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Care homes say agencies lure away nurses with higher pay

“Workers will leave their employer and work for several care homes on an ad hoc basis, or a care home will be forced to hire that same worker back at a much-higher rate”
Terry Lake, chief executive of the B.C. Care Providers Association. DARRYL DYCK, CP

Care homes in B.C. are losing nurses to private agencies that are promising wages they can’t compete with, which is leading to unstable staffing that has an impact on residents, says the B.C. Care Providers Association.

“Workers will leave their employer and work for several care homes on an ad hoc basis, or a care home will be forced to hire that same worker back at a much-higher rate out of desperation,” Terry Lake, chief executive of the association and a former B.C. health minister, said at a Tuesday news conference in Victoria.

He said unstable staffing can be a particular problem for people with dementia, because familiarity with staff is critical to their care. “When staffing is unstable, that has very real impacts on the people who live in long-term care.”

It can also make it difficult for regular staff who work alongside agency staff earning higher wages, Lake said, adding a private-nursing-agency worker can make 25 to 40 per cent more an hour than a care-home worker.

He said a registered care-home nurse might be making $42 or $43 an hour, but could be hired away by an agency that can contract the nurse back to the care home at $90 or $100 an hour.

The contracted nurse might make up to $75 an hour, with the rest going to the agency, Lake said, although he noted that an agency job probably doesn’t include benefits, union membership and seniority.

Lake urged the provincial government and private agencies to collaborate more to reduce the impact of the problem. The association said it would also like to work with the province and agencies to address what it called a human-resource crisis.

Lake noted that legislation passed in Quebec essentially bans the use of the agencies, but said a consensual solution would be the best approach.

In the Interior, he said, as much as 50 to 75 per cent of long-term care nursing shifts are being filled by people from temporary-staffing agencies.

Some facilities have 100 per cent of the positions filled by temporary-agency staff, said Lake, warning things will get worse as summer approaches and ­workers take vacations.

The situation is leading to “exorbitant and unexpected costs” that are destabilizing care homes, he said.

“Unless there is immediate action, this could result in bed closures and serious disruptions to care.”

The B.C. Nurses’ Union said in a statement that it believes the reliance on agency nurses is not a sustainable practice.

“We echo the concerns of the B.C. Care Providers Association when it comes to the over-reliance on agency nurses in long-term care facilities throughout the Interior and elsewhere in B.C.,” the union said.

“We believe the extraordinary amount of money spent on agency nurses each year should be invested in long-term nurse recruitment and retention strategies that will better serve the patients of this province into the future.”

The Ministry of Health issued a statement saying use of agency nurses rose significantly during the COVID-19 pandemic, which added to long-standing health workforce challenges.

It said there are 17 staffing agencies in the province with public-sector contracts, and of those, 14 were added in the last three years.

A moratorium was placed on new agency contracts in November, the statement said, adding agency nurses are used as a last resort for vacancies and difficult-to-fill positions “to ensure the safe continuity of care for patients and clients.”

On average, it said, agency-nurse hours made up only 1.4 per cent of total nurse productive hours in B.C. in 2021-22.

The ministry said staffing agencies contract a wide range of professions, including physiotherapists, occupational therapists, and laboratory and imaging technologists, but nursing hours represent the most hours provided by staffing agencies.

There are financial incentives for nurses to take regular full- and part-time positions in the public sector, with a focus on the same rural and remote communities that are currently using agency staff at a higher rate, the ministry said.

“This incentive is currently available in northern health communities and has been extended to Grand Forks and Mount Waddington [in Island Health],” it said. “The incentive will be expanded to support other high-needs rural and remote communities in the coming months.”

The B.C. Care Providers Association represents over 450 members in the continuing-care sector, including assisted-living and long-term care facilities.

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