VICTORIA, B.C. — Auditor General Carol Bellringer has released a new report which says Northern Health needs to do more to recruit and retain registered nurses in communities under its authority.

According to Bellringer’s report, Northern Health had a substantial number of registered nurse vacancies in rural and remote communities, explaining that all communities in Northern B.C. except Prince George were classified as rural and remote. As of April 1st, 2017, Bellringer’s report shows that Northern Health was short 121 RNs across the northern 2/3rds of the province, or roughly 15 percent.

The findings, though based on data from the Spring of 2017, are in stark contrast to a report from Northern Health’s Human Resources Department released on Monday, saying that the health authority has had modest success with recruitment so far this fiscal year.

The nurse workforce in the Peace River North and Fort Nelson areas was found to be more than 20 percent short of Northern Health’s forecasted demand. The North Peace was short 31.5 full-time equivalent nurses, while the South Peace had a shortage of 15 full-time equivalent nurses. Fort Nelson was short also five nurses, out of a forecast workforce of almost 22 FTEs.

Photo by Office of the Auditor General.

“Any shortage of health practitioners has impacts,” said Bellringer. “First: quality of care concerns. RNs were challenged to meet patient needs and worried about patient safety due to reduced patient supervision, missed equipment checks, and fatigue causing reduced awareness, perception, decision-making, and motor skills as a result of long hours. Second is higher overall cost due to overtime and paying for more expensive nurses via agencies to fill shifts.”

Photo by Office of the Auditor General.

The Auditor General’s report said that when there is a vacancy or someone calls in sick or takes a vacation, in some cases Northern Health is able to find a nurse to fill in temporarily. Northern Health was able to fill approximately half of its vacant RN and Nurse Practitioner shifts with casual or existing nursing staff, sometimes at an overtime rate. It had the toughest time filling vacant shifts with existing nursing staff in northeastern B.C.

“The third example is nurse burnout, and by that, we mean the effects of prolonged stress, including emotional exhaustion, disengagement, and reduced performance.”

Photo by Office of the Auditor General.

Bellringer’s report did acknowledge that some of the reasons for the health authority having difficulty in recruiting and retaining RNs were because of external factors such as geographic location, weather, and housing affordability. However, she and her staff found that there were three internal factors that influenced the shortage of nurses.

Bellringer explained that Northern Health’s practice of using primary care nurses that deliver services in public health, mental health, and home care nursing. She said that since many RNs previously focused on only one of those aspects, many nurses have experienced burnout because of working long hours. Bellringer also gave both praise and criticism to Northern Health’s management, saying nurses had left because of management practices at some facilities, but did not include an example.

The third area inside of Northern Health’s control was the lack of a nursing school in Northeast B.C. She said that the health authority could help get a nursing school established in the Peace by partnering with post-secondary institutions and the provincial government.

The report did say that Northern Health has already implemented many good practices for recruitment and retention. These include a formal employee referral program, staff recognition programs, multiple targeted marketing campaigns, and student placements/clinical rotations at rural and remote locations.

Bellringer made nine recommendations in the report that address the root causes of the RN and NP shortage as well as the gaps between their current state and good practice.

Bellringer’s full report can be read here: