Here’s the latest on what senior managers in health care, long-term care, and post-secondary education are doing to recruit and retain more people to staff nursing homes, hospitals, and family medicine clinics.
This information was obtained from witnesses who appeared before the legislature’s Standing Committee on Human Resources on Tuesday.
A 23% wage increase for continuing care assistants (CCAs) last year combined with a government decision to make tuition and books free for people applying to the CCA program at Nova Scotia Community Colleges has “stabilized” staffing levels at many nursing homes.
Tracey Barbrick, the associate deputy minister with the Department of Seniors and Long-term Care, said 35% of nursing homes now have enough staff to provide residents with the 4.1 hours of daily care the Houston government promised during the 2021 election campaign. Barbrick expects that meeting the 4.1 hours standard in every long-term care home will be achieved within the next two years as more people graduate from training programs.
The CCA training programs at NSCC campuses are turning out an additional 300 graduates for a total of 1,000 CCAs each year. NSCC president Don Bureaux said there has been a 300% increase in enrollment over the past three years and these programs currently have waiting lists. This fall, Bureaux said a CCA program will be tailored to welcome a new cohort of 30 Mi’kmaw students.
Last year, the province announced funding for an extra 230 seats at community colleges to train licensed practical nurses (LPNs). The move was driven partly by the fact that in 2021, hundreds of nursing home beds remained empty because there were not enough staff to care for residents. Those long-term care beds re-opened in 2022-23, but the cost was high.
In response to a question, Barbrick said the department spent $50 million in 2022-23 to bring in and compensate travel nurses on short-term contracts so those beds in nursing homes could be reopened. Barbrick said the number of people in “travel positions” working in long-term care today is tapering down from the 100 previously employed to fill vacancies created by staff shortages that COVID exacerbated. She noted that for the first time in many years, Northwood campuses in Halifax and Bedford are reporting a full complement of CCAs with no vacancies.
“Our efforts are paying off and we are seeing results,” Barbrick said. “We are stabilizing and growing our workforce and ensuring that continuing care continues to have high quality, well-trained staff.”
The Health Association of Nova Scotia (HANS) operates a registry for 9,000 CCAs who work in home care as well as long-term care. HANS has also been assigned the task of recruiting CCAs internationally.
“We are making headway,” HANS CEO Mary Lee told the Committee. “We have made 171 new hires, including 90 offers to internationally trained CCAs.”
A visit to two refugee camps in Kenya last fall produced 65 conditional offers of work, although their re-location to Nova Scotia could take many months because refugees often lack documents required to immigrate.
For those who do arrive, Mary Lee said “the biggest challenge will be settlement.” She said HANS has learned whether workers will stay in Nova Scotia depends on finding necessary support such as housing, food, and church, all factors she said should be considered ahead of their arrival.
In her closing remarks, Lee urged the province to consider extending the $10,000 “thank you” given to registered nurses to managers of long-term care homes. Lee said many managers slept at work during the early days of the pandemic and often help out with patients when homes are short-staffed. She said their work is not only important but if it goes unrecognized, the sector could soon lose half its managers to retirement.
There are currently about 96 vacancies across the province for family doctors.
“Recruitment is a global challenge and we are competing with every other jurisdiction,” said Suzanne Ley, executive-director of the Office of Healthcare Professional Recruitment. Ley told the committee “a record number of new doctors were recruited last year,” but she did not provide a number nor the net gain to the province after subtracting those who retired or departed.
Ley promised to find an answer to a question posed by Dartmouth North MLA Susan Leblanc. Leblanc wanted to know how many doctors who began practicing in Nova Scotia three years ago have since given up their practice.
Eastern Shore MLA Kent Smith noted that a new family doctor is coming to the Sheet Harbour area this September through a program that encourages internationally trained medical graduates to work under a mentor before being licensed to practice in Nova Scotia. There are openings for 10 international medical doctors who agree to work under supervision and remain in the province for three years after getting licensed.
Nova Scotia Health offers $125,000 over five years to family doctors willing to work outside of urban Halifax-Dartmouth. A new satellite campus of the Dalhousie Medical School that will be launched at Cape Breton University is another initiative to try to convince more people to enter family medicine and work in rural communities.
“We see the CBU opportunity as a new way to provide medical education,” said Greg Ells, executive director for the higher learning division of the Department of Advanced Education.”This is certainly a focus on family practice, it’s a focus on rural, and it’s a focus on addressing the health needs of an ageing population and Indigenous communities. So, I think Cape Breton is a wonderful setting.”
Ells notes $6.2 million of the Cape Breton medical school allocation is for a new collaborative care clinic, which will provide services to about 10,000 people in the Sydney area. This fall, a total of 10 students will be enrolled at CBU with instruction offered by Dalhousie Medical School. That number will eventually grow to about 30 each year.
Suzanne Ley told the Human Resources Committee that 231 internationally trained nurses moved to Nova Scotia and began work last year. Recruitment efforts continue in English-speaking countries such as the UK, India, the Philippines, Nigeria, Australia, and New Zealand since licensing requirements have been fast-tracked by the Nova Scotia College of Nursing. Health Minister Michelle Thompson has said the province has openings for as many as 1,200 nurses.
Other health care professionals
The province urgently needs medical laboratory technologists. Greg Ells said we are short 70 lab techs. The decision was made to partner with the Michener Institute in Ontario for the next three years rather than re-launch the training program previously offered through the NSCC. The first group of 40 students will start this fall.
Pharmacy technicians are also in demand and Suzanne Ley said the government realizes this shortage also needs to be addressed.
Paramedics, which the province has been losing for the past three years since the pandemic began, are finally getting some encouragement. The province is promising a tuition rebate of $11,500, if the graduate agrees to remain in the province for three years.
An additional 165 training places will be available this fall and this winter. Courses will be added at campuses in Yarmouth and Pictou as well as in metro Halifax.
The shortage of nurses, lab, CCA’s, and Doctors has been pointed out the successive governments over the last several decades. Also, the increasing number of long term care beds needed to care for our aging population was not another shocker. We need to take the health care planning out of the election cycles, and government needs come up with a realistic plan, with input from the workers, that is followed by all elective officials no matter the party.