https://www.infirmiere-canadienne.com/blogs/ic-contenu/2026/08/10/temps-reserve-au-perfectionnement
Dedicating paid hours for learning, innovation, and skill development shows positive results in organizations bold enough to implement it
By Ibrahim Akbar
August 10, 2026
istockphoto.com/Drs Producoes
Protected professional development time, where nurses spend a designated portion of their paid hours on learning, innovation, and skill development rather than direct patient care, has quietly demonstrated remarkable results in organizations bold enough to implement it.
Takeaway messages
- Protected professional development time (80/20 models) can significantly reduce nursing turnover, with potential savings of $380,000-$760,000 per percentage point of retention in a 1,000-nurse organization.
- Ontario’s Nursing Graduate Guarantee reinvestment guidelines explicitly support 80/20 staffing models, yet most hospitals haven’t implemented them despite the clear policy framework and funding pathway available.
- Successful nurse retention requires executive commitment to protect development time above staffing complement, dedicated coordinator or retentionist support, and may benefit from alignment of nurse development goals with organizational priorities.
The numbers are stark: 69% of Canadian nurses plan to leave their positions within five years (Grinspun et al., 2022). Hospital leaders scramble to recruit, schools are pressured to open more seats, and yet there continues to be a systematic hemorrhaging of nurses from the profession. Health-care leaders and organizations have embraced improved onboarding and retention practices for new graduate nurses, but few, if any, focus on retention of mid- to late-career seasoned nurses. Meanwhile, the solution may not be about training or hiring more, but structuring time differently.
Protected professional development time, where nurses spend a designated portion of their paid hours on learning, innovation, and skill development rather than direct patient care, has quietly demonstrated remarkable results in organizations bold enough to implement it. Studies dating back to 2007 and earlier have demonstrated turnover rates dropping from 22% to 5% (Arthur et al., 2020), zero attrition among program participants, and negligible increases to costs of maintaining staffing complements (Bournes & Ferguson-Paré, 2007). These are documented outcomes from health-care organizations that changed how nurses spend their working hours.
Ontario’s Ministry of Health and Long Term Care (MOHLTC), for example, has recognized this potential in the past with the Late Career Nurse Initiative, which provided nurses aged 55+ the opportunity to spend 20% of their work time in less physically demanding nursing roles like mentorship. This intiative continues in some capacity at present. Ontario’s Nursing Graduate Guarantee (NGG) Program guidelines explicitly list “80/20 For Staff Nurses” as an eligible use of reinvestment funds, describing it as an opportunity to “back-fill staff nurses, allowing them to spend 20% of their time on professional development opportunities,” while “the remaining 80% of their time would be spent in clinical practice” (MOHLTC, 2025, p. 16). The policy framework exists. The funding pathway is clear. Yet adoption remains sporadic at best.
What protected time actually means
Protected professional development time is not time off or an escape from clinical work. It is a structured, purposeful time dedicated to activities that strengthen both the individual nurse’s capabilities and the organization’s capacity to deliver excellent care.
Initially developed in the corporate world for large organizations like 3M and Google, health care’s adaptation of this principle through 80/20 models follows the same logic with a clinical twist. Nurses spend 80% of their paid time in direct patient care and 20% in professional development activities. Critically, this development time builds on their clinical practice rather than replacing it. A nurse might spend their protected time conducting a quality improvement project to reduce falls on their unit, developing expertise in wound care through mentorship with specialty teams, participating in research that will inform future practice guidelines, or pursuing formal education that advances their clinical judgment. Nurses can lead quality improvement initiatives that streamline medication administration, enhance pain management protocols, and address workflow inefficiencies that direct-care clinicians observe daily.
The 2007 study by Bournes and Ferguson-Paré at University Health Network in Toronto implemented this model on two units, adding 20% more nurses to the staffing complement specifically to accommodate the professional development time. Their results disrupted conventional wisdom about health-care staffing. Despite the upfront investment, average variable direct labour costs did not increase significantly compared to control units (Bournes & Ferguson-Paré, 2007). Overtime hours decreased significantly throughout the intervention, sick time remained low, and patient satisfaction scores increased. Among the study participants in year two of the program, turnover was zero.
Multiple studies across different health-care settings demonstrate consistent retention improvements when organizations implement structured professional development with protected time. A perioperative clinical advancement program reduced turnover from 12% to 7% (Finlayson et al., 2025). An integrative nursing fellowship decreased attrition from the national average of 22.5% to just 6% among participants (Sullivan et al., 2025). A peer mentoring program achieved a 3.9% reduction in turnover, saving the organization $4.4 million (Fleming, 2023).
Protected professional development time transforms nurses from care deliverers into care innovators. Organizations implementing these programs report five-fold increases in publications by participating nurses, doubled rates of conference presentations, and nearly doubled rates of specialty certification, such as those through the Canadian Nurses Association (Fusilero et al., 2008).
Making it work: implementation strategies from successful programs
If this resonates with readers, the following are implementation strategies to consider sharing with your organization’s leaders. Organizations that successfully implement protected time programs connect individual development to organizational priorities rather than functioning as disconnected personal pursuits.
Executive commitment
Executive commitment entails protecting the protected time. When staffing gets tight, the temptation to pull participants back to fill gaps undermines the entire model. Organizations must maintain the principle that nurses with protected time remain above staffing complement even when units operate below normal levels. This requires a shift in organizational culture and a genuine organizational belief that the long-term retention and development benefits outweigh short-term staffing flexibility.
Dedicated infrastructure
Protected time programs cannot function as add-ons managed by already overextended leaders. Successful programs have dedicated support, either in the form of a dedicated coordinator/manager role or support for a leader to mentor participants. This infrastructure includes clear processes for application, selection, and ongoing support. Standardized application processes ensure fairness and help nurses articulate their development goals and proposed projects. Ongoing support through regular check-ins keeps participants on track and addresses barriers before they derail progress.
Strategic program design
A framework that aligns protected time with strategic goals creates mutual benefit, in which nurses pursue interests that matter to them while advancing initiatives that matter to the organization. One approach integrates protected time with existing quality improvement infrastructure. Organizations with a continuous quality improvement culture can match nurses with active projects needing clinical expertise. A nurse interested in patient safety could work on fall prevention. A nurse passionate about pain management could lead the implementation of enhanced protocols. This alignment ensures development activities generate tangible organizational value while nurses build project management and change management leadership skills.
Another effective strategy leverages specialty nursing teams as development pathways. Organizations often have specialty teams in areas like wound and ostomy care or simulation-based education. Protected time fellowships that place nurses with these teams for skill development serve multiple purposes: the specialty team gains support for projects and initiatives, the fellow develops expertise that may fill future vacancies, and the fellow’s home unit benefits when that nurse returns with enhanced capabilities and knowledge to share.
Union partnerships
In unionized environments, protected time programs require genuine partnership with union representatives from the beginning. Protected time programs affect working conditions, equity of opportunity, and terms of employment. Union concerns typically focus on the fairness of selection, impact on bargaining unit positions, and protection against exploitation. Early union engagement in program design, ongoing communication about implementation, and union verification of reporting all build the trust needed for sustainable programs.
Diversified and sustainable funding
While NGG reinvestment funds provide an immediate opportunity for pilot programs, long-term sustainability requires diversified funding strategies. Successful organizations combine multiple sources: NGG reinvestment funds for initial cohorts, foundation partnerships for specific program streams, unit or department budget allocations to match corporate allocations that create shared ownership, and corporate investment that signals organizational priority. Hospital foundations typically seek initiatives that demonstrably improve patient care and organizational capability, so protected time programs that generate quality improvement projects, enhance clinical excellence, and build leadership capacity align well with their priorities. Organizations that articulate the connection between nurse development and patient outcomes can secure foundation support that extends beyond what operational budgets alone could fund. In particular, a dedicated nursing advancement liaison position within an organization’s foundation arm is critical for future program expansion.
A structured program
A 0.2 full-time equivalent (FTE) fellowship of 360 hours (based on an 1,800 hour work year) would result in 48 shifts of 7.5 hours or 32 shifts of 11.25 hours and cost about $20,000, whereas a fellowship of 390 hours (from a 1,950 hour work year) would result in 52 shifts of 7.5 hours or 34.6 shifts of 11.25 hours and cost about $22,000. In terms of return-on-investment (ROI), in an organization of 1,000 nurses, a 1% retention improvement of 10 nurses might cost $200,000 in fellowship opportunities and upwards of $100,000 in staffing a coordinator or manager, but with projected savings of $380,000-$760,000 for retaining those nurses, an organization stands to save more than double the investment at the upper end. A data summary is available from the author at https://tiny.cc/IAFellowship in the Final Report, Appendix E: Retention Savings from Literature (p. 36).
A model for the future
Health care stands at a crossroads. Multiple Ontario hospitals’ annual nursing reports indicate hiring anywhere from 100+ to 700+ new nurses in the past year, and so each organization is positioned to lose $3.6M to $7.2M for each cohort of 100 new hires if they cannot retain those nurses.
The Nursing Retention Toolkit: Improving the Working Lives of Nurses in Canada repeatedly references protected professional development time, and aligns with what research consistently identifies as crucial to retention: meaningful work, ongoing learning, opportunities for growth, and organizational cultures that value nurses’ expertise and aspirations (Health Canada, 2024). Excellence in clinical practice requires self-actualized nurses, yet we structure their time to maximize task completion while minimizing opportunities for the reflection, learning, and innovation that defines professional practice. Staffing practices focused on extracting 100% of labour out of nurses hinders their capacity to support their patients beyond immediate direct care needs. In contrast, we can look to outpatient clinic practices to set the example, in which appointment time slots on a given day may have time slot holds or blocks and not be 100% booked to allow for improved capacity for last-minute or urgent needs.
Ontario’s policy framework supports the protected time shift: NGG guidelines explicitly encourage 80/20 models, and a number of other provinces have similar guidelines, so funding mechanisms exist. What’s required is organizational prioritization to challenge the assumption that every paid nursing hour must solely be direct patient care, and the strategic vision to recognize that investing in nurse development isn’t a distraction from patient care, but essential to delivering it. Protected time for professional development is a strategic necessity for organizations serious about retention, innovation, and excellence.
References
Arthur, E., Brom, H., Browning, J., Bell, S., Schueler, A., & Rosselet, R. (2020). Supporting advanced practice providers’ professional advancement: The implementation of a professional advancement model at an academic medical center. The Journal for Nurse Practitioners, 16(7), 504–508. https://doi.org/10.1016/j.nurpra.2020.04.012
Bournes, D. A., & Ferguson-Paré, M. (2007). Human Becoming and 80/20: An innovative professional development model for nurses. Nursing Science Quarterly, 20(3), 237–253. https://doi.org/10.1177/0894318407303126
Finlayson, S., Brull, S., Peñaloza, M. T., & Ciofalo, N. (2025). A perioperative clinical advancement program to improve nurse recruitment and retention. AORN Journal, 121(4), 245–256. https://doi.org/10.1002/aorn.14318
Fleming, K. (2023). Reducing staff turnover through the implementation of a peer mentoring program. Nursing Management, 54(1), 32–39. https://doi.org/10.1097/01.numa.0000905016.75550.3f
Fusilero, J., Lini, L., Prohaska, P., Szweda, C., Carney, K., & Mion, L. C. (2008). The career advancement for registered nurse excellence program. JONA: The Journal of Nursing Administration, 38(12), 526–531. https://doi.org/10.1097/NNA.0b013e31818ebf06
Grinspun, D., Perry, L., Abu‐Qamar, M. Z., Stannard, D., & Porritt, K. (2022). Nursing crisis: Challenges and opportunities for our profession after COVID‐19. International Journal of Nursing Practice, 28(3), e13075. https://doi.org/10.1111/ijn.13075
Health Canada. (2024). Nursing retention toolkit: Improving the working lives of nurses in Canada. Health Canada. https://www.canada.ca/en/health-canada/services/health-care-system/health-human-resources/nursing-retention-toolkit-improving-working-lives-nurses.html
Ministry of Health. (2025). 2025/26 Guidelines for participation in the nursing graduate guarantee (NGG) program. Ontario Ministry of Health. https://www.ontario.ca/files/2025-11/moh-2025-26-guidelines-participation-nursing-graduate-guarantee-program-en-2025-11-17.pdf
Sullivan, S. D., Cormier, P. J., Lincoln, N., Heelan-Fancher, L., & Hayes, C. (2025). An integrative nursing fellowship approach to increase nurse retention. JONA: The Journal of Nursing Administration, 55(3), 146–151. https://doi.org/10.1097/nna.0000000000001547
Ibrahim Akbar, RN, BScN, CPMHN(C), recently completed a Registered Nurses’ Association of Ontario (RNAO) Advanced Clinical Practice Fellowship examining professional development as a retention strategy.
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