BY NORM TOLLINSKY

The province’s Nursing Graduate Guarantee program is helping to provide mentoring and training opportunities for new graduates.
As of late summer, the program has placed 4,700 Ontario nursing graduates with 276 health-care employers.

“In the past year, we hired 13 RPNs and eight RNs (through the program), but that’s not even going to touch the holes we have,” said Tiziana Silveri, vice president, surgery & maternal/child care centres and chief nursing officer at North Bay General. “We have quite a high nursing shortage and we find that the number of applications doesn’t match the need, but the program itself is good.”

The Nursing Graduate Guarantee program provides funding to hospitals and other health-care organizations to hire Ontario nursing graduates for a six-month period in positions above the normal staffing complement. Employers are permitted to hire the nurses full-time after three months and retain the remaining funds to support other front-line nursing priorities.

According to an interim evaluation of the program, 86 per cent of graduate nurses participating in the program have been transitioned to full-time positions.

Retention

The objective of the New Graduate Guarantee program is primarily related to retention, explained Vanessa Burkoski, chief nursing officer for Ontario.

“The College of Nurses statistics show us that there’s a very high percentage of nurses in Ontario who do not re-register in the first five years of their practice.”

Studies suggest that nurses are stressed out from being prematurely expected to handle a patient caseload without sufficient training.

“Normally, you’re hired, you’re given your three days of orientation, handed a manual and told ‘Here’s your patient caseload,’ said Burkoski. “It’s very tough. What nurses are saying to us after the six months of being in a supernumerary position is that they feel really confident, familiar with the team they’re working with and comfortable in the environment, so they’re ready to go. That’s the idea behind the NGG.”

In North Bay, the program has allowed graduate nurses to get training in emergency, critical care and ORs.

“They’re not working by themselves, so they’re closely monitored while getting training in these specialty areas,” said Silveri. “Before, as a new graduate, you didn’t go directly into those areas.”

North Bay General usually ends up hiring the nurses as full-time employees after three months. Most of them are graduates of Nipissing University and Canadore College in North Bay, but some applicants have come from other areas of the province.

Nursing shortage

Alleviating the nursing shortage isn’t as simple as increasing enrollment, said Silveri.
Enrollment is capped because of the high cost of nursing programs, but opening up more spots in the local RN and RPN programs would severely tax the community’s ability to provide the necessary clinical placements.

“It becomes difficult because they have to be monitored by an experienced nurse or a clinical instructor from the university,” said Silveri. “There are only so many spots. In North Bay, we have only one hospital, so all of our surgical programs are in one location and they have to be able to get that experience. Even if we wanted to increase enrollment, it would be a challenge because of the difficulty of finding placements. We’d have to be very creative.”

Silveri also attributes the shortage of nurses to the aging population and the introduction of the four-year degree program for RNs several years ago, which made it more difficult academically and more expensive for young people considering a career in nursing.

“So we have fewer nurses coming out and more demand,” she noted.

The hospital is forced to cope by asking nurses to work overtime or “work short.” In some cases, especially during the summer, the shortage of nurses also forces the cancellation of procedures.

North Bay General is on the leading edge in expanding the scope of RPNs and may be forced to “go down the road of hiring personal support workers” to fill in some of the gaps, said Silveri.

At the other end of the spectrum, the hospital is offering incentives to retiring nurses to work shortened workweeks and is taking advantage of the Late Career Initiative, a provincial program aimed at mitigating the trend toward early retirement among nurses 55 and older by providing funds for less physically demanding, alternative roles for a portion of the workweek.

According to College of Nurses statistics, some 28,000 nurses in Ontario will be eligible to retire over the next five years, said Burkoski.

“Based on the enrollment at nursing schools, we may not be able to keep up with the needs, so there is a concerted effort on many fronts through the Ministry of Health and Long-Term Care, HealthForceOntario and the Ministry of Training, Colleges and Education to identify our short-term, mid-range and long-range needs and build into the system supports to ensure that we have an adequate supply.”

The Nursing Graduate Guarantee program has been extended for 2008-2009 at a cost of approximately $94 million.

Graduate nurses and employers interested in applying for or posting jobs are required to register on the New Graduate Guarantee web portal accessible from www.healthforceontario.ca