Hundreds of nurses gathered outside Ontario hospitals on Thursday, urging hospital CEOs to tackle staffing shortages and enforce registered nurse-to-patient ratios to enhance patient care, according to the Ontario Nurses’ Association (ONA).
Nurse burnout in Canada has escalated into a crisis, driven by increasing patient needs, critical staffing gaps, and a lack of sufficient institutional support, putting immense pressure on the healthcare system.
A 2024 survey conducted with 5,595 nurses practicing in Canada by the Canadian Federation of Nurses Unions (CFNU) found that nine in ten nurses registered some amount of burnout.
Dr. Crystal Garvey, a professor in the collaborative BScN program at Durham College and Ontario Tech University, said the current crisis stems from chronic underfunding, inadequate staffing levels, and prolonged patient wait times.
“It’s been about three and a half years since I have practiced at the bedside. The problem then is the same problem we’re having today,” Dr. Garvey said. “With regards to wait times in the institution… it really does start with the funding that institutions receive to staff appropriately.”
Staffing shortages have created a domino effect, leading to overworked nurses, extended wait times, and an overburdened healthcare system. “With the ratios not being reflective of providing safe client care,” she said, “you are allocated a certain number of patients based on their acuity of sickness.”
“Having four clients 15 years ago and having four clients today is not the same workload,” she emphasized.
The lack of community healthcare support has forced more patients into hospitals. “The systems are not strategically organized or updated to safely or appropriately provide care in the community,” Dr. Garvey said. “And because the community care and supports are not there, clients now have to come to the hospital.”
Dr. Abi Sriharan, a management scholar specializing in digital innovations and their impact on work environments, said increasing workloads and an aging population are key factors in nurse burnout.
“With increasing demand for healthcare services, we are seeing a lot of aging population. So there is a lot of demand on nurses’ time to manage these people,” she said.
The COVID-19 pandemic exacerbated the issue. “What happened was a high number of nurses retired, which also increased the workload for existing nurses,” Dr. Sriharan said. “Then there was also the opportunity to do travel nursing many nurses left healthcare organizations to pursue outside opportunities.”
Dr. Garvey echoed this sentiment. “I am not going to say it got worse. I just think it exposed what has already been happening,” she said.
The “mass exodus of professionals leaving the profession for various reasons” during the pandemic worsened staff shortages.
According to a survey conducted by the Registered Nurses Association of Ontario (RNAO), over 75 per cent of Canadian nurses reported experiencing burnout during the COVID-19 pandemic.
Armaan Amlani-Kurji, who works for Everwell Counselling and is a registered nurse and registered psychotherapist (qualifying), said burnout takes a serious emotional and physical toll.
“They (nurses) are exposed to so much trauma and suffering with patients. I think it’s an emotional toll,” he said. “No matter who you are, it slowly chips away at you.”
The physical demands also add to the burden he added “You have long shifts. You’re constantly moving, helping patients mobilize, providing bed baths. You are doing a lot of manual work. The fatigue comes with that.”
Dr. Garvey expressed frustration over patient aggression. “They get mad at the nurse or they get mad at the doctor and they take out their frustration, which compounds the issue,” she said.
“Depending on how visceral the client gets, it can end up being the case where the nurses or doctors say, ‘We’re not going to provide you care because you’re being abusive.’ But we understand why they’re upset it’s just difficult.” Dr. Garvey added
Amlani-Kurji said institutional culture often discourages nurses from seeking help. “You’re taught to be independent and self-sufficient, so you sort of have this mindset of ‘toughing it out.’ Just push through,” he said.
“Seeking help is sort of viewed as a sign of weakness,” he said
Many nurses are leaving the profession or moving to other countries for better pay and work-life balance.
“We’re leaving the profession or we’re leaving the country to go work somewhere else where we’re being appropriately compensated,” Dr. Garvey said.
“I can work at Starbucks as a new grad and make almost the same money. The Costco customer service representative or the Starbucks barista doesn’t have to put up with what I (nurses) have to put up with.”
According to the CFNU’s survey of 5,595 nurses, 30 per cent reported dissatisfaction with their career choice and 40 per cent intended to leave nursing or retire.
“During COVID, there was a lot of assumption that burnout is an individual thing,” Dr. Sriharan said.
“But what COVID showed us is burnout is beyond just an individual issue. It’s an organizational issue.”
She said leadership must focus on fostering an environment that truly supports nurses. This goes beyond just offering standard benefits like salaries and pension plans. “Those kinds of things but more of a day-to-day support, encouragement, a positive organizational environment where they feel that they can thrive and grow.”
Technology, including artificial intelligence, could help ease workloads if implemented properly, Dr. Sriharan said. “AI or automation technologies could speed up (tasks) so nurses can focus on patient care.” However, she warned that if poorly integrated, technology could increase stress rather than reduce it.
Amlani-Kurji emphasized the need for accessible mental health resources. “Institutions need to recognize the importance of mental health for staff and provide resources at that level,” he said. “Prioritizing self-care for staff.”
To address burnout, systemic changes are necessary, including better pay, improved staffing levels and policies to support healthcare workers.
Dr. Sriharan noted that policies must evolve to retain nurses and ensure the system has enough nurses and healthcare professionals to meet demand.
“Policies ensuring that nurses are financially supported for the work that they do so we can retain them versus losing them to other organizations or countries that may pay them better.” she added
Dr. Garvey emphasized the role of nurses as the backbone of the healthcare system.
“If we were to walk away, the system collapses on itself,” she said.
“Many people don’t know what nurses do. Nurses are not just providing pills. Nurses have to know the inner workings of the organization. They need to know what each profession does outside of their own.”
She highlighted the complexity of nursing roles. “We are the voice for the client,” Dr. Garvey said. “We need to be able to support that client’s mind, body, and spirit.”
Amlani-Kurji suggested institutional mentorship programs as a possible solution. “Mentorship programs can be really big,” he added. “I think it can be really healing having people who are in positions like you, helping you feel validated in what you’re going through.”
As burnout rates climb and staff shortages worsen, the Canadian healthcare system faces mounting pressure.
“The pandemic only opened the eyes of the community to what was really happening all these years,” Dr. Garvey said. “Our algorithm for funding is not logical.”
Amlani-Kurji urged struggling nurses to prioritize their well-being. “Burnout is very normalized in our career, but that doesn’t mean you have to tough it out. You can ask for support and it will only serve you better,” he said.
He added, “It’s not selfish. It’s, in fact, a very selfless thing to do and it shows that you want to learn ways of coping with this.”
“Please extend grace to the nurses and doctors because they really are working tirelessly… just for the system not to collapse on itself.” Dr. Garvey concluded.