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A respiratory therapist and six nurses prone a COVID-19 patient inside the intensive care unit of Humber River Hospital in Toronto, Ont. on April 19, 2021.Carlos Osorio/Reuters

Doris Grinspun is chief executive officer of the Registered Nurses’ Association of Ontario. Brenda Stade is a nurse policy analyst at the RNAO.

For nearly two years, nurses have been on the front lines of Ontario’s unrelenting battle with COVID-19. Over that time, more than 650,000 people in the province have tested positive for the coronavirus, leading to more than 10,000 lives lost and many thousands more left to grieve. While tirelessly fighting to save the lives of those in their care, nurses have also had to fight to protect themselves and their families.

All the while, they have worked under wage restraint legislation – Premier Doug Ford’s Bill 124 – which limits compensation increases for registered nurses and other public-sector workers to a maximum of one per cent for three years. This has caused their real income to fall since the legislation passed in 2019. The bill is profoundly unfair and symbolizes what is wrong with the government’s approach to the nursing profession.

And now, the Omicron variant, whose rapid spread threatens to overwhelm hospitals again. As resilient as they are and have been throughout the pandemic, registered nurses in hospital emergency rooms, intensive care units and other critical-care areas have reached their limit.

The length and intensity of the pandemic has hit RNs in Ontario especially hard. The province entered the pandemic with the lowest number of registered nurses per capita in the country – by a wide margin. The government would have to hire 22,000 RNs just to catch up to the rest of Canada. Exhausted, burnt out and financially penalized, RNs are leaving their jobs, leaving the province and, in some cases, leaving the profession.

For some, leaving their jobs means joining the rosters of nursing agencies and opting for fewer hours of work, higher wages and greater control over their professional and family lives – leaving emergency rooms and intensive-care units overwhelmed and short of RNs. Across the health system, including hospitals, thousands of RN vacancies remain unfilled.

Ontario’s nursing human-resource crisis comes as no surprise. The staffing shortage in hospitals and nursing homes, in particular, has been highlighted over and over for years. The government and employers – including the Ontario Hospital Association – have known this and looked the other way.

Last winter, amid swirling rumours of nurses leaving their jobs, RNAO surveyed its membership. The survey painted an even grimmer picture. RNs of all ages plan to leave the workforce at higher rates than in the past. In particular, it signalled the impending exit from the profession of early career RNs and the loss of late career RNs who plan to retire earlier. A more recent survey of nurses, sponsored by RNAO, told the same story of excessive stress, high workloads and little in the way of support or respect from employers and government. Both surveys draw a straight line between support, respect and likelihood to leave the job or the profession.

Compounding the province’s crisis is the pull on Ontario’s nursing workforce to the south. The U.S. Bureau of Labour Statistics estimates there will be about 200,000 openings for RNs each year over the next decade to meet the demands of the growing population and deal with the United States’ own pandemic-induced nursing shortage. Rewards and incentives – such as paid relocation expenses, higher salaries, clear staffing and workload standards, generous vacation packages and education supports – abound for Ontario RNs who want to feel valued and start afresh.

We are in the midst of an RN human-resource crisis in Ontario that deepens daily. On Dec. 9, the legislature recessed without taking the one, simple step necessary to change the decades-old course that has led us to this place – repealing Bill 124. The way out of a crisis is never easy and the way out of this one will involve a complex set of retention and recruitment initiatives that includes increasing baccalaureate (Bachelor of Science in Nursing) spots, fast-tracking internationally educated nurses, supporting new nursing grads and more.

But it will not begin until Ontario has a government that sees, values and respects its nurses by compensating them for what they are worth. Today that message must come with the repeal of Bill 124. We urge Mr. Ford to act and avert a full health-system collapse.

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