Cross-Country Check-Up

Canada’s health care system is in crisis. Nurse unions and other groups that advocate for health-care have been waving red flags since before the pandemic – since then, an already burnt-out workforce has steadily declined, leaving fewer health care workers to keep our sinking system afloat.   

Results of a recent survey by The Association for Canadian Studies (2023) suggests that the vast majority of Canadians are concerned about the state of our health-care system. In Atlantic Canada, residents are especially concerned as the region faces ongoing challenges to maintain emergency services. 

Across the country, provinces are competing for the same solution: more nurses. 

New Brunswick

New Brunswick is facing a severe shortage of licensed health care workers, particularly when it comes to nurses. In January, the New Brunswick Nurses Union told Global News that there are roughly 1,000 vacant positions in the province. 

With a heavy focus on recruitment, New Brunswick has implemented several initiatives. Recently, the province introduced Step Up to Nursing. This initiative is a workplace-based, wage-supported model that provides education to New Brunswickers who are interested in advancing their nursing careers. This education pathway offers LPNs and PSWs the opportunity to further their nursing education – working in the health-care system on a part-time basis while completing the Practical Nurse PSW Pathway program or the Licensed Practical Nurse Bridge program, leading to the Bachelor of Nursing program. Participants are paid a full-time wage and receive tuition, both covered by the provincial government. 

Additionally, UNB now offers a certificate in nursing leadership and management. The program was created with charge nurses, nursing managers, unit leaders and other healthcare management roles in mind. Horizon Health officials are hopeful that the program will show nurses that there is a future for them in the province. 

Prince Edward Island

Facilities in Prince Edward Island have been so understaffed, entire departments shut down from as little as one sick call. In too many parts of the small province, one nurse is all that is keeping health care going. This is a constant source of psychological stress on Island nurses, as they know that their colleagues will bear the burden if they aren’t able to make it to work. 

PEINU has made several recommendations to ensure patient care and prevent nurses from resigning, going part-time or retiring early. These recommendations include introducing legislation that reduces workload by implementing safe nurse-to-patient ratios and making direct investments to support and retain nurses. The Union also recommended the expansion of training and targeting recruitment to bring more people into the nursing workforce. 
While the provincial government has initiated $8 million in retention bonuses for healthcare workers (including nurses), the Health PEI board was not involved in planning. PEINU maintains that financial incentives themselves will be ineffective in solving the nursing shortage. 

While P.E.I. nurses were hoping to have a new agreement before the summer, contract negotiations have been put on hold during provincial elections. After two years with an expired contract, nurses are left feeling frustrated and neglected.

Newfoundland & Labrador 

The RNUNL says the number of RN vacancies is growing, nurses are struggling with burnout and ERs are dealing with staffing shortages and closures. With more than 750 registered nurse vacancies in Newfoundland, the RNUNL is calling for new retention incentives for RNs. 

Union President Yvette Coffey warned that the situation in the province will only worsen if their government fails to address retention and protect patient care. She has urged the government to take immediate action to improve retention and provide incentives to keep their nurses in the profession. 

The government has stepped up its efforts to recruit doctors and nurses from abroad, most recently setting up what it calls recruitment missions in India and Ireland. 


For decades, new nurses who graduated with university degrees in Quebec would start their careers at a minimum of echelon 7, reflective of their higher education. This incentive was implemented to stop nurses from leaving the province in search of more competitive pay. If these nurses were to look for higher pay, they would find it anywhere outside of Quebec. 

The starting annual full-time salary for nursing in Quebec is still the lowest in the country by nearly $20,000 per year, even with those starting at echelon 7. Despite this, a simple incentive of higher echelons for more education succeeded in retaining many university-graduated nurses. 
Now, this incentive is being stripped away, leaving nurses feeling blindsided, betrayed and disrespected. 

In their latest contract, all nurses who received their licenses after December 12, 2022, regardless of education level, will start at the lowest pay scale, echelon 1. This is a $6.44 hourly difference, which adds up to $515.20 over a two-week pay period, close to a 20% decrease in pay. 

As student nurses rethink their intentions to remain in Quebec after graduation, Quebec nursing unions say they hope to fix this issue in their next collective agreement. 


The Ontario Nurses’ Association started bargaining with the Ontario Hospitals Association in late January and began mediation in early March – what nurses call a “last-ditch effort” to reach a negotiated settlement. If no deal is reached through arbitration, it will go to an arbitrator in May. 

The ONA has not said how much it is seeking for wages, but interim president Bernie Robinson said it’s safe to say they are expecting “far more” than the past contract. 

ONA has held several marches and rallies to call for higher wages, increased hospital staffing, improved working conditions and a better contract.


After a five day recruitment mission to the Philippines in early 2023, 350 health-care workers have been offered letters of intent. Of these recruits, there are nearly 190 registered nurses and 50 individuals with qualifications equivalent to a licensed practical nurse. 

In the coming weeks, these 350 recruits will engage in the process of immigration, English language requirements and scheduling their clinical competency exams. 

The government is working with the College of Registered Nurses of Manitoba to “modernize the pathways” to get these nurses into the workforce faster while they are receiving additional clinical and language training. 


Saskatchewan’s Health Human Resources Action Plan to recruit, train, incentivize, and retain is said to be seeing progress in all pillars of the Plan. 

Bringing in health care workers from at home and abroad, the Action Plan has involved recruitment of health care professionals from the Philippines, an advertising campaign featuring testimonials from healthcare workers who have built a successful career in Saskatchewan, various training pathways and volunteer opportunities for students or adults considering a career in healthcare, as well as a Rural and Remote Recruitment Incentive. 

Other incentives such as improved job offers and connections for nursing graduates are also included in the Plan. 


In an effort to make sure the priorities of frontline nurses are part of the solution to the current nurse staffing crisis, the United Nurses of Alberta shared a list of recommendations with Health Minister Jason Copping. These recommendations, focusing on retention and recruitment, are based on the practical experience of frontline nurses and can be implemented immediately to improve the retention and recruitment of nurses currently working in Alberta’s public health care system. 

Recommendations for retaining nurses includes eight items, including the creation of more publicly funded long term care beds along with hiring the nursing staff to care for the patients in those beds and offering financial incentives to nurses at remote and rural facilities. Recommendations for recruitment put forth five more items, including increased supports for new nurses, increased seats in nursing schools and financial supports for nursing students to encourage them to work in rural communities. 

The UNA, along with doctors and other unions are concerned that the record-high health spending in the budget for 2023-2024 fails to address the big issues plaguing the health care system – particularly ongoing staffing shortages. 

Most recently, Alberta has introduced a campaign to spread the word of low taxes, high wages, affordable housing and plenty of job opportunities. Alberta Calling aims to recruit individuals from out-of-province for work in all industries, including nursing. 

British Columbia

In early March, British Columbia Premier David Eby joined Prime Minister Justin Trudeau to announce an immediate $273 million in health funding to address urgent needs, especially in pediatric hospitals and emergency rooms, and to address long wait times for surgeries. Funding for BC also includes a $3.32 billion bilateral agreement to help Canadians age in their homes, with access to home care of care in long-term care facilities. 

The BC government said their priorities for the additional cash will be to expand access to primary health care, including in rural, remote and Indigenous communities, reduce waitlists, support health care workers, improve access to quality mental health and substance-use services, and modernize health data systems. 

Prior to funding announcements, the BCNU made it clear that specific investments in nurse recruitment and retainment strategies would be needed to tackle the dire staff shortage in the province. 

B.C.’s Nurses’ Bargaining Association, along with the Health Employers Association of B.C., commenced negotiations for their new collective agreement on December 8, 2022.

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