The Trajectory of Agency-Employed Nurses in Ontario, Canada: A Longitudinal Analysis (2011-2021).

In Canada, reports of nursing staff shortages, job vacancies and the use of private agency nurses, especially in hospitals, have increased since the start of the COVID-19 pandemic. Media reports suggest the pandemic exacerbated nursing shortages among other issues, and nurses are leaving their traditional positions to work at such agencies. Public spending on agency nurses has increased appreciably. Using 2011 to 2021 regulatory college data on all registered nurses (RNs) and registered practical nurses (RPNs) in the province of Ontario, Canada, we investigated trends in the count and share of nurses working for employment agencies. We also examined the rate at which previously non-agency employed nurses transition to employment in at least one agency job. We found the prevalence of RNs and RPNs reporting agency employment was relatively stable from 2011 to 2019, and decreased slightly in 2020 and 2021. However, there was a small increase in transitions from non-agency employment to working at an agency job. We also found the mean hours of practice in all jobs reported by agency and non-agency nurses increased during the pandemic. Based on these findings, an increase in hours and/or prices for agency nurses may explain the increase in public funding for agency nurses, but it was not driven by an increasing share of nurses working for employment agencies. To fully understand employment agency activity, policymakers may need to monitor hours of work and hourly costs rather than only costs. Further research is required to investigate any long-term effects the pandemic may have had on agency-employment.

Multiple jobholding and part-time work among nurses in long-term care homes compared to other healthcare sectors: Evidence from Ontario.

About two-thirds of Canadian COVID-19 related deaths occurred in long-term care homes (LTCHs). Multiple jobholding and excessive part-time work among staff have been discussed as vectors of transmission. Using an administrative census of registered nurses (RNs) and registered practical nurses (RPNs) in the Canadian province of Ontario, this paper contrasts the prevalence of multiple jobholding, part-time/casual work, and other job and worker characteristics across health sectors in 2019 and 2020 to establish whether the LTCH sector deviates from the norms in Ontario healthcare. Prior to COVID-19, about 19% of RNs and 21% of RPNs in LTCHs held multiple jobs. For RPNs, this was almost identical to the RPN provincial average, while for RNs this was 2.5 percentage points above the RN provincial average. In 2020, multiple jobholding fell significantly in LTCHs after the province passed a single site order to reduce COVD-19 transmission. Although there are many similarities across sectors, nurses, especially RNs, in LTCHs differ on some dimensions. They are more likely to be internationally educated and, together with nurses in hospitals, those who work part- time/casual are more likely to prefer full-time hours (involuntary part-time/casual). Overall, while multiple jobholding and part-time work among nurses are problematic for infection prevention and control, these employment practices in LTCHs did not substantially deviate from the norms in the rest of healthcare in Ontario.