Number of private agency nurses rises

As the province tries to move away from its reliance on private agency nurses, data show the practice continues to increase in Manitoba.

A report Thursday from the College of Registered Nurses of Manitoba shows there were 1,611 nurses working for private agencies in 2024, up from 1,418 in 2023.

“Our fundamental mandate as the professional regulator is to ensure public protection and provide the conditions that work towards supporting and ensuring patient safety,” said college spokesman Martin Lussier.

“When there is a significant shift in the practice of (nurses) that we regulate, part of our work is to assess: does that create new challenges or risks.”

There wasn’t just an increase in for-profit agency nursing, he said.

“There also was an increased number of nurses who had limited experience in any Canadian jurisdiction who were, in some cases, joining the workforce and immediately working for a nursing agency.”

Agency nurses were most likely to be working in emergency rooms, general medicine wards and long-term care, the data reported.

While the use of agency nurses in long-term settings isn’t new, the increased use of them in emergency rooms is, Lussier said.

“If you have somebody who has very limited experience in what is a high-acuity care environment, that’s an issue for patient safety, period.”

The college also found 66 per cent of all agency nursing practice is in rural and remote areas.

“That’s a known risk factor that we’ve identified around the potential for errors in nursing practice being made due to a lack, potentially, of oversight or supports — where there can be one or two nurses at most on shift in certain very small health centres,” Lussier said.

“We felt there was a need to study this, come up with some evidence-informed guidelines and then to move that forward in a way that was productive.”

The college now requires 2,015 hours of practice in a Canadian setting in order to work in agency nursing.

The NDP government set out to curb the public health system’s reliance on for-profit nursing agencies after taking office in 2023. A float pool offered incentives to nurses to return to the public system from the for-profit sector, with better pay and work-life balance.

A statement from Health Minister Uzoma Asagwara Friday said there are now close to 400 nurses recruited to the pool that fills staffing gaps, reducing the reliance on private agency nurses.

“The main reason we’re seeing an increased shift to agency nursing is a shortage of acceptable working conditions in the public system.”

If the province wants to recruit and retain nurses, safety issues in the public health system need to be addressed, the Progressive Conservative health critic said.

“The main reason we’re seeing an increased shift to agency nursing is a shortage of acceptable working conditions in the public system,” said MLA Kathleen Cook (Roblin). She pointed to nurses recently grey-listing the Health Sciences Centre over safety concerns following attacks there this summer.

“That should set off alarm bells for the minister of health and that whole department about why we’re seeing this and what needs to be done to address it,” Cook said.

Asagwara’s statement said Manitoba became “the Wild West for private agencies” under for former Tory government. The NDP are now trying to rein in spending on private nurses that has soared since the COVID-19 pandemic. Regional health authorities spent $40 million on agency nurses in 2021-22, $60 million in 2022-23 and nearly $75 million in 2023-24, Shared Health has reported.

In December, the province banned public health providers from signing new contracts with agencies. More than 70 agencies held contracts with regional health authorities and health-care facilities, without any policies or controls that govern the rates they’re paid, Asagwara said earlier.

The province also issued a request for proposal to reduce the number of contracted agencies and set controls for the rates they charge. It wants to work with as many as three contract vendors per health region and service delivery organization. Its objectives are to “obtain the highest quality of services” in its hiring of nurses while saving money.

“Our government is investing in the public system, to ensure that Manitoba health care is a place where people want to work.”

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The nursing regulator’s report shows how important it was for the province to issue that request for proposal, the minster said.

“Private agencies play a role in relieving the pressure in a health system that has been under intense pressure for many years, but under the PCs we became reliant on them,” Asagwara said. “Our government is investing in the public system, to ensure that Manitoba health care is a place where people want to work. The number of net new staff who have joined our workforce is evidence that we are on the right track.”

Until the province invests in staffing up the provincial nurse float pool, it will continue to rely on private agency nurses, the head of the Manitoba Nurses Union said.

“This is going to be a huge saving, but you have to actually make an investment to get it done,” MNU president Darlene Jackson said Friday.

carol.sanders@freepress.mb.ca

Carol Sanders
Legislature reporter

Carol Sanders is a reporter at the Free Press legislature bureau. The former general assignment reporter and copy editor joined the paper in 1997. Read more about Carol.

Every piece of reporting Carol produces is reviewed by an editing team before it is posted online or published in print — part of the Free Press‘s tradition, since 1872, of producing reliable independent journalism. Read more about Free Press’s history and mandate, and learn how our newsroom operates.