Cures for the Nursing Shortage - More Seats in Licensed Practical Nurse Education Programs

Licensed practical nurses are in demand. There are wait lists for public nursing programs and the nursing shortage in Canada is acute.

It might seem that a logical solution to prepare more nurses to meet the demand is simply to create more spaces for students in licensed practical nurse education programs. However, it really is not that simple.

Let's imagine for a moment that the government is prepared to address the nursing shortage and has announced that nursing schools can register any number of students they want to and the funds will be there to support that seat.
It might appear at first glance that more nurses in the system more quickly is exactly what our what the Canadian health care system needs. But if you use a systems approach to analyzing this decision it is obvious that a number of problems would arise from this imaginary blessing.

• who will teach these students? - Virtually all nurse education programs report unfilled vacancies for nursing faculty. Without qualified and experienced nursing instructors to teach these new students the quality of the education program is at risk and the mandate of public protection is not being fulfilled.
• where will the physical space to house these new students come from? - Many nursing labs are already too small to service the needs of existing nursing schools. Creating more space will require funds and time.
• where will these students receive their clinical experience? - There is tremendous pressure on the system already for clinical placements. Clinical placements must be requested up to 10 months in advance. How can placements be requested if the school is unsure of how many students they will have at that time? and how can an already pressured system handled more requests?
• who will mentor these new graduates at work? - New nurses need mentoring in order to adjust to the workplace and develop the independence needed to work as an autonomous and independent practitioner. Mentoring new nurses is a rewarding but a demanding addition to an already stressful workload for most nurses. Flooding the workplace with a large number of new graduates might lead to mentor burnout with the result that more nurses leave the system.
• who will supervise these new licensed practical nurses? - In almost all provinces in the Canadian health care system the nursing scope of practice for a LPN is to work under the supervision or direction of a registered nurse. With large numbers of vacancies in the system for registered nurses who will supervise these new practical nurses when they start working?

All systems have various parts and processes that contribute to final outcomes. In order to create a good quality outcome all parts of a system have to be stable and strong. The Canadian health care system in no different.

This analysis has revealed some of the parts of the system that are necessary to support an increased number of nurse education seats for LPN's. All parts of the system have to be considered in order to create lasting and effective solutions that creat quality outcomes.

In this case quality outcomes would mean graduates of nursing schools who are able to pass the Canadian nursing entrance test for a licensed practical nurse at a consistent rate and additionally are successful in the workplace as competent, knowledgeable, and ethical practitioners.

Although the Canadian health care system needs more licensed practical nurses to address the prolonged nursing shortage, long term practical solutions must be sought, not quick fixes.

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