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Nursing remains critical profession throughout pandemic, future

Sustainable nursing careers are important through the COVID-19 pandemic and the future
Nurse with patient
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There has been an increased interest in people getting into the nursing field during the COVID-19 pandemic. 

But, despite the increased interest, some nurses who have been in the industry for quite some time have considered leaving the profession after COVID-19. 

The Registered Nurses Association of Ontario published a survey in March 2021, where it asked 2,100 nurses across Ontario where they see their careers going after the pandemic.

13 per cent of respondents between the age of 26-30 and 31-35 have said they are 'very likely' to leave the profession after the pandemic. 17.4 per cent of respondents have also said that they are likely to leave the profession due to very high-stress levels they are experiencing on the job.

Despite these results that were outlined in the survey, the interest has not levelled off. 

Heidi Holmes is the coordinator of the practical nursing program at Conestoga College - University Gates campus as well as a nurse at Guelph General Hospital. 

She said that over the course of the pandemic, admissions into the program have increased. 

"There are not enough spaces for the number of applicants," she said, "last year we had over 1,200 applicants and we only have 168 spaces. We've always had the issue where we have way more applicants than spaces. Applications have risen for the fall meaning more people want to get into nursing which is great." 

Holmes outlined what students have had to deal with during the course of the pandemic. 

"Students were in the midst of their four-semester program when the pandemic began, so, unfortunately, they were pulled from their placement and had to take a break but they just finished and graduated last month," she said, "they kind of lived the before and after of what nursing looked like and we had great retention. All of them wanted to stay in the program, they learned very quickly in placements and knew what was involved with the risks in nursing and caring for people, both who may have COVID and those without." she said.

Holmes said that many of the students stepped up and became PSW's or clinical attendants until they could get certified and licensed as a nurse.

"It really pushed people to want to become nurses more and really understand what is involved in nursing and the risks we take, the need for healthcare providers, and all of them wanted to step up and be a part of that." 

Holmes said that the interest that these students kept in trying to get into the field really speaks volumes to the type of people that are being attracted to the nursing programs.

"It says a lot about the person who wants to become a nurse, and the cohort I had knew this was going on and we still had a full cohort of students coming in with high competition for those spaces," she said, "I think once they are in the program and being a bit more exposed to the health care field and some of the issues they may face with COVID or without, I think they also realize they will be well-supported so emotionally, physically but there are risks and we make sure they are well-educated about those risks." 

Holmes said the pandemic has been used as a teaching tool for those wanting to get into the profession where they could see it unfolding in real-time.

"The most common thing is infection control. It was a very basic lesson we had in the first semester of the program but how much it has been emphasized in terms of importance, how much we've reviewed and gone over it, the students had to do a lot of extra learning on infection control."

Holmes said that her work as a nurse at Guelph General Hospital, helps bring real-world experience to the students.

"Our faculty can bring first-hand experience to the students [with what we are dealing with at the hospitals], the students are learning that it's a whole team approach which is necessary. It's not just nursing, so as always we really emphasize that team approach. We are very fortunate to have really good local clinical partners who have accepted our students and have really integrated our students into that team." 

Back on May 4, the province announced Conestoga College will receive nearly $5 million over the next two years to train 500 individuals to deliver a long-term care assistant training program, which is supposed to address the need for more trained care workers. 

The training initiative comes following a pilot program hosted out of Conestoga College in the fall of 2020, which saw 180 applicants for 30 available positions.

Vicki McKenna is the President of the Ontario Nurses Association. She said her organization has been lobbying with the federal and provincial governments to deal with Ontario - and Canada's nursing shortage. 

"Our nursing situation in the province is really serious. Whether it's in long-term care, hospitals, or public health, it's pretty startling. One of the primary pieces is around the recruitment of nurses. Just last week the Ontario government made some announcements about opening up more spaces in nursing programs in the province which is welcome," she said, "that is a positive start, but this is a multi-pronged approach and it's pretty serious."

McKenna said she is most concerned about the mid-career nurses who are the most dissatisfied with the working conditions.

"A lot of the dissatisfaction stems from the fact they are short-staffed often and the workload they are carrying is tremendous," she continued, "some of the nurses have said that they are not sure they can stay in the profession for the next 10 or 15 years if they don't get the support in the system to be able to do that." 

McKenna said the average age of nurses is around 48-49, where she said a lot of those nurses are eligible to retire early.

"We survey them often and ask them how long they are going to stay, just to get some predictions and many were planning on staying in the profession beyond 55 but now with COVID, I'm hearing a different story and they are saying to me 'I'm going to stick with it until we get through this but I'm not sure I can continue on' which is really frightening, to be honest," said McKenna.

McKenna said that the challenge right now is that nurses are getting tired through the pandemic.

"Those working on the front lines right now, they are exhausted, tired, described symptoms of burnout and they have witnessed some really horrific situations. It weighs on you a lot and they are struggling with that." 

Another challenge McKenna outlines are trying to create the best environment to attract and keep people in the system.

"For the students, having a program that offers the proper clinical exposures so they feel confident is another piece of that. That's a lot of part of what we are trying to work on and push the government and learning institutions to do just that."

She adds that many workplaces are still battling with issues of not having the proper PPE.

"They did not have the proper equipment in the workplace to protect themselves and to protect the patients that they care for. The health care worker infection rate in the first wave of COVID was horrific, it was some of the worst infection rates across healthcare workers looking across other jurisdictions across Canada and around the world. We were not as a province prepared properly, we didn't have the equipment and there was also a need for training to ensure the people knew how to use the equipment as well." 

McKenna is encouraged by the recent funds that have been given to post-secondary institutions in order to bring in more students into the field.

"We supported the degree-granting in community colleges for just that reason," she said, "we believed that will open more opportunities and seats in order to bring in more students. What I'm hearing is that they have oversubscribed for the seats that they had and these are qualified candidates that they are vetting right now to get into the program, so it is positive but it takes time."

According to McKenna, registered nurses need a four-year program before they can work in the industry and the registered practical nurses it's two years while nurse practitioners are registered nurses who also spent time in clinical settings while going on to get their post-grads done.

"It is encouraging that there is attention being paid at the front-end of the problem but we've got to deal with our current workforce right now in order to keep them and also to gain the skills that these nurses have, we don't want to lose them in the system. We need them to be able to support new nurses coming in. Government, employers need to ensure that nurses who are in the system are supported and can contribute the way they want to."

McKenna said that Ontarians will reap the rewards of having skilled nurses at the bedside.

"We want our workforce to be sustained and sustainable," she continued, "the research is really clear about that. We certainly don't want our healthcare system de-skilled, we want more skilled nurses at bedsides in hospitals and in LTC facilities."

McKenna said that it's important for governments to have a pandemic plan ready to go, reviewed on a regular basis and updated and it's on all of us." 

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