Overview

  • The College of Nurses of Ontario (CNO) 2016 membership statistics report provides good news about Ontario’s nursing workforce, which is growing in all health care sectors.

  • Most of the growth in the nursing workforce has been due to increases of Registered Practical Nurses (RPNs) in the long-term care and home and community care sectors, which reflects the continual growth and aging of the province’s population, and the education and expertise that RPNs have in providing high-quality care to Ontario’s older adults.

  • The full-time employment rate for Ontario’s RPNs remains below the 70% provincial target, which threatens to undermine access to quality nursing care in all health sectors.

Background

  • The annual CNO membership statistics report provides information about provincial nursing workforce trends, including the number of nurses employed in Ontario, and the number of nursing positions in various health care sectors. 

  • The annual report is helpful because it provides a general picture of Ontario’s nursing workforce, but it provides no definitive information about the impact of provincial nursing trends on the actual contact hours that nurses have with patients, residents, and clients.

  • The report does not establish benchmarks for the numbers of nurses to patients or measure ratios of nurses in different nursing categories or practice sectors, nor does the report analyze the appropriateness or effectiveness of nursing skill mix decisions made at the point of care.

Considerations

1. The total number of nurses employed in Ontario increased in 2016 
  • There are 140,167 nurses employed in Ontario, an increase of 2,642 nurses (+1.9%) since 2015. 

  • The number of RPNs employed in nursing in Ontario increased in 2016 (+6.1%), as did the number of Nurse Practitioners (+10.4%), while the number of Registered Nurses remained stable (+0.0%).

  • Almost two-thirds of all nursing positions in the area of seniors’ care in Ontario are RPN positions, and the vast majority (97.0%) of these are direct practice positions at the beside. 

2. The growth in Ontario’s nursing workforce is due largely to additional nursing positions in the long-term care and home and community care sectors
  • Most of the growth in Ontario’s nursing workforce in 2016 was attributable to sizeable but anticipated increases in the number of RPN employment positions in the long-term care sector (+5.5%) and in the community care sector (+9.2%), while there was a more moderate increase in the number of RPN positions in the acute care sector (+3.9%).

  • The number of RN employment positions remained about the same in the community care and long-term care sectors and increased in the acute care sector, where the number of RN positions grew (+0.3%) for the fifth consecutive year.

3. The full-time employment rate for Ontario’s nurses remains below the 70% provincial target
  • For the fourth straight year, the full-time employment rate for RPNs decreased significantly (-0.9%).

  • The rate of full-time employment for Ontario’s RPNs was 54.2% in 2016 (compared to 60.9% in 2012), while the full-time rate for RNs (66.2%) remained close to the provincial target.

  • The full-time employment rate for new graduate RPNs was only 24.0% in 2016, whereas the full-time employment rate for new graduate RNs was 43.5%.

Recommendations

Efforts to increase patients’ access to nursing services and nurse-patient contact hours should focus on:

1. Further improving value for money and the overall quality of care by optimizing the role of RPNs in Ontario and removing outdated and unnecessary barriers to practice that restrict these nurses from using their full knowledge, skills and competencies for the benefit the people they care for; and

2. Increasing the RPN full-time employment rate to meet the Quadruple Aim of enhancing the patient experience, improving population health, reducing costs, and improving the work life of nurses. 

Note: The College of Nurses of Ontario is the source of the statistics referenced on this page.