The nursing workforce in Canada and Australia: two sides of the same coin.

This paper compares characteristics of the nursing workforce in Canada and Australia and provides insights into reasons why the shortage of nurses is more critical today than ever before. Workplace issues are discussed in a global context. Factors that affect retention and recruitment are described. Factors that make the current shortage more serious and different than at other times are also presented. Despite the shortage of registered nurses, their replacement with unskilled workers jeopardizes the quality of care.

Nurse turnover: a literature review - an update.

BACKGROUND: Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations. OBJECTIVES: The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies. DESIGN: A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years. DATA SOURCES: Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications. REVIEW METHODS: Keyword searches were conducted for publications published 2006 or later that examined turnover or turnover intention in employee populations of registered or practical/enrolled or assistant nurses working in the hospital, long-term or community care areas. Literature findings are presented using an integrative approach and a table format to report individual studies. RESULTS: From about 330 citations or abstracts that were initially scanned for content relevance, 68 studies were included in this summary review. The predominance of studies continues to focus on determinants of nurse turnover in acute care settings. Recent studies offer insight into generational factors that should be considered in strategies to promote stable staffing in healthcare organizations. CONCLUSIONS: Nursing turnover continues to present serious challenges at all levels of health care. Longitudinal research is needed to produce new evidence of the relationships between nurse turnover and related costs, and the impact on patients and the health care team.

Where are nurses working? Employment patterns by sub-sector in Ontario, Canada.

OBJECTIVE: As care shifts to home and community, have nursing jobs followed? We examined changes in the absolute and relative size of the nursing workforce by sector/sub-sectors in Ontario, Canada. METHODS: All nurses registered with the Ontario College of Nurses over the 11 years from 1993 to 2003 were categorized as Active, Eligible or Not Eligible. Active nurses were then categorized by sector (Hospital, Community, Other) and sub-sector. The analysis was repeated by age group and for registered nurses and registered practical nurses. RESULTS: The decline in Active and Eligible nurses was particularly pronounced for younger workers. Both the absolute number and proportion of nurses working in the hospital sub-sector has dropped. In the community sector, growth was evident in the use of nurses as case managers (in the CCAC sub-sector), community agencies and community mental health (representing a shift from hospital-based workers). However, the steady growth in the number and proportion of nurses working in home care agencies was reversed in 1999, with this sub-sector shedding 19% of its nurses by 2003. CONCLUSION: Despite considerable rhetoric to the contrary, nurses still tend to work within institutions (hospitals and long-term-care facilities). However, compared to their numbers in 1993, there were fewer nurses providing direct patient care in Ontario in both the hospital and community sectors, and a higher proportion of older nurses.

Health human resources modelling: challenging the past, creating the future

Three separate but related projects were undertaken to link population health needs to health human resource planning, to illustrate the value and challenges in using health human resource data to inform policy decisions on nursing productivity and to generate evidence based retention policies to guide nursing workforce sustainability. Using health survey data, project 1 explored the level, distribution and patterns of health indicators by demographic and social strata. In project 2, productivity was studied by analyzing select acute care nursing services using Management Information Systems data for nursing hours and other inputs and Discharge Abstract Database data for inpatient episodes of care and severity. Project 3 surveyed former nurses and registered nurses across six Canadian jurisdictions. (AU)