The Nursing Shortage in Canada: What It Means for Patients, Wait Times & Safety

Discover how Canada’s nursing shortage is stretching emergency services, delaying priority procedures, and risking patient safety. Learn what’s driving this crisis and how patients and policymakers are working to fix it.

Introduction

You go to the emergency department for what feels like a minor but worrying symptom—a high fever, some shortness of breath. You sit in the waiting room. Two hours pass. Then four. Eventually, you hear that there is no bed available in the hospital because staffing is too thin. This kind of scenario is becoming more common in Canada.

Across provinces, there’s a growing gap between what our health care system needs and the number of nurses available. It’s not just about longer wait times—it’s about safety, delayed care, and pressure building on everyone: patients, nurses, and administrators alike. In this article, we’ll look at the most recent data (2024-25), show where the shortages are worst, explore how patients are affected (especially in ERs and delayed services), dig into why this is happening, and what’s being done. We’ll also cover what you as a patient or public member can expect or do, and how the system can support its nurses better.

The Scale of the Nursing Shortage in Canada

To understand what’s going wrong, we first need to get a clear picture of how big the nursing shortage is—how many nurses are employed, how many positions are unfilled, where the strain is worst.

Key Metrics: Nurse Supply, Vacancies, & Overtime

Provincial & Rural/Urban Differences

• Some provinces show much higher vacancy rates than others—for example, Quebec has among the highest growth in nurse job vacancies.
• Urban areas tend to employ more nurses in direct patient care than rural or remote ones; data shows a large majority of RNs and psychiatric nurses are in urban settings.
• In long-term care, staffing has gone down: both RNs and LPNs working primarily in LTC have declined in some provinces while resident care needs have increased.

Trends Over Time: From Before COVID-19 to Projections

• Before COVID-19, forecasts already warned of a looming shortfall. One estimate predicted Canada would need more than 117,000 additional nurses by 2030 to meet demand.
• Since 2015, while more nurses are being employed, the rate at which vacancies, overtime, and unmet demand are increasing shows that growth in nurse numbers has not kept pace with the system’s needs.
• The supply per population (nurse‐to‐population ratio) has barely improved or in some places has declined, especially when considering direct patient care roles.

What’s Causing the Shortage

Many forces have combined to stretch Canada’s nursing workforce thin. Some are long-term trends. Others were accelerated by COVID-19 or recent policy bottlenecks.

Burnout, Working Conditions & Mental Health

Burnout is no longer fringe—it’s a primary driver. According to a recent survey by the Canadian Federation of Nurses Unions, 93% of nurses reported experiencing symptoms of burnout in 2024. Many also report anxiety, depression, or sleep disturbances. Overwork, unpredictable staffing, long shifts, running short of breaks: these are frequent complaints.

Here are some of the working conditions worsening burnout:

• Frequent mandatory overtime; many nurses report shifts longer than 12 hours.
• Workplaces regularly overcapacity—beds, emergency departments, ICUs pushed beyond safe operational thresholds.
• Exposure to violence, verbal abuse, or mistreatment, whether from patients, colleagues, or visitors. These “extra” burdens pile up.

Burnout doesn’t just hurt morale. It raises turnover, increases sick leave, reduces quality of care, and contributes to errors. When nurses feel emotionally exhausted or physically drained, capacity suffers. Systems lean more heavily on those who remain, sometimes causing cascading failures.

Retirement & Aging Workforce

Canada’s nurse workforce is aging. Many long-serving nurses are approaching or have reached retirement. Even those who stay are often working in physically and emotionally demanding roles longer than they expected.

Meanwhile, replacements (new grads, migrating nurses) are not entering fast enough to keep up. This mismatch contributes to higher vacancy rates, more overtime, and places younger and less experienced nurses under more pressure.

Barriers for Internationally Educated Nurses

Internationally educated nurses (IENs) represent a crucial potential to fill gaps. But in many provinces they face delays and difficulties in getting licensed or practicing at full capacity.

Some of the obstacles include:

• Lengthy credential recognition processes. Some IENs report waiting many months for decisions or having to complete extra courses even for skills they already have.
• Limited access to orientation, mentorship, or continuing-education programs compared to domestically trained nurses. This hinders integration and confidence.
• Regulatory or bureaucratic inconsistencies across provinces: rules that vary, duplicate requirements, or unclear communication. Combined, these hurdles can discourage IENs or delay their contribution.

Addressing these barriers has become a priority for several provinces. For example, British Columbia implemented new legislation in 2024 to streamline credential recognition.

Education, Training & Capacity Constraints

Another constraint is the limited capacity in nursing education.

• Schools of nursing are often underfunded, meaning fewer seats, larger class sizes, or delayed access to clinical placements.
• Recruitment into the profession is strong in many places, but the bottleneck is graduating enough nurses with the needed specialities (acute care, ICU, emergency) and ensuring that their training meets current care demands.
• Training faculty shortages also matter: if there are not enough instructors or clinical preceptors, expanding capacity is hard without compromising quality.

Internal Migration and Geographic Disparities

Even within Canada, nurse distribution is uneven.

• Rural, remote, and Indigenous communities often have much greater shortages. Nurses in these areas may face more stress, fewer supports, professional isolation, and less opportunity for career growth.
• Some provinces are losing trained nurses to others with higher pay, more flexible working conditions, or better supports. This internal migration further compounds shortages in weaker regions.

Summary: Why supply isn’t keeping up

Putting it all together:

• Though nurse numbers have increased overall, demand is rising faster (aging population, more complex care, chronic disease, emergencies).
• Burnout, turnover, and retirement deplete effective capacity.
• Delays in bringing IENs fully into practice mean potential capacity is held back.
• Education/training constraints, geographic maldistribution, and uneven working conditions weaken the system’s resilience.

How Patients Are Affected

When the nursing shortage deepens, the ripple effects reach patients in many ways—longer waits, delayed treatments, safety risks. Here’s how that plays out in Canada today.

ER Wait Times & Lengths of Stay

Emergency departments (EDs) are often the first place where staffing shortages become visible to patients.

• In 2024-2025 (April to March), Canadian hospitals reported over 16.1 million unscheduled emergency department visits—up from ~15.5 million the year before.
• For visits that end in hospital admission, 9 out of 10 patients spent up to 48.5 hours in the ED; for those discharged home, the median stay was about 8 hours.
• These delays lead to greater crowding, delayed diagnosis, and strain on patients with serious conditions who might need rapid care.

Delays in Priority & Surgical Procedures

Not all care in hospitals happens through the ER—but many non-emergency treatments are also delayed, affecting quality of life and outcomes.

• Between 2019 and 2024, wait times for priority procedures (including hip and knee replacements, cataract and cancer surgeries) have increased or stayed longer than recommended targets.
• For example: hip replacements completed within a recommended 6 months dropped from ~75% (2019) to ~68% (2024); knee replacements from ~70% to ~61%.
• Even though more surgeries overall are being done vs pre-pandemic levels, demand (especially from older patients) is growing faster. Hospitals are under pressure to catch up while also managing the backlog.

Patient Safety Risks & Care Quality

Reduced nurse staffing affects more than wait times—it has implications for safety, errors, and patient outcomes.

• When nurses have too many patients, or too many overlapping tasks (high dependency patients, emergencies, ongoing care), it increases risk of missed care—things like delayed medication, missed monitoring, reduced rounds.
• Overcrowded EDs or wards with inadequate staffing have been linked to higher rates of complications, infections, and readmissions.
• Data show that when surgical procedures are delayed, conditions may worsen (more pain, reduced mobility, more complex treatment needed), which increases risks for older patients or those with chronic conditions.

Differences by Region & Type of Care

The impact isn’t uniform. Some patients or areas are hit harder.

What Governments & Health Systems Are Doing

Governments and health systems across Canada have begun taking steps to reduce the nursing shortage, improve retention, and protect patient safety. Some actions are showing promise; others are still early or uneven. Here are what’s underway and what seems to be working.

National Initiatives & Tools

One of the broadest recent moves is the Nursing Retention Toolkit from the federal government. It provides practical strategies for employers and health organizations: ways to reduce administrative burdens, improve leadership, promote mental health supports, allow more flexible scheduling, mentorship, and strengthen safe staffing practices. This toolkit is meant to help stabilize the workforce by improving the work environment for nurses.

Another national policy document, from the Canadian Nurses Association, emphasizes the importance of reducing barriers to practice and improving recruitment and retention across provinces and territories.

Provincial Policies & Minimum Ratios

Some provinces have adopted stronger measures, including setting minimum nurse-to-patient ratios, to protect both nurses and patients.

• British Columbia has led the way. BC introduced minimum nurse-to-patient ratios (mNPRs) in 2023 under a memorandum of understanding involving the Nurses’ Bargaining Association. The policy covers medical/surgical units, long-term care, assisted living, and community health settings.
• The goal is to ensure that, for example, medical/surgical wards have one nurse for every four patients in certain units, and stricter ratios in high-acuity settings.
• In mid-2025 a study in BC confirmed early positive results from implementing mNPRs: better nurse satisfaction, reduced burnout, and measurable improvements in patient care.

Retention Strategies & Return to Practice

Retention is a frequent theme: keeping the nurses we already have is often cheaper and more sustainable than recruiting new ones.

• The Nursing Retention Toolkit includes suggestions like flexible work hours, reduced admin tasks, mental health and wellness supports, inspired leadership, and mentorship programs. These are meant to reduce burnout and turnover.
• Some jurisdictions are offering incentives for nurses returning to practice after leaves. Provinces like BC, Newfoundland & Labrador, and the Northwest Territories are among them.
• Also, several provinces are working with unions and health authorities to streamline credential recognition and reduce red tape for internationally educated nurses.

What’s Working & What Still Needs More

Here are what early indicators show, and what gaps remain:

Case Study: British Columbia’s mNPR Rollout

British Columbia is becoming a test case for how much a province can move the needle with strong policy.

• The mNPR policy is being implemented in phases. The first phase (medical/surgical units) has begun.
• The evidence so far shows safer workloads for nurses and improvement in quality metrics—less missed care, better nurse retention.
• Challenges include: finding enough nurses to fill all required positions under the new ratios; ensuring funding matches the growing operational costs; extending ratios to all hospital units (ICU, ED) and non-hospital settings.

How We Can Support Nurses & What Patients Can Do

To lessen the nursing shortage’s impact, there are things that health systems, communities, and individual patients can do. Many are already being tried; more could scale.

Supporting Nurse Well-Being Directly

1. Mental health and wellness resources
   Provinces are expanding access to counselling, peer support, debrief sessions, and wellness helplines. For example, Alberta maintains hotlines and partner programs like Wellness Together Canada for nurses. (albertanursing.ca)
2. Mentorship and transition support
   Programs like residency for new nurses (e.g. McGill’s Genesis Nurse Residency) help new grads adjust, reduce stress, build confidence. Structured mentoring as they enter clinical practice reduces early career turnover.
3. Flexible scheduling & workload management
   Allowing part-time options, shift swapping, more stable schedules helps nurses balance work and life. Reducing administrative tasks and paperwork also frees time for care and recovery.
4. Investments in training & recognition
   Increasing seats in nursing programs, training more instructors, supporting internationally educated nurses in getting credentials, recognising specialities. Educational capacity is being addressed through the 2025 Health Workforce Education & Training study. (canada.ca)

What Patients & the Public Can Do

• Advocate for transparency & accountability
  Ask your hospital or provincial health authority about nurse staffing levels, ER wait times, delayed surgeries. Push for reporting so policy-makers can’t ignore the data.
• Use services wisely
  For non-urgent issues, consider walk-in clinics, telehealth, virtual care, or scheduled primary care visits instead of going to the ER. This helps reduce strain on emergency departments.
• Support local initiatives
  Community support (volunteering, advocating for better funding in your region), donations, or even recognising the work nurses do (through social media, local government) helps morale.
• Vote & engage politically
  Nursing shortages cross provincial and federal lines. Support candidates and policies that commit to improving health workforce planning, safe staffing legislation, mental health supports for health workers.

Outlook — What to Expect in the Next 3-5 Years

If current trends continue, several outcomes are likely. Some may already be set in motion; others will depend on policy choices.

Projected Supply & Demand Trends

• The modelling studies show that although nurse numbers are increasing, the growth is not keeping pace with rising demand from an aging population, more chronic disease, mental health care needs, and post-COVID recovery of delayed services.
• Forecasts suggest Canada could remain well short of what is needed by 2030 unless retention improves, credentialing barriers shrink, and education/training expands more aggressively.

Potential Policy & System Changes

• Further adoption of minimum nurse-to-patient ratios in more provinces. Where these ratios are enforced, early signs point to improved care and reduced burnout.
• Broader use of technology & innovations, such as better scheduling tools, telehealth and remote care to reach rural communities, digital tools to reduce paperwork, and better workforce tracking systems.
• Enhanced focus on rural/remote health workforce — recruiting locally, offering incentives, improving infrastructural supports.
• Strengthening data systems: collecting real-time data on vacancy, overtime, nurse well-being, patient safety incidents, so planning can be more responsive.

Risks If No Action

• Wait times in ERs and for surgical or diagnostic services will continue to grow.
• Patient safety risks increase: more errors, delays, worse outcomes especially for vulnerable populations.
• More nurses may leave due to burnout or retire early, making shortages worse.
• Geographic inequities deepen: remote and Indigenous communities suffer disproportionately.

Conclusion

Canada’s nursing shortage is not just a statistic—it’s reshaping how health care looks and functions for patients and for nurses. We’ve seen how supply is failing to keep up with demand, what causes lie behind the gap, the real risks to safety and access, and some of what’s being done or could be done.

What matters now is how those responses scale and whether they reach the places that need the most help—rural, remote, under-resourced regions. For patients, it means knowing what to expect, being a part of the solution, and holding systems to account. For governments and institutions, it means investing in education, well-being, retention, and smart workforce planning.

If you want to stay updated, consider subscribing to provincial health authority updates or national nursing association reports. Share this article so more people understand what’s at stake. Let’s ensure high-quality, safe, and equitable care for all Canadians—while making sure nurses themselves are supported, respected, and able to carry out the work they came to do.

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