Upstream, long-term and visionary thinking

Access to Nursing


File 52

Public health nurses like Lindsday Croswell are making a difference for at risk families 

RNAO. 2010. Registered Nurse Journal (July-August 2010)

Improving Access to Nursing Services
Access to registered nurses is an essential component of vibrant communities and optimal health outcomes. There is clear evidence linking care provided by RNs with better health outcomes in a variety of settings – hospitals, long-term care, and the community. Full-time RNs, as compared with part-time and casual employees, are closely associated with lower mortality rates, continuity of care and continuity of caregiver for patients, and better morale. Nurse practitioners augment other roles, further improving access to community and hospital-based services.

Ontario’s RN workforce, however, is failing to keep pace with the province’s growing and aging population. To bring Ontario’s nurse-to-population ratio up to the equivalent of the rest of Canada, Ontario would require almost 15,000 additional RNs. As workload increases, patient care suffers.

Numbers alone do not tell the whole story. Some hospitals, driven misguidedly by budget cuts, have moved away from models of nursing care delivery that advance continuity of care and continuity of caregiver, which are proven to be in the best interests of patients and nursing. Both appropriate skill-mix and nursing model of care delivery are critical pillars to optimize patient, staff and organizational outcomes. Moreover, skill-mix applications done in the absence of continuity of caregiver compromise both nursing practice and patient safety.