ArticleBMJ open2025
Trends and indicators of nursing workforce shortages in Canada: a retrospective ecological study, 2015-2022.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Success by Design: Senior Leadership Perspectives on Optimising the Role of Clinical Nurse Specialists.Journal of advanced nursing · 2026Article
- The Sounds of Silence: Problematizing Voicelessness in Nursing Practice.Nursing inquiry · 2026Article
- Facilitators, Barriers, and Educational Preparedness of Early-Career Nursing Graduates Entering Practice in Rural and Remote Areas: A Mixed-Method Study.Nursing reports (Pavia, Italy) · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine longitudinal trends and identify key indicators of nursing workforce shortages across Canadian provinces and territories using publicly available data.
designRetrospective ecological study.
settingPrimary and secondary care in Canada. National data were extracted from Statistics Canada and the Canadian Institute for Health Information (CIHI) between 2015 and 2022 at the provincial and territorial levels.
participantsThe study included registered nurses and registered psychiatric nurses employed in the Canadian healthcare system. Licensed practical nurses and nurse practitioners were excluded. Territories with missing data were excluded from the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was nursing workforce shortage, assessed in relation to potential indicators, including the nurse-to-population ratio, job vacancy rate and annual costs of overtime work, using structural equation modelling (SEM).
resultsThe Canadian nursing workforce grew by 8.0%, with the nurse-to-population ratio increasing from 11.08 to 12.13 per 1000 population. Job vacancies rose by 6.4% (95% CI: 6.29 to 6.51%), overtime hours increased by 13.09 million (95% CI: 10.28 to 15.87) and yearly overtime costs rose by 0.78 billion CAD (95% CI: 0.64 to 0.92). SEM revealed significant associations between workforce shortage and the nurse-to-population ratio (standardised β=0.863, 95% CI: 0.942 to 0.975), job vacancy rate (β=0.958, 95% CI: 0.927 to 0.990) and yearly overtime costs (β=0.983, 95% CI: 0.967 to 0.999). Predicted shortage scores were lower before 2020 but increased significantly after 2020, potentially reflecting the impact of COVID-19 pandemic.
conclusionsDespite growth in the nursing workforce, increasing job vacancies, overtime hours and costs highlight persistent shortages. Monitoring these indicators is essential for effective workforce planning and sustainable healthcare delivery.
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