An Independent Audit of the Recruitment and Retention of Rural and Remote Nurses in Northern B.C.
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An Independent Audit of the Recruitment and Retention of Rural and Remote Nurses in Northern B.C.

January 8, 2020

Thanks for joining us. In this audit we
looked at Northern Health’s recruitment and retention of rural and remote nurses. The
Northern Health Authority is responsible for planning and delivering health
services to approximately 300,000 northern B.C. residents across a largely
rural and remote territory covering about two-thirds of British Columbia. Our
audit looked at whether Northern Health was effectively recruiting and retaining
enough registered nurses and nurse practitioners to fill the rural and
remote positions it identified in its 2016-2017 Health Human Resources plan. We
concluded that it was not. As of last April, more than a quarter of Northern
Health’s rural and remote nurse practitioner positions were unfilled and
it was short a 121 registered nurses or 15% of its rural
and remote workforce. Not having enough registered nurses and nurse
practitioners can negatively impact patients staff and the organization. We
found that RNs were challenged to meet the needs of patients in the
community as well as those of patients in acute and long term care. RNs
were all so worried about patient safety because they were not always able to
adequately supervise patients or perform regular equipment and medication checks
and because they retired due to working long hours thereby increasing the risk
of medical error. We found evidence of nurse burnout by which we mean the
effects of prolonged stress including emotional exhaustion, disengagement and
reduced performance. And finally there were higher overall costs to fill shifts
due to paying over time and for more expensive nurses via agencies. Both
external and internal factors contributed to the nursing shortage.
Northern Health cannot influence external factors like weather and
isolation. But it is directly responsible for, or can influence internal factors
like the implementation of interprofessional teams.
RNs on the interprofessional teams provide primary care and nursing
services including public health and home care. In the past many RNs focused
on just one of these areas. Some are not interested in or don’t feel comfortable
expanding their practice to other areas without additional training. In terms of
management we heard examples of registered nurses choosing one community
over another because a hiring manager was quick and attentive throughout the
recruitment process, while in other cases RNs left their position due to poor
management. Areas close to a nursing school enjoy a greater supply of
registered nurses there isn’t an RN training program in the northeast part
of our province and many people we spoke with indicated that this contributed to
the significant shortage of RN in this region. We made nine recommendations to
address the root causes of the registered nurse and nurse practitioner
shortage and close the gaps between good practice and Northern Health’s current
state. These recommendations include: – developing comprehensive recruitment and
retention strategies for Registered Nurses that have clear goals and
performance measures to guide Northern Health’s activities and enable it to
assess its progress. – Establishing clear responsibilities for all aspects of its
recruitment and hiring processes including oversight. – Working with other
organizations to develop new recruitment and retention programs and address
systemic issues like housing availability and affordability, and the
distribution of nursing education programs in the north.
That’s our summary for today. Thanks for joining us to read this report and
others or for more information about us and our work please visit our website at

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