We are going to run out of people. It’s a weird problem to have, but here we are. We are running out of people.
Specific kinds of people, I should be clear. Specifically specifically, nurses and personal-support workers. Especially the latter. This isn’t a new problem, but it was brought to mind with stark new numbers recently from The Canadian Press. It reported on an Ontario government document it had obtained that laid out specific challenges facing the long-term-care sector. The government has committed to increasing, to four, the number of hours of direct hands-on care a patient in an LTC receives each day. Since Ontario is also expanding the number of beds in the system — long overdue and desperately needed — the system is doubly crunched for staff. Growing both the number of patients and the level of care they each receive each day is obviously a major challenge.
So major, in fact, it looks like the province is going to fall short. The document obtained by CP says that staffing shortfalls in the LTC system in both nurses and PSWs are critical, and there aren’t going to be enough people to both grow the system and increase the level of care. This is interesting — and bad — all on its own merits, but what jumped out at me were the numbers CP viewed. In the government document it obtained, which dates back to September of last year, the LTC minister was warned that the province was short 37,700 PSWs and 13,200 nurses.
And that is ... a lot.
My mind sometimes (often?) works in unusual ways, and one of the little quirks I have is always trying to figure out how best to visualize a large number. I am now going to inflict that quirk on my readers. The shortage in nurses and PSWs combined is just under 51,000 people. One way to put that number into perspective: that is the entire population of North Bay. I was going to say that if we magically forced every single man, woman, and child in North Bay to become either a nurse or a PSW, that would solve the problem, but even that wouldn’t work. Some of them are no doubt already nurses and PSWs. So we’d still need to make up that difference.
Let’s move to sports stadiums. In recent seasons, the SkyDome has had a capacity of around 50,000 when configured for baseball (football can be more, and concerts are pretty variable, so let’s stick with baseball). But the recent renovations have reduced the capacity to just under 40,000. So let’s roll with that: sell out a Jays game, and then use that same magic as above to convert every single baseball fan at the Dome into a nurse or PSW, and that would get us 80 per cent of the way there. And, of course, hockey playoffs are starting. The Leafs — go Leafs go! — can host just shy of 20,000 fans at a home game, and if any of you would like to give me some playoff tickets, I could be one of those people. In any case, let’s do that math: two sold-out Leaf games gets us, again, to 80 per cent of the goal if we magically make them all into PSWs and nurses.
Okay, last one, I promise: the RMS Titanic could carry around 2,500 passengers (various sources conflict on the exact number, which is odd for something as extensively studied as the Titanic, but no matter). Assuming we somehow found all the nurses and PSWs Ontario needs, and further assuming they were all eager to move here and were also conveniently clustered together in a coastal city with a large pier, it would have taken the Titanic 21 trips to ferry all those workers to Canada. I am not counting the 800-and-change crew members against the total. Just the passengers. Twenty-one trips. The last one would have some empty berths.
That should help to give us some sense of the scale of the shortfall of these critically needed people. While the document obtained by CP was focused on the LTC system, the shortage of these workers is, of course, broadly felt across the entire health-care system; I’ve heard anecdotally that it’s getting harder to hire these workers privately. Not just more expensive, but simply harder at any price, due to shortages.
Maybe the most damning number of all, though, came from a CBC report published last year. I vaguely remembered reading it at the time and mentally flagging it. The CBC was reporting on the Financial Accountability Officer’s report last year that warned that Ontario would be short a combined 33,000 nurses and PSWs ... by 2028.
It ain’t 2028 yet, and we’re already worse than that?
The province is trying to expand the system. It is trying to recruit and retain people. But we are setting up the health-care disasters of the next decade here, and that decade starts now. The system is already buckling; my sources are telling me that the shortage of PSWs could mean home and community care will be the first critical piece of the overall health-care machine to simply break down entirely. LTCs may not be far behind.
I hate leaving readers with nothing hopeful to reflect on, though I do seem to be doing a lot of that of late. I simply cannot think of a way to put a positive spin on these numbers. Each one of those tens of thousands of unfilled positions accounts for multiple patients going without care. That also increases the burden on every remaining worker, which won’t help with recruitment or retention. I wish I could see a path where this doesn’t lead to a catastrophic failure of the health-care system in the near future — or knew of a plan that any order of government or industry had that could fix this fast enough to avoid the worst. I’d even settle for having faith that anyone was capable of such a plan. But I don’t have that faith.
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