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https://www.infirmiere-canadienne.com/blogs/ic-contenu/2026/06/08/penurie-infirmier-peuvent-mener-le-changement

Understanding the factors that contribute to this issue, and considering solutions to ensure a sustainable health-care workforce

By Kristi McManus
June 8, 2026

The nursing shortage has been well documented worldwide, with health-care organizations struggling for decades to find experienced, qualified practitioners to meet the needs of their communities. Despite the attention, the shortage continues, leaving the system in a continual state of turmoil, and nurses in a state of strain.

However, nurses are in a unique position to help address this challenge from the inside through advocacy, leadership, and shared governance. It is vital for organizations, nurses, and nurse leaders to understand the factors that contribute to this issue to determine and implement appropriate, effective solutions to ensure a sustainable health-care workforce.

What the data says

The inability to retain young nurses has contributed to the nursing shortage for years, and Canada is no exception (Faubert, 2024). Forecasting has anticipated a shortage of 117,000 nurses by 2030 (McKendrick Calder, Topola, & Heuver, 2024). In Canada, 4 in 10 nurses left the profession before the age of 35 in 2022, an increase of 25% since 2013 (Faubert, 2024). This statistic is echoed by the Canadian Federation of Nurses Unions (CFNU), which found that 35% of young nurses (less than 35 years old) were dissatisfied with their work, citing occupational disappointment, which is feeling disheartened with one’s career choice (McKendrick Calder et al., 2024).

In examining the shortage by province, New Brunswick loses approximately 8 of every 10 nurses prior to age 35 in comparison to Manitoba, which loses less than 3 for every 10 nurses (Faubert, 2024).

Proportion of young nurses entering profession to leaving profession before age 35, by province

Source: Faubert, 2024

What are the contributing factors?

The nursing shortage cannot be attributed to a single factor. Like any issue of this magnitude, several factors play a role in the problem. These include remuneration, stressful work environments, poor work-life balance, an aging workforce of experienced nurses, and burnout leading to moral distress (Faubert, 2024). While some contributors have been heavily researched, such as workload and environment, others deserve equal attention, such as the overall supply of nurses and the high demands of the job.

Decreased supply

The decreased number of available nurses across the country has an impact on the nursing shortage. The Canadian Institute for Health Information (CIHI), as noted by the Ontario Nurses’ Association (2023; 2024), demonstrated a continual decrease in the number of available nurses, with 668 nurses per 100,000 people in 2021, 661 in 2022 and 2023, and 651 in 2024. The Ontario Nurses’ Association (2024) has cited the need for more than 25,000 registered nurses to bring Ontario on par with the national average. Exit rates from the profession are another consideration, with 2% of nurses aged 35-49 and 11% of nurses aged 60 and over leaving the profession altogether(McGill Nursing Collaborative for Education and Innovation in Patient- and Family-Centered Care [McGill Nursing Collaborative], 2019).

Workload and work environment

According to CFNU, as cited by the McGill Nursing Collaborative (2019), workload is the number one concern for nurses. Working short staffed results in an increase in workload, which contributes to increased rates of burnout, stress, absenteeism, job dissatisfaction and more (McGill Nursing Collaborative, 2019). Further, despite much discussion around nurse-to-patient ratios, there is no formal consensus on this standard, with the average ratio in Canada being a recommendation of 1:4 (Ariste, Béjaoui, & Dauphin, 2019). This, in turn, impacts the rate of hire for nurses, which does not always match the need (Ariste et al., 2019).

Physical and verbal abuse are on the rise within health-care environments, making the provision of care a challenge when nurses fear for their safety (Perkins, 2021). Workplaces that do not adequately support nurses have more staff dissatisfaction and, ultimately, turnover, further exacerbating the shortage (Perkins, 2021). CFNU, as noted by McKendrick Calder et al. (2024), indicated in a survey of 5,595 nurses that 30% were dissatisfied with their career, and 40% intended to leave nursing or retire.

Unrealistic expectations

Nurses are often asked to do more with less. Exposed to high stress and the daily demands of the job, nurses provide care with little support from administration or from the organizations they work for (McKendrick Calder et al., 2024; Perkins, 2021). This can result in negative work environments, poor job satisfaction, burnout, and moral distress, leaving nurses feeling as though they cannot provide adequate care (McKendrick Calder et al., 2024; Perkins, 2021).

One result of these unrealistic expectations is that staff work overtime, which is not a new phenomena within health care. According to CIHI (2024), 8% of total hours worked by front-line health-care providers in hospital nursing units during 2023-2024 was overtime. This percentage varies by province/territory: British Columbia, 11.5%; Manitoba, 10.2%, Northwest Territories, 8.7%; Alberta, 7.8%; Newfoundland, 7.6%; New Brunswick, 7.4%; Ontario, 6.7%; Prince Edward Island, 6.5%; Yukon, 6%; and Nova Scotia, 5.5%. (No data was available for Saskatchewan, Quebec, or Nunavut at the time of the CIHI study.) Notably, Quebec is the only province where nurses are legally obligated to work overtime (Canadian Federation of Nurses Unions, 2022).

Interestingly, despite Manitoba’s high rate of overtime — which amounted to nurses working an extra million hours in 2023 (McKendrick Calder et al., 2024) — this province also has the highest rate of young nurses remaining in the profession. This seems to be a discrepancy warranting further study.

Related article

How an Alberta emergency department shifted its educational approach to boost staff retention and morale

What are the impacts?

The impacts of the nursing shortage are as varied as the causes, with some being well documented, while others are less discussed. The mental and physical impacts of nursing shortages include burnout, moral distress, and fatigue, with additional considerations such as displacement and the draw of private sector opportunities compounding the issue.

Mental and physical

Research indicates a direct link between nursing shortages and increased rates of burnout, stress, job dissatisfaction, and workplace violence involving patients, visitors, and colleagues (McGill Nursing Collaborative, 2019). Burnout is the emotional and physical state of chronic overwork and lack of job fulfilment and perceived support, and has been correlated with feelings of exhaustion, cynicism, and low personal satisfaction (McGill Nursing Collaborative, 2019). Persistent feelings of burnout can contribute to a negative workplace environment, thus exacerbating the issue. The negative impacts of nursing shortages have also been connected to an increase in absenteeism, with Canadian nurses missing an average of 19 days per year due to illness or leave in 2022 (McKendrick Calder et al., 2024).

Workplace violence incidents also rise in the wake of nursing shortages, putting the safety of nurses at risk. These incidents consist of physical or verbal assault by patients, family members, or even peers and management, and directly impact nurses’ intention to leave the profession (McGill Nursing Collaborative, 2019). The burden of physical and mental abuse places further strain on nurses, and 93% of nurses report experiencing physical assault during the course of their career (Nelson et al., 2023).

Displacement

While staffing shortages are a well-known issue within health care, there are additional considerations that require attention. One such factor is displacement, or the movement of nurses from one area to another based on staffing needs. According to CFNU’s survey, 42% of nurses indicated they were displaced due to staffing shortages, and 40% of those reported feeling inadequately trained for the unit on which they were placed (McKendrick Calder et al., 2024). This can result in poor patient outcomes and frustration for nurses.

Private sector opportunities

According to some studies, nurses who cited their intention to leave the profession indicated an interest in moving to the private sector for better flexibility and working conditions (Faubert, 2024). This finding shows that while remuneration is important, positive work environments and working conditions directly contribute to maintaining a public health-care workforce.

What can we do?

Strategies to address the nursing shortage have been a point of discussion for years, with many governments seeking ways to increase registration in nursing programs, and improve the process for internationally trained nurses to practise within Canada. One such strategy at the federal level was the release of the Nursing Retention Toolkit, developed in collaboration with the nursing community to improve the health-care system and the lives of nurses (Government of Canada, 2024). This document, created at the federal level, demonstrates the result of nurse advocacy for the well-being of the profession, and is an example of shared governance practices in action.

While many nurses may often feel unable to address the problem themselves, they are in a unique position to advocate for change within organizations; nursing leaders and managers, meanwhile, can implement strategies to mitigate the impacts.

Shared governance

Increasing job satisfaction in nursing practice through nurse involvement in policy and practice development can improve nursing outcomes (Government of Canada, 2024). Shared governance, the practice of involving staff in decision-making opportunities, allows for nurses’ voices to be heard, increases job satisfaction, and has been connected to a 4.8% reduction in turnover (Wetmore, 2018). This demonstrates that nurses who participate in such opportunities can improve outcomes for peers and increase their sense of practice autonomy in the process.

Work-life balance

Creating more flexible work designs can improve work-life balance, and thus decrease burnout, job dissatisfaction, and turnover (Perkins, 2021). This can be achieved through the development of part-time positions, dual roles, job sharing, and other strategies that allow for nursing coverage without the strain of full-time work schedules (Government of Canada, 2024). Nurse leaders and managers can ensure adequate shift coverage while also improving work-life balance of staff through the creation of such positions.

Development programs

Developing programs to transition new graduates into practice and experienced nurses into leadership positions can provide the support needed to deliver high-quality care, ease integration, and improve practice collaboration (Government of Canada, 2024). Additionally, nurse managers and leaders can include alternative positions such as clinical mentorships and clinical scholars within departments to provide clinical and practice supports to staff daily. This can improve not only patient outcomes, but also increase staff confidence and satisfaction at work (Government of Canada, 2024).

Conclusion

The nursing shortage is not a new issue in health care, and is one nurses are intimately familiar with. The main objective of this article was to bring Canadian data to the forefront for nurses and nurse leaders to, in turn, advocate for greater support in the workforce, one organization at a time. Nurses advocate for their patients every day. It is now time we advocate for ourselves, and each other, to safeguard our future.

References

Ariste, R., Béjaoui, A., & Dauphin, A. (2019). Critical analysis of nurses' labour market effectiveness in Canada: The hidden aspects of the shortage. The International Journal of Health Planning and Management, 34(4), 1144–1154. https://doi.org/10.1002/hpm.2772

Canadian Federation of Nurses Unions. (2022). Canada’s nursing shortage at a glance: A media reference guide. https://nursesunions.ca/wp-content/uploads/2022/07/nurses_shortage_media_ref_guide_comp.pdf

Canadian Institute for Health Information. (2024). Health workforce: Overtime and staffing challenges in hospitals. https://www.cihi.ca/en/health-workforce-overtime-and-staffing-challenges-in-hospitals

Faubert, E. (2024, September 24). Which provinces struggle the most to keep young nurses? Montreal Economic Institute. https://www.iedm.org/which-provinces-struggle-the-most-to-keep-young-nurses/

Government of Canada. (2024). Nursing retention toolkit: Improving the working lives of nurses in Canada. https://www.canada.ca/en/health-canada/services/health-care-system/health-human-resources/nursing-retention-toolkit-improving-working-lives-nurses.html

McKendrick Calder, L., Topola, L., & Heuver, T. (2024, May 7). How the nursing shortage is affecting the healthcare system, patients, and nurses themselves. MacEwan University. https://www.macewan.ca/campus-life/news/2024/05/news-conversation-nursing-shortage-24/

Nelson, S., Leslie, K., McCormick, A., Gonsalves, J., Baumann, A., Thiessen, N. J., & Schiller, C. (2023). Workplace violence against nurses in Canada: A legal analysis. Policy, Politics, & Nursing Practice, 24(4), 239–254. https://journals.sagepub.com/doi/pdf/10.1177/15271544231182583

McGill Nursing Collaborative for Education and Innovation in Patient- and Family-Centered Care. (2019). Global shortage of nurses. McGill University. https://www.mcgill.ca/nursing/files/nursing/nurse_shortages.pdf

Ontario Nurses’ Association (2023). Ontario registered nurse levels fall again, still the lowest in Canada. https://ona.org/news/20230803-nurse-levels-fall/#:~:text=The%20CIHI%20report%20reflects%20the,data%20to%20CIHI%20this%20year.

Ontario Nurses’ Association. (2024). New data confirms nurse staffing ratio continues to plummet in Ontario. https://ona.org/news/20240725-cihi-data-staffing/

Perkins, A. (2021). Nursing shortage: Consequences and solutions. Nursing Made Incredibly Easy, 19(5), 49–54. https://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/nie_15445186_2021_19_5_49.pdf

Wetmore, M. (2018). The impact of shared governance on nursing satisfaction and retention. (Doctoral dissertation, Walden University).

Kristi McManus, RN, MN, BScN, OHN, is an occupational health nurse with Air Canada.

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