October 19, 2023

New report highlights pan-Canadian need for safe staffing to protect patient safety

Silas: To protect patient safety, we need to better retain nurses.

October 19, 2023 (Ottawa, ON) – Amidst chronic staffing shortages, hospital inpatient units across Canada have seen a rise in the rate of unintentional harm to patients for the third year in a row, according to the Canadian Institute for Health Information (CIHI). At the same time, nurses and health care professionals in these units logged 14 million hours of overtime in 2021-2022 – a 50% increase from the previous year.

“Nurses have been sounding the alarm on patient safety and unsafe working conditions for years,” said Linda Silas, president of the Canadian Federation of Nurses Unions (CFNU). “Nurses are shouldering the weight of an overcapacity health care system where overtime has become the go-to band-aid to systemic staffing shortages. In the absence of staff to replace nurses when their shifts end, they are working increasingly long hours. It’s not safe for nurses, and it’s certainly not safe for patients.”

Silas pointed out that nurses overwhelmingly cite high workloads and insufficient staffing levels as the top reasons they are considering leaving their workplace or the profession altogether. More than 75% of nurses report workplaces that are regularly overcapacity, demonstrating the widespread challenge.

In the face of these staffing challenges, the use of costly private nursing agencies to fill staffing needs has ballooned with an 80% increase in the volume of purchased hours – up to 1.5 million hours in 2021-2022. In 2022, the number of registered nurses who are self-employed or working for private nursing agencies increased by 867.

“To protect patient safety, we need to better retain nurses in our public health system, which means making workloads for frontline nurses manageable and creating better work-life balance,” said Silas. “Health systems with ratios in place, like California, see improved outcomes for patients and higher job satisfaction. B.C. and Nova Scotia have committed to safe staffing ratios, and it’s time for every province and territory to follow suit.”

In addition to nurse-patient ratios, legislation setting limits to avoid excessive hours of work is one of the key recommendations the CFNU is proposing as part of a pan-Canadian retention strategy to fix the nursing shortage and complete the recovery of our ailing health care systems.

“We have rules around the hours truck drivers can be on the road, and around the hours pilots can safely fly planes, but nurses have no such safeguards,” Silas pointed out. “With all due respect to other professions, nurses are responsible for the most precious cargo of all. Patients are no less important than airline passengers. It is paramount that we address health care working conditions and create environments where nurses and their patients can thrive.”


The CFNU is Canada’s largest nurses’ organization, representing 250,000 frontline unionized nurses and nursing students in every sector of health care – from home care and LTC to community and acute care – and advocating on key priorities to strengthen public health care across the country.

For more information please contact Adella Khan, CFNU Communications, media@nursesunions.ca, 613‑807-2942.