CIRANO releases the results of a major study on the nursing shortage in
MONTREAL, Jan. 19 /CNW Telbec/ - The Centre interuniversitaire de
recherche en analyse des organisations (Center for Interuniversity Research
and Analysis on Organizations, or CIRANO) released this morning a study
providing a thorough and unbiased assessment of the context of the nursing
practice and the shortage of nurses in the province of Quebec.
According to Claude Montmarquette, Vice-President of Public Policies at
CIRANO: "Many indicators suggested that the context in which nurses practise
their trade was better than we had been led to believe, and that the shortage
had been overstated. We felt it was necessary to conduct a study to test this
1. The shortage computed by the ministère de la Santé et des Services
sociaux (MSSS) only considers staffing levels needed to reduce
overtime. The Ministry's calculations thus do not account for the
nursing workforce needed to meet the demand for healthcare services.
Hiring 1807 nurses, in accordance with the initial shortage calculated
by the MSSS on March 31, 2007, would consequently have little impact
on waiting times or patient care.
2. It has proven impossible to establish the full scope of the shortage
which would enable us to eliminate waiting times for healthcare
services that are deemed unreasonable.
According to Mathieu Laberge, project director at CIRANO: "Despite the
overtime, waiting lists remain long, so the method for computing the shortage
needed to be overhauled to make it account for the actual requirements of the
healthcare system and not only the number of overtime hours worked. This was a
prerequisite for generating a transparent portrait of the shortage."
3. The calculation method retained by the MSSS overestimates the
shortfall by 458 individuals, or 25.4 %. This overestimation is partly
attributable to a methodological choice by the MSSS that ignores the
real work effort provided by nurses.
Fewer hours worked and not more overtime
The other source of the overestimation springs from the lower work
intensity of Quebec nurses in comparison to their Ontario counterparts. In
fact, Quebec nurses average 28 effective hours of work (expressed on a basis
of 52.18 weeks per year, including overtime, holidays, vacations, and sick
leave). For purposes of comparison, civil servants in Quebec work 30.2 hours
(8 % more than nurses) while Quebec private sector employees work 33 hours per
week (18 % more than nurses). Nurses in Ontario work 31.3 hours per week (12 %
more than their Quebec colleagues). In the ROC, nurses work an average of 30.9
hours (10 % more than Quebec nurses). Contrary to popular opinion, this lower
number of hours worked is not compensated by a larger number of overtime hours
in Quebec than in the ROC.
Causes: more absences and more part-time work
There are two probable causes for the lower work intensity of Quebec
nurses. The first is the greater proportion of nurses working part time. In
this vein, we observe that 15 % of all nurses and 21 % of nurses below age 35
work part time because they cannot find full-time employment. However, these
proportions are comparable to those of the ROC.
The second cause is Quebec nurses' more frequent and longer absences from
work. Compensation levels may partially explain these choices of Quebec
nurses, because they are less well paid than their colleagues elsewhere in
Canada. They also enjoy a smaller wealth premium over the remainder of the
population than in other provinces.
Among potential solutions, we might seek to increase the supply of
services by nurses. An initial solution path may be to increase the number of
available full-time positions. Barring that, we could also promote a hybrid
solution by encouraging nurses working part time but desiring full-time
employment to complete their schedule with other employers, especially in the
private sector. Offering a premium on wages and providing skills upgrading
programs could also make the profession more appealing, allowing retirement
age nurses to remain on duty and even convincing some who have already retired
to return to active service.
Other solutions might be advanced to fill very short-term needs, for
example auctioning off vacant shifts in the event of a temporary absence. The
nurse bidding the lowest wage, while still exceeding the regular wage, would
work the shift.
To identify the best practices for retaining staff, we could promote the
establishment of a certification program like the "Magnet recognition program
process" developed by the American Nurses Credentialing Center.
This report is available on the CIRANO site at the following address:
The study titled "Portrait des conditions de pratique et de la pénurie
des effectifs infirmiers au Québec" was written by Mathieu Laberge and Claude
Montmarquette, who are respectively project director and Vice-President,
Public Policies, at CIRANO. The complete text of the study is available (in
French) at http://www.cirano.qc.ca.
The Center for Interuniversity Research and Analysis on Organizations
(CIRANO) is an independent, non-profit organization with a dual mission of
fostering research and promoting liaisons and the transfer of state-of-the-art
knowledge. Bringing together over 100 professor-researchers, CIRANO focusses
its activities on five principal areas of research: public policy,
experimental economics, finance, risk, and sustainable development. Thanks to
its high level of expertise in these fields, CIRANO is a key institution for
any firm or organization, whether private or public, that seeks to find
innovative ways to improve the efficiency of its activities.
For further information:
For further information: or to request an interview: Elizabeth Huart,
Senior Communications Advisor, CIRANO, (514) 923-3242, (514) 985-4003, poste