Number of newly licensed Quebec nurses reaches 10-year low

The number of new nursing licences issued in Quebec has declined for a third consecutive year, reaching a 10-year low as the province struggles to staff its medical facilities and provide timely care to patients.

The professional order that regulates nursing in the province — the Ordre des infirmières et infirmiers du Québec — published its latest workforce report on Thursday, showing it granted 2,864 licences between April 2022 and March 2023, down from 3,565 in the preceding 12 months and 3,629 the year before that. There were 4,183 new nursing licences in 2019-20.

The order nevertheless reported an increase in its total number of members — from 79,748 in March 2022 to 83,418 a year later — continuing a long-standing upward trend. Yet only 92.6 per cent of them were employed in the province, the lowest proportion in the last 10 years.

In a news release Thursday, the organization highlighted a 20 per cent increase in the number of specialized nurse practitioners — nurses with advanced degrees who wield additional powers, including to prescribe treatments. There were 1,314 nurse practitioners in Quebec in March 2023, up from 1,097 in 2022 and 842 in 2021. Their numbers have swelled 134 per cent since 2019.

The workforce data land amid a contentious labour dispute between Quebec and its largest nurses union, the 80,000-member Fédération Interprofessionnelle de la santé du Québec — known as the FIQ — and as health-care facilities contend with staffing shortages. Unions representing more than 550,000 public sector workers went on strike in November, and the FIQ is the only one without some sort of agreement with the province; working conditions are the major sticking point.

Quebec's statistics agency says nursing was one of the most in-demand professions in the third quarter of 2023, with more than 10,400 vacant jobs for registered nurses and registered psychiatric nurses.

Meanwhile, both health-care wait-lists and emergency room wait times have steadily increased in recent years. There were 164,168 people awaiting non-cardiac surgery in Quebec at the beginning of December 2023, up from 129,371 in December 2020.

In emergency rooms, the seven-day average wait time to see a doctor after triage was 3.14 hours on Jan. 8, 2024, compared to 1.82 hours two years earlier.

The professional order's report doesn't include possible reasons for the decrease in new nursing licences, and the organization declined to elaborate when contacted by The Canadian Press on Friday.

It said in an email statement that it's developing an action plan with the Quebec government to increase the number of qualified nurses in the province in 2024, but declined to provide further details. The order added, however, that it is "hopeful" the number of new licences will increase in the year ahead.

In an interview, Canadian Nurses Association CEO Tim Guest said he doesn't know why Quebec was issuing fewer licences. But he said the drop was not surprising given a national shortage of nurses, driven by what he described as dissatisfaction with work conditions in the profession, such as excessive overtime.

Guest said he wasn't aware of comparable decreases in other provinces, but he said he has heard reports of nursing schools struggling to recruit students.

In an emailed statement, the FIQ union said Quebec needs to improve working conditions in order to attract workers to its health system. The union called the decline in the number of new nursing licences "very worrying."

"Care professionals are an extremely valuable resource, but the government isn't making them a priority," the statement reads. "This is very disappointing and frustrating for the FIQ members who single-handedly uphold the health-care system, and for the patients!"

Quebec's Health Ministry did not respond to a request for comment.

- The report by The Canadian Press was first published on Jan. 12, 2024