Helena is a chief nursing officer of a large hospital.

Her jurisdiction has invested in increasing primary care access through new policy that includes the expansion of nurse practitioner (NP) led primary care clinics, which may have an impact on her facility’s ability to recruit or retain NPs and/or RNs who would train up to become NPs as part of the incentive offered with the new policy. In addition to looking at her local wellness survey results that can influence retention, she wants to assess trends in NP and RN employment within hospitals in both her own as well as neighboring jurisdictions to better understand how she may need to manage the impact.

Five ways Health Workforce Canada dashboards can help Helena

1. She checks the Policy Tracker to see whether there have been provincial policies that may influence the recruitment and retention of RNs and NPs, both in her own jurisdictions as well as in neighbouring ones that could impact her hospital staffing.
2. In the Provider Profile dashboard, she selects her province and NPs using the drop-down menus at the top to get a sense of how the proportion working in hospital settings has changed over time. She compares the results of neighbouring jurisdictions and the pan-Canadian average to the internal data she has access to that is specific to her own facility and others in the same health region.
3. In the Employment dashboard, she monitors trends in vacancies reported for nurse practitioners in her jurisdiction as well as across the country to get a better sense of the historical and current labour market demand.
4. Helena navigates to the Recruitment and Retention dashboard to review the supply of NPs and RNs categorized by early, mid, or late career stage, to start to assess possible risk of a greater pipeline of RNs moving into the NP profession, which could have an impact on the available supply of RNs.
5. On the Primary Health Care module, she notes the percentage of her jurisdictions’ population that has a regular care provider, as well as the types of regular care providers that are most common. This provides her with a sense of the gap that could be filled by the expansion of NP-led primary care clinics.

Five things Helena learned

1. In the Policy Tracker summary for her jurisdiction, Helena sees that there were only two policies targeted at recruiting RNs compared to the four policies for NP recruitment. Most recruitment policies focused on internationally educated nurses. There were also two policies focused on NP retention in neighbouring jurisdictions, including the establishment of new compensation models which could attract NPs to relocate.
2. In Helena’s province, the proportion of NPs working primarily in hospital settings has decreased slightly over the past two years. In contrast, the proportion of NPs working in community health agencies and nursing home/LTC facilities have stayed constant, and NPs working in other sectors have increased, alerting her to an overall trend that NPs in the jurisdiction are shifting away from working in hospitals to other sectors.
3. While vacancies for NPs have been on the rise, her province has experienced consistent growth in the supply of NPs across all career stages, which suggests to Helena that both recruitment and retention is strong overall in this profession. Additionally, she knows that some of the rise in vacancies can be attributed to the positions at new clinics that are being opened.
4. However, growth in the RN supply has stagnated, and there have been fewer early career RNs over the last five years. Additionally, she notices that more RNs left the profession than entered in recent years. This is consistent with the data she has access to from her own facility and suggests to her that there have been system level challenges in retaining newly employed RNs.
5. While recruitment and retention are strong for NPs in her jurisdiction, they serve as a regular care provider for less than 2% of the population that has a regular care provider. Family doctors or general practitioners continue to be the main regular care provider for people residing in her jurisdiction. She notes that still 15% of her jurisdiction’s population does not have access to a regular care provider.

What Helena and her team will do with this information

• Examine retention incentives that have been put in place in other jurisdictions that may work for her facility to reduce risk of significant movement of NPs to other sectors.
• Conduct an evaluation of how to optimize RN and NP scope of practice in her facility and consider the offering of upskilling opportunities to further improve retention and mitigate occurrence of talent gaps.
• Ensure adequate measures are taken to avoid a continued decline in the RN workforce in their facility through additional recruitment policies targeting new graduates and leveraging wellness survey results to inform retention strategies.
• Begin further research on education and training pipeline trends for RNs moving into the NP profession, starting by browsing the Data Catalogue to check how she can access more specific data on nurses’ education levels and career stages.