Nursing retention toolkit - Improving the working lives of nurses in Canada

Transcript

Transcript

Since I was appointed to the Chief Nursing Officer role, I have prioritized engagement with the nursing community across Canada in a variety of academic, clinical and community settings. During these visits with nurses, students, faculty and administrative leaders, it has been clear that nursing retention is a significant challenge. Information garnered from the engagement prompted the development of the Nursing Retention Toolkit to help improve the working lives of nurses from coast to coast to coast.

The toolkit is the result of a pan-Canadian collaboration with the nursing community and with nurses who are committed to optimizing the working conditions in Canada. Development began in June 2023 at the Nursing Retention Forum, which brought together a diverse group of nursing experts, including point-of-care nurses, nurse-employers, decision-makers, nursing regulators, union representatives and others. As a resource created by nurses, for nurses, it draws on evidence-based practice, lived and living experiences of point-of-care nurses, and insights from nursing professionals at all career stages, including nursing students.

The toolkit, which can be found at Canada.ca/NursingToolkit, was developed to support nursing retention. The goal of the toolkit is to provide Canadian nurse-employers and health authorities with practical strategies and tools to improve the working conditions of nurses and develop standardized programs aimed at fostering nursing retention across health care organizations and systems in Canada.

Nurses are critical in providing high quality care, but they are facing many challenges in their everyday work. Increased violence and discrimination as well as high patient acuity and  volumes are causing  moral distress which, among other factors, are causing many nurses to leave the profession. We need them to stay. We need to support nurses.

This toolkit focuses on eight core themes that impact nurses’ day-to-day working life. Each of the core themes are underpinned by the values of respect, anti-racism and anti-oppression, transparency and accountability. Additionally, each theme has a goal, and accompanying initiatives that can be used as a guide for employers and organizations to implement as strategies that target retention. The order in which the eight themes appear do not indicate priority or sequence. Each theme may have greater or lesser relevance depending on the local context of the specific employers, organizations, or health systems. The first theme is:

• Inspired leadership. The goal of this theme is to empower nurses of all levels, roles, and settings to experience fulfilment in their work and become leaders within their organizations. The initiatives include: Cultural Change, Leadership Competencies, and Emerging Nursing Leaders.

The second theme is:

• Flexible and balanced ways of working. This theme involves promoting nurse autonomy and flexibility in scheduling and career progression, initiatives tied to this theme include: Flexible Work Design, Scheduling Systems, and Workplace Resources and Amenities.

The third theme is:

• Organizational mental health and wellness supports. The goal of this theme is to increase timely and comprehensive access to appropriate and effective preventative and acute health and wellness supports, with an urgency and focus on mental health supports. Initiatives include: Zero Tolerance for Violence, Bullying, and Racism, Moral Distress and Injury Care, and Best Practices for Vacation and Time Off.

The fourth theme is:

• Professional development and mentorship which focuses on providing options for nurses across the entire career span to enhance their skills and pursue their career goals. Initiatives include: Transition Programs, Mentorship Programs, as well as Career Pathways and Bridging Programs.

Next is:

• Reduced administrative burden. The intent of this theme is to free up nurses to focus on the tasks and care that they are uniquely skilled to provide. Initiatives tied to this theme include Work Re-design, Digital Preparedness, and Documentation Requirements.

The following theme considers the importance of:

• Strong management and communication, with a goal of promoting cultures of transparent leadership and mutual respect between management and point-of-care nurses. Initiatives to support building these cultures include: Nursing Management Competencies, Supporting Nursing Leaders, and Nurse Engagement and Listening.

Next, we wanted to focus on

• Clinical governance and infrastructure, this theme will help to ensure that supportive clinical governance and infrastructure is in place to ensure that nurses have a core role in decision-making and are at the forefront of driving the development of a sustainable health system. Initiatives include: Structured Participatory Governance, Nursing Shared Governance, and Nurse-led Models of Care Initiatives and Practice Standards.

The final theme included in the toolkit is:

• Safe staffing practices. The goal of this theme is to support physically safe and psychologically brave workplaces by implementing staffing practices that reflect factors like patient acuity, nurse experience, and work-life balance. Initiatives included to support this theme are Clinical Supports and Safe Staffing Framework and Tools.

I encourage employers and health authorities to engage nurses in their analysis and implementation of the toolkit in order to collaborate together to better support the nurses who care for us and our loved ones when we need it the most.

The toolkit provides a framework that can be utilized as a key resource for employers and organizations to enhance the working conditions of nurses. I would encourage employers and health authorities to share the toolkit through their social media platforms, via email, at staff meetings,  with colleagues, and with other healthcare organizations. This will help promote awareness of the release of the toolkit and of its contents. I would also encourage all users of the toolkit to connect with organizations that are highlighted in the toolkit as best practice initiatives under the resources section. These connections  will help scale up initiatives we know have had success in other organizations, and allow for collaboration and the development of strategic partnerships. Finally, I would recommend adopting and implementing the best practice initiatives in the themes that have the most value for your organization or health authority. I recognize that not all themes and initiatives will align with each workplace, but would encourage implementing those that correspond best to your needs.

I continue to be inspired by nurses across Canada, and I know that when we work together, we can create solutions that will drive meaningful change in the health care system. Canada is fortunate to have nurses with such great knowledge, expertise and professionalism in the health system; despite the complex and ever-changing healthcare environment, nurses respond with humanity, composure  and competence. It is clear that the profession needs support now more than ever.

More must be done to improve the working lives of nurses in Canada, and the Nursing Retention Toolkit is a great starting point to initiate lasting positive change. To consult the toolkit, visit: Canada.ca/NursingToolkit