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When Kathleen MacMillan hears health system officials say they can’t find nurses, she questions the structures and processes in place to attract and retain the ones they have.
“What we have now is nurses who love nursing and they hate their jobs,” said MacMillan, who has been a registered nurse for more than 50 years and served as Ontario’s provincial chief nursing officer.
“It’s not that you’re short of nurses. They don’t want to work for you,” MacMillan said.
CBC News reported recently about a group of travel nurses, including those working in Shellbrook, Sask., who say an Ontario-based staffing agency called EZ Care stopped paying them this summer.
Travel nurses take short-term contracts through private staffing agencies to fill gaps, often in rural facilities. They typically earn more than staff nurses, with travel and housing often covered.
From 2019 to 2024, the Saskatchewan Health Authority estimates its annual spending on travel nurses increased to $98.8 million from $2.1 million.
After that increase, the SHA focused on reducing its reliance on travel nurses.
For 2024 to 2025, the SHA spent $75.8 million on travel nurses, a 23 per cent decrease from the previous year, according to an audit of the system.
WATCH | Travel nurses working in rural hospitals say they haven’t been paid for months:
Travel nurses working in rural hospitals say they haven’t been paid for months
Some travel nurses deployed in Saskatchewan facilities through a private staffing agency called EZCare say they’re owed thousands of dollars in missed pay and expenses. The Saskatchewan Health Authority says it can’t intervene.National framework for retaining nurses
MacMillan, who has also led the School of Nursing at Dalhousie University and the School of Health Sciences at Humber College, researched what keeps nurses on the job.
She said governments and employers often argue that nurses simply want more money. But the research on what attracts and keeps nurses finds pay is far down the list, she said.
“Money only matters when everything else is equally miserable.”
What keeps nurses working is supportive leaders, being part of a strong team, and going home feeling they did good work; instead, many see a focus on cost control, unmanageable workloads, sicker patients and rising workplace violence, she said.
Agency nurses get more than a bigger paycheque — they get control over where they work, when and how much, MacMillan said.
A nursing vacancy rate of 10 per cent is considered a “five-alarm fire” and many hospitals are now well past that, she said.
Saskatchewan’s Opposition NDP says one travel nurse can cost the system about $29,350 a month. It called the government’s reliance on them “incompetence” at a news conference in Saskatoon on Wednesday.
That money should go to permanent jobs instead.
“They’re wasting your money, money that could be spent to reduce wait times, to improve service delivery. It’s unacceptable,” NDP health critic Keith Jorgenson said.
“If you could imagine for a second that we paid substitute teachers 10 times what we paid classroom teachers, it’d probably be pretty hard to hire classroom teachers.”
In a prepared statement, the Saskatchewan Health Authority said it only uses contract nurses when there are prolonged vacancies that can’t be filled by staff.
“This is a last resort short-term measure taken to ensure health care services are not interrupted,” the statement said.
Spending on contract nurses was reduced by $44.8 million in the last two fiscal years and nursing vacancies have dropped by 68 per cent since June 2023, including a 79 per cent drop in rural and northern communities, the statement said.
MacMillan points employers to Health Canada’s nursing retention toolkit and the Magnet Recognition Program for nursing excellence and patient care.
Mount Sinai Hospital in Toronto is the only hospital in Canada to receive a Magnet recognition for nursing excellence.
She also wants health employers held accountable for their retention rates, not just their staffing budgets, she said.
“I’m appalled that employers are not held accountable for their retention rates, and why they’re spending all this money on the contractors.”