The Nursing Directorate

Assess and Intervene

A report to the Minister of Health on the Recruitment and Retention of Registered Nurses and Registered Psychiatric Nurses in British Columbia submitted March 2000.

Report Downloads

Main Body of Assess and Intervene Report - (PDF 410 Kb)

List of Appendices

  • Appendix 1 - Health Human Resources Advisory Committee - (PDF 13 Kb)


  • Appendix 2 - Public Sector Accord on Recruitment and Retention of Registered Nurses and Registered Psychiatric Nurses in BC's Health Care System - (PDF 17 Kb)


  • Appendix 3 - Interim Report and Recommendations to the Minister of Health - October 1, 1999 - (PDF 349 Kb)


  • Appendix 4 - Regionalized Health Services Responsibilities for Delivery and Management of Services - (PDF 14 Kb)


  • Appendix 5 - Qualitative Study of RNs Leaving/Intending to Leave Nursing Jobs in BC - (PDF 28 Kb)


  • Appendix 6 - Provincial Data from the BC Nursing Recruitment and Retention Survey - (PDF 44 Kb)


  • Appendix 7 - Health Care Occupational Health and Safety Agency Constitution - (PDF 6 Kb)


  • Appendix 8 - Recommendations for Aboriginal Nurse Recruitment and Retention Strategies Presented to the Federal Branch Executive Committee in January 1999 - (PDF 12 Kb)


  • Appendix 9 - Health Labour Adjustment Agency Specialty Nurse Training Report, Report No. 3, September 1999 - (PDF 52 Kb)


  • Appendix 10 - Health Authorities' and Employers' Recruitment and Retention Strategies - (PDF 11 Kb)


  • Appendix 11 - Database Sources - (PDF 25 Kb)


  • Appendix 12 - Data Elements - (PDF 10 Kb)


  • Appendix 13 - Projected Attrition of Current RN/RPN Workforce for 1999 - 2005 - (PDF 7 Kb)


  • Appendix 14 - Notes to the Forecasting Model - (PDF 55 Kb)


  • Appendix 14a - Forecasting Model: Mid Point Assumption Scenario - (PDF 8 Kb)


Introduction - An Excerpt from the Report

In the last year there have been numerous anecdotal reports of nursing shortages from around the province and similar reports from other jurisdictions. Against this backdrop a 1997 CNA study predicting significant nursing shortages began to receive serious consideration. Based on the demographics of the nurse workforce and increasing evidence, the Ministry of Health (MOH), Health Employers Association of BC (HEABC) and the Nurses’ Bargaining Association (NBA) each concluded that BC had a shortage of RNs and RPNs, and that absence of action would result in a worsening of the problem.

In 1999, the HEABC, the NBA and the Government of British Columbia (represented principally by the MOH) entered into the Public Sector Accord on Recruitment and Retention of Registered Nurses and Registered Psychiatric Nurses in BC’s Health Care System (the “Accord”) (see Appendix 2).

The Accord incorporated the following points of agreement:

  • Recognition that a nursing shortage is occurring now and that absence of action will result in worsening of the problem.
  • There are important advantages in a co-operative approach to developing policy solutions for the challenges facing nursing in the coming decade.
  • Technological, organizational and demographic change are giving rise to the need for ongoing training and upgrading of nursing skills, particularly in specialized areas.
  • Particular challenges exist in recruitment and retention of nurses in rural and northern BC.
  • The profession of nursing is facing increasing competition from other occupational choices for young people.
  • There is a need for the development of a comprehensive approach to nursing human resource planning.

The objectives of the Accord are to:

  • Examine, assess and develop policy solutions for recruitment, retention and deployment of nurses.
  • Develop or refine databases for tracking the entry, exit, training, career development, deployment and allocation of nurses within the BC health care system.
  • Address specialty nursing shortages and rural and northern nursing shortages.
  • Identify additional opportunities to develop and enhance the skills of BC’s nurses.
  • Identify what needs to be done to encourage young people to consider nursing a desirable career choice.

The parties to the Accord agreed items such as workload, working conditions and compensation are issues for collective bargaining and would only be discussed in the Report for the purposes of policy development.

As directed by the Accord, a committee (the “Committee”) was established and held monthly meetings beginning in April 1999. The meetings were co-chaired by Cathy Ferguson, President of the British Columbia Nurses’ Union (BCNU) and spokesperson of the NBA and Gary Moser, CEO of HEABC. The NBA and HEABC each had two additional members on the Committee. The MOH was also represented and provided secretariat services to the Committee. The Ministry of Advanced Education, Training and Technology (MAETT) and the Hospital Employees’ Union (HEU) attended in observer roles. During the monthly meetings Committee members discussed issues, initiatives and strategies. They also received written submissions and oral presentations from a number of interested groups and individuals.

In June 1999, the Committee presented the Minister of Health (the “Minister”) with some initial recommendations and these were reaffirmed in the Interim Report that was delivered to the Minister in October 1999 (see Appendix 3). Those recommendations included an additional 400 nursing seats, a fund be established which employers could access for clinical placement needs, funding be provided for two teaching ward pilot projects, and support for a research team to assist the Committee.

The Committee established a research project team (the “Research Team”) to compile and analyze existing information and submissions; request additional information and conduct original research through surveys sent to all health authorities and BCNU members; propose recommendations for the Committee’s consideration and draft a final report.

The issue of recruitment and retention of nurses needs careful review and a strategic plan in order to be successful. The Committee is pleased to report to the Minister the view of its members that the process has been constructive and solution-oriented. Throughout, the Committee has done its best to remain true to the “big picture”: the public interest in the effective delivery of health care.

The parties to the Accord will continue to have some differences. In particular the NBA and HEABC will continue to differ with respect to collective bargaining issues, some of which may also have implications for recruitment and retention. There is a time, place and process outside of this Accord to address those issues. However, it is a sign of the maturity of the parties’ relationship that the Committee members can recognize this and proceed to work together on an issue that transcends their different perspectives. The Committee’s ability to work together is reflected in the joint analysis and recommendations which we believe make a positive contribution toward understanding and working to resolve the current shortage of RNs and RPNs.

No single intervention and no single party will be able to successfully deal with the shortage of nurses. The recommendations are intended to be complementary parts of a human resource strategy. Our assessment leads to a clear conclusion: there is an urgent need for the kind of intervention set out in our recommendations. We welcome the opportunity to be part of the solution.