who should be in their home or in long-term care facilities. That is where that $5 million to $6 million is spent. Our acute care sector, our hospitals, are the most expensive facilities there are. We need to move those clients into the community, but right now there are no services in the community. We need to have programs where the workers are all concentrated, which is your hospital, to move into the community safely. That care has to be as safe as in their home.

We talk to seniors and their families all the time; they don't want to be in a hospital. They want to be in their home. It is more effective, and they are happier there.

[The Chair, Conservative, Ed Komarnicki]

Thank you for that.

We'll move to Mr. Shory.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Thank you, Mr. Chair, and thank you, Ms. Silas, for being here today. I congratulate you on nurses' week.

My questioning will be around retention and recruitment, which you mentioned as item 2 on the first page of your presentation. I understand there is a shortage of qualified nurses in some regions. I suppose one of the solutions might be to encourage older workers, specifically Canadian nurses, to stay on. I represent the hardest working riding of Calgary Northeast, which is also the most ethnically diverse riding in Canada, I would say.

I'd like to comment on the issue of foreign credentials and their lack of recognition here. Would you say there might be an opportunity for new Canadians who have qualified elsewhere as nurses to help fill these shortages, in combination with older Canadians remaining in the profession? Would there be an opportunity to keep the older Canadians and encourage them with flexible hours or part-time work, so they can give hands-on training to new Canadians who are nurses?

[Linda Silas]

That's a great question; it's a great point. Again, the land of pilot projects is Canada. We had a pilot project in Saskatchewan, partly funded by the Government of Saskatchewan and the federal government, on exactly what you're saying. They looked at nurses coming from the Philippines. They took one country specifically and analyzed their credentials before they moved to Canada. One thing is you don't want to reduce your credentials because you are coming from another country. You are entering Canada.

They looked at their credentials. They passed to come to Canada. Then they matched them up, both in the community and the health care sector, for over a month each. They adapted to the community as a Filipino nurse working in Regina or Saskatoon, but also in the health care sector. Their results were unbelievable on the retention of those immigrant nurses, who are still there. But that was a pilot project, and it's gone. We need more of those.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Thank you for your comment. I'll use the word “standards”. Under no circumstances would I agree to lower our health care standards, so whatever is required from new Canadians is required.

I also wanted to ask you about any best practices you are aware of. Is a particular region or hospital health group having success implementing a program to retain older Canadian nurses?

[Linda Silas]

I would say Ontario is. The province had an older worker initiative for health care workers. Now it has paused, but they allowed nurses to stay in the workforce after the retirement age. The best scenario was at the Ottawa Hospital, where after retirement age they would offer two nurses the opportunity to become specialist mentors. They would be brought back into the workplace to do one-on-one education and work on policy standards for the facilities. Those are about the only two programs that I know of offhand.

[Devinder Shory, Conservative, Calgary Northeast, AB]

Do you have information on the key issues and challenges for older nurses that have been identified in terms of employment opportunities?

[Linda Silas]

We are in the business 24/7. It's the shift work; it's the workload. Nurses have the highest level of back injuries, and sadly, even if you've learned all the proper techniques on how to lift and bend, if a patient is falling, you are going to pick up the patient and forget about the proper technique. When we're older, even if we don't want to admit it, we're not as flexible as we were when we were 25.

[Devinder Shory, Conservative, Calgary Northeast, AB]

In this profession, I understand there is a lot of physical work required. How can we get the best benefits from experienced older nurses?

[Linda Silas]

It's keeping them in the workplace as mentors. We don't do a great job in health care for any profession. I tell my members that they are not angels of mercy any more; they are health care professionals, and they have to be treated as health care professionals. That doesn't mean they graduated with a university degree and can save the world. There has to be a transition period, and we're working on that.

It's all about patient safety. We're very lucky in Canada. We are not the U.S., and it's not about the privatization debate; it's about the liability debate. We don't go through that legal route in Canada—we are blessed—but we have to provide safe and quality care to everyone.

[The Chair, Conservative, Ed Komarnicki]

Your time is up, Mr. Shory.

We'll now move to Monsieur Lapointe.

[François Lapointe, NDP, Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC]

Thank you, Mr. Chairman.

Thank you, Ms. Silas, for being here today.

I wanted to let you know that your French version is much appreciated. In fact it is quite well done. This is not Google Translate.

[Linda Silas]

I will mention this to Carole, in Moncton. She worked on this quite hard this morning.