When 23-year-old Srisudhakar (Sri) Nowduri was 16, he suddenly developed severe lower back pain that eluded an explanation as well as attempts at treatment. “I kept getting negative test results,” he says, “and I felt a lot of despair and hopelessness.” His pain is manageable now, though its original cause is still a mystery. “It gave me a glimpse into how other patients might feel, and the idea of giving someone in that position any kind of relief gave me a sense of purpose. So I decided to pursue a career in health care.” In 2020, he completed a double major in biochemistry and human biology at the University of Toronto Scarborough, and then applied to a few different programs, including nursing, medical school and pharmacy.
Nowduri always had “a stereotypical idea of nursing,” he says. “I mistakenly thought it was like being a glorified assistant to a ‘real’ health-care provider.” But when the pandemic hit, he volunteered as a COVID-19 screener at Baycrest Health Sciences, a research and teaching hospital for elderly patients in Toronto. One day on the job, he faced the difficult task of telling the family of a rapidly deteriorating palliative patient that only two relatives would be allowed in to say goodbye. The nurse managing the floor was consulted and eventually made the call to let one additional family member in the room. “I learned that nursing is so much more meaningful and impactful than I’d initially thought,” says Nowduri. “Nurses hold positions of authority, perform complex medical procedures, work independently as nurse practitioners and can specialize in numerous advanced areas [of medicine].” Nowduri accepted an offer of admission to U of T’s Lawrence S. Bloomberg Faculty of Nursing and started his studies there in September 2021.
During the pandemic, Ontario nursing schools saw a significant increase in interest. As the country braces for an impending nursing shortage, driven in large part by an aging workforce, it is also experiencing a rise in applications to nursing schools, sparked, in part, by a greater awareness of the critical role nurses play in the health-care system.
Nurses in Canada work in a wide range of settings, from hospitals and care homes to policy centres and private businesses. The base qualifications are the RPN (registered practical nurse) and RN (registered nurse) designations, which take four semesters of college and four years of university, respectively, to obtain. Afterward, nurses can pursue various kinds of advanced education and become clinical specialists, independent practitioners or researchers and educators. A nurse who goes on to become an NP (nurse practitioner), for instance, can autonomously offer primary care and prescribe medication, while a CNS (clinical nurse specialist) holds a master’s degree or Ph.D. and can work as an expert consultant and specialize in a niche area of medicine. Salaries, depending on a nurse’s role and level of education, range from around $52,000 to upward of $100,000 a year.
Registered nurses are in fact already in critically short supply. The Canadian Nurses Association predicts that Canada will be short 60,000 nurses by 2022, barring policy interventions. The recent surge in applications to nursing schools is a step in the right direction, but with other factors at work—namely, limited clinical placements and government funding for spots in nursing schools—it might not be enough to stave off the shortage. “Our application rate is up more than 60 per cent,” says Dr. Erna Snelgrove-Clarke, vice-dean and associate professor at the Queen’s University School of Nursing. “We discuss it in every meeting. And while we will increase the number of spots a little bit this year, we need to be more creative about ways students can learn with and without direct patient contact.”
McMaster University—where applications to its four-year nursing program are up about 20 per cent—incorporates simulation technology in its curriculum. But that’s not a substitute for direct patient care, stresses Dr. Joanna Pierazzo, assistant dean of the school’s undergraduate nursing programs. “I think any school would say, ‘Give me more seats and we will produce more graduates,’ ” she says, referring to the number of spots funded by the government in a given program. “But every academic program has a clinical component, and there are only a certain number of placements available. I was immersed in simulation as a scholar for a number of years, including in my Ph.D. work. You have to determine where simulation learning fits and has good outcomes, and where direct patient care has better outcomes. We balance that, and the pandemic has not changed our thoughts about it. We haven’t decreased our direct patient care.”
At the University of Toronto, Lesley Mak—assistant dean and registrar of the Lawrence S. Bloomberg Faculty of Nursing—says there’s been a roughly 25 per cent increase in applications to undergraduate nursing programs and a 22 per cent increase for graduate programs. “In a normal year, you might waver up or down around five per cent, so these numbers are pretty unprecedented in recent history,” she says. “I think, unfortunately, this is partially driven by job loss, since the entire professional landscape has shifted during the pandemic. And of course the pandemic is a health crisis, and lots of people are thinking about how they can be the greatest help to society.”
However, the pandemic has also led to an exodus of nurses from public hospitals and care homes in parts of the country. It’s a challenging time to be a nurse: they bear the burden of overtime and the risk of working on the frontlines of a global pandemic. An online survey conducted by the Registered Nurses’ Association of Ontario in early 2021 found that 9.3 per cent of RN respondents were “very likely” to leave the profession, and a further 7.1 per cent were “likely” to do the same. The first figure is nearly twice the proportion of nurses who actually leave the profession in a typical year.
Still, educators hope the incoming pool of nurses will start to course-correct Canada’s march to a serious nursing shortage. “As people got sick, nurses were expected to carry the same load with fewer people. It was hard, and stressful. But I think nurses coming out of a program today will shine,” says Snelgrove-Clarke. “At Christmastime I got 700 shirts printed, one for every undergraduate student. The back of the shirts say ‘Committed’ and ‘Resilient.’ They will be different from the nurses who never lived through a pandemic like this. A nurse knows how to come together in a time of hardship and get the job done.”
This article appears in print in the 2022 University Rankings issue of Maclean’s magazine with the headline, “A new generation of nurses.”