Recruitment and retention can be challenging for hospitals, and finding ways to strengthen support for emergency department (ED) nurses, particularly in rural and remote areas, is crucial to ensuring the stability and long-term sustainability of EDs in these communities.
“Nursing in rural hospital EDs requires a unique skill set, including a broad range of knowledge and the ability to act quickly to provide the best quality care to patients,” says Lynanne Mason, Vice President Partnerships, Transformation & Chief Nursing Executive at Huron Perth Healthcare Alliance (HPHA) in southwestern Ontario. HPHA includes Stratford General Hospital as well as three rural sites – Clinton Public Hospital, St. Marys Memorial Hospital and Seaforth Community Hospital.
“ED nurses must be highly skilled, not only in all aspects of nursing care but also in remaining calm and guiding the rest of the ED team in patient care.”
To address these needs, Ontario Health launched the Emergency Department Nursing Education, Retention, and Workforce Program, which aims to support ED nurses entering the field for the first time as well as enhancing the knowledge and skills of more seasoned nurses. Together, this helps hospitals continue to deliver high-quality ED care, retain and recruit ED nurses to meet their ED staffing needs, and in turn support the needs of the community.
“This ED -specific education has allowed us, as hospital leaders, to optimize the education required and provide consistent, ongoing opportunities for continuing and updating these skills. In most rural EDs , the nurses themselves teach new staff. These education opportunities help with new recruitment and retaining our current nurses, who feel supported and have the ability to grow and hone their skills as needed,” notes Ms. Mason.
“Our three rural hospitals currently have a full complement of full-time ED nursing staff, and we know the investments in rural ED nursing have helped us achieve this. We continue to see high enrollment numbers from our ED nurses in the online learning modules and look forward to continuing to offer these opportunities.”
In small rural and remote hospitals where EDs are staffed with a small complement of nurses, education opportunities to support recruitment and retention of ED nursing staff are especially important.
“We have seen fewer new nurses applying to work in EDs and experienced ED nursing staff retiring or leaving their position. We recognized that we needed to increase access to learning opportunities for nurses working in EDs , particularly in rural and remote communities, where long-distance travel could be a barrier to participation,” says Judy Linton, Executive Vice-President and Chief Nursing Executive, Acute and Hospital-Based Care, at Ontario Health.
Supported by $4.7 million in provincial funding, and in collaboration with the Ministry of Health as well as in consultation with hospital leaders, the program, launched in summer 2023, initially targeted rural and remote settings with several key components:
- Virtual training modules to deliver high-quality, interactive curriculum to onboard and orient ED nurses as well as provide core competency skills training;
- Immersion programs that provided multi-day, in-person skills training to educate new ED nurses in small, rural, and remote hospitals; and
- Specialty training fund grants to support nurses complete essential training courses for core ED skills.
Demand for the ED Nursing Education, Retention, and Workforce Program exceeded expectations in its first year. From August 2023 to March 2024, more than 4,300 ED nurse attendees from over 102 hospitals, most in rural and remote settings, took part in the program.
Based on the high-volume of participation, the Ministry of Health committed an additional $10 million in July 2024 and the program has expanded access to all 163 Ontario hospitals with an ED to support recruitment and retention, onboarding and training for ED nurses.
“Nurses are telling us this program is invaluable. They are able to effectively apply the content and skills learned in the course to their work, which is helping to ensure quality care to more Ontarians in EDs across the province,” says Ms. Linton.