According to experts, nursing companies are staffing hospitals at a ‘great expense’ to the health care system.
Burned-out nurses who left Canada’s healthcare system in large numbers are now coming back through commercial organisations, which is costing the public sector millions of dollars annually.
According to individuals in the field, nurses who work for these temp agencies can make more than twice as much money as staff nurses who perform the same tasks at the same hospitals, with complete control over their work schedules.
At Oak Valley Health, which runs Markham Stouffville Hospital in Ontario, Terri Stuart-McEwan, vice president of clinical programmes and chief nursing officer, said she has observed a regular stream of nurses leave their positions due to exhaustion and frustration.
We spent more over $4 million on agency nurses last year in this organisation, which she described as being of medium size. “That is a significant expense for our healthcare system.”
Long-time nurses claim that unless anything is done to address fundamental problems in the Canadian healthcare system that are causing professionals to quit their positions, those expenses will only continue to rise.
In the interim, the agency sector is thriving. In comparison to just one or two nursing agencies prior to the epidemic, Stuart-McEwan claimed that she now has contracts with 13 of them.
She refers to these organisations as the Ubers of nursing, and some of them have instituted surge pricing, which causes prices to increase occasionally.
It would be a Saturday night, the critical care unit would be short on nurses, and Stuart-McEwan added, “We know we cannot survive without another nurse.”
“As an organisation, you’re saying I have a choice between paying $300 an hour or putting my patients and staff at risk.”
High agency charges ‘doesn’t make sense,’
Hourly fees like that can add up very rapidly.
In Toronto, University Health Network spent $6.74 million on nursing agencies in the fiscal year that ended in 2022, a significant increase from the $775,926 it paid in the previous year.
According to the provincial NDP, Manitoba spent $3.9 million in a single year to fill shortfalls in Winnipeg alone, and according to Global News, the total cost for the entire province in 2021–2022 was more than $40 million.
Additionally, the Department of Seniors and Long-Term Care in Nova Scotia planned $3.1 million for agency nurses in December 2021 but later had to increase it by $18.4 million.
Taxpayers in Quebec paid $960 million last year for private healthcare staffing firms, and the province has spent roughly $3 billion on these firms since 2016.
The provincial government enacted a bill earlier this year that will restrict the use of healthcare staffing firms, with the aim of outlawing their use by hospitals by the end of 2025.
Health Minister Christian Dubé stated, “You’ve seen the cost of that, it doesn’t make sense.”
According to Robert Handelman, CEO of Staff Relief Healthcare Services in Toronto, businesses like his are crucial in supplying staff when hospital resources are depleted.
According to Handelman, his company has been around for 25 years and has a history of working with several hospitals. However, he pointed out that there are minimal barriers to entry and no regulations of the field, which has allowed a number of “predatory” agencies to emerge recently, charging exorbitant prices and taking a sizable chunk out of workers’ salaries.
“A butcher for nurses”
Natalie Stake-Doucet contends that the rising employment of agency nurses is merely a symptom of a much more serious issue. She recently left the nursing field after ten years of employment in Québec, and she is now a professor at McGill University.
The fact that our healthcare system is a “meat grinder for nurses,” she claimed, is being exploited by commercial agencies.
She contends that the significant turnover in Quebec’s healthcare system—caused by subpar working conditions, low pay, required overtime, and high patient-to-nurse ratios—is simply being abused by private nursing organisations.
Stake-Doucet stated that “nurses have been warning about this crisis for at least 20 years now.”
Basil Byfield, an emergency room nurse at Markham Stouffville Hospital, admits that it has been more difficult to retain employees in recent years.
Emergency situations can be difficult, he remarked, but I shouldn’t call them beasts.
He has worked for agencies during the course of his 35-year career, but he acknowledges that there are drawbacks, such as needing to quickly learn new processes and technologies when transferred to a new site.
But many people find the extra compensation to be worthwhile, and many with regular positions at the hospital find that difficult to accept.
For the normal workers, having to perform the same duties for less money might be discouraging, according to Byfield.
Kian Johnson, a registered nurse in Ontario, claimed that she started working shifts for an agency seven years ago to augment the money from her full-time hospital position.
She said that her income from a full-time job alone would not be enough to cover her basic needs.
She has since left her staff position to work completely for the agency, where she can choose her own hours, while she pursues her studies to become a nurse practitioner.
According to Johnson, there is never a lack of staff nurses in Ontario hospitals.
Eight agency nurses were working on the ward during my shifts, and there were perhaps 10 or 12 nurses total, according to Johnson.
“Adequate staffing is required, and the actual hospital does not provide it.”
She thinks that increasing pay in the public system and giving those jobs more flexibility are the only ways to lessen the need on agency nurses.
We do our best to look out for folks, said Johnson. I believe that our needs are not being satisfied, hence we are not appreciated.
