As Nova Scotia struggles with a strained healthcare system, some nurses in the province are signing contracts with travel nursing agencies to work elsewhere in Canada.
Higher pay and more flexible schedules are two reasons early-career nurses are leaving Nova Scotia hospitals, as the Nova Scotia Health Authority (NSHA) struggles to fill 1,024 vacancies and concerns about working conditions remain.
Some Nova Scotian traveling nurses say there are no retention strategies in place to keep nurses here and alleviate staffing shortages. And there is no incentive for traveling nurses to return to full-time positions because they are paid at least double the hourly wage of government nurses and can take unlimited time off between four and six week contracts.
Vice President of the Nova Scotia Government and General Employees Union Hugh Gillis said the NSHA must address these issues in order to retain nurses on staff.
“Our nurses are burned out because recruitment and retention issues have been ignored for so long they can’t take time off when they need it,” Gillis said.
“If you work 16-hour days, five to six days a week, there’s no future,” he said. “It’s not sustainable in the long run.
“It’s about work-life balance and if you push people hard enough, they just go somewhere else.”
balance is missing
Nicole Horechuk only started travel nursing two years into her career.
She worked full-time positions in two different emergency rooms in Nova Scotia, but quickly found that she was working so long hours that she didn’t have time for other activities.
“I was granted little to no leave,” she said. “So I retired to a casual position and started doing travel nursing.”
Horechuk saw practicing her skills in rural hospitals while seeing different parts of Canada as a learning opportunity — and it made a lot more money.
“I was definitely asking myself, am I part of the problem? But the answer is no,” Horechuk said. “If I didn’t do travel nursing, I wouldn’t be able to do this bedside job at all. I would be too burned out.
“I still work that way in an ER. I’m still at the bedside. I’m still providing direct patient care in an area where staffing is scarce,” she said.
Some nurses choose not to stay at all.
Horechuk noted that nurses were moving from stressful critical care jobs to jobs in research facilities, private clinics, or even cosmetic services.
“People don’t want to experience burnout and a bad work-life balance for the same pay when they could have a great work-life balance and a less stressful job,” she said.
Horechuk has heard traveling nurses say they don’t know if they would return to a full-time position in Nova Scotia because of the pay cuts, lack of vacation time and grueling hours.
“If they could correct those things, they would see a return to full-time,” she said. “But until then, people might stick with their agency jobs.”
Difficult locations
But travel nursing isn’t always easy.
“They usually go somewhere that isn’t a good place to work if there’s a shortage of staff or it’s very busy,” said Jenna Arsenault, a former traveling nurse from Sydney, NS
She worked in British Columbia, Manitoba, Newfoundland and Labrador and even in Bridgewater, NS as a traveling nurse.
Many of the rural hospitals where she worked were staffed almost entirely by traveling nurses. They couldn’t get people to stay because of the location or the nature of the job.
If employees leave in droves, Arsenault says it could indicate a larger problem with the unit.
“If employees don’t get breaks when they’re super understaffed, most people will just leave,” she said. “And then you end up needing more travel nurses.”
A vicious circle”
This is also playing out in hospitals in Nova Scotia, as the health board is hiring temp workers to fill vacancies between 50 and 80 percent in some units.
They’ve been spending millions more on contract workers in recent years.
In fiscal year 2021-2022, Nova Scotia Health spent $8.89 million on travel nursing services including Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Nursing Practitioners, Patient Attendants, Ward Assistants and Ward Clerks.
So far this fiscal year, the Board of Health has already spent about double that amount — between April 1 and December 31, 2022, the Nova Scotia Board of Health spent $16.3 million on agency RNs.
Janet Hazelton, President of the Nova Scotia Nurses’ Union, speaks of a vicious circle.
“They can’t get time off, so they leave,” she said. “It only makes the shortage worse.”
Hazelton says federal and provincial governments across the country need to come together to address the shortage as provinces poach nurses from each other.
“We have to pay nurses more money to come from other provinces to work here as travel nurses, and yet some of our own nurses are leaving this province to go to other provinces to become travel nurses,” she said.
“We have to come together as a country and decide, OK, how are we going to deal with these shortages?”
Conservation efforts underway
NSH spokesman Brendan Elliott said in an email the health agency’s focus is on hiring new nurses and retaining the ones they already have.
A new approach is conducting ‘residence interviews’ – a different approach to an exit interview – to determine what caregivers would need to stay with the agency.
“There’s no point in us trying to figure out what didn’t work when a nurse walks out the door,” Elliott wrote. “Instead, while they’re still with us, let’s hold this on record and do what we can to address those concerns.”
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