Skip to main content Accessibility help
×
Home

A Profile of Regulated Nurses Employed in Canadian Long-Term Care Facilities

  • Janet E. Squires (a1) (a2), Jennifer Baumbusch (a3), Melissa Demery Varin (a1), Ibo MacDonald (a1), Stephanie Chamberlain (a4), Anne-Marie Boström (a5), Genevieve Thompson (a6), Greta Cummings (a4) and Carole A. Estabrooks (a4)...
  • Please note a correction has been issued for this article.

Abstract

Registered nurses (RNs) and licensed practical nurses (LPNs) provide the skilled component of nursing care in Canadian residential long-term care facilities, yet we know little about this important workforce. We surveyed 309 RNs and 448 LPNs from 91 nursing homes across Western Canada and report descriptively on their demographics and work and health-related outcomes. LPNs were significantly younger than RNs, worked more hours, and had less nursing experience. LPNs also experienced significantly more dementia-related responsive behaviours from residents compared to RNs. Younger LPNs and RNs reported significantly worse burnout (emotional exhaustion) and poorer mental health compared to older age groups. Significant differences in demographics and work- and health-related outcomes were also found within the LPN and RN samples by province, region, and owner-operator model. These findings can be used to inform important policy decisions and workplace planning to improve quality of work life for nurses in residential long-term care facilities.

Le personnel infirmier autorisé (PIA) et les infirmiers auxiliaires (Iaux) fournissent le volet spécialisé des soins infirmiers dans les centres de soins de longue durée au Canada. Cependant, peu d’études se sont penchées sur cette main-d’œuvre importante. Une enquête a été réalisée chez 309 PIS et 448 Iaux provenant de 91 centres pour personnes âgées situés dans l’Ouest canadien afin de décrire leur profil démographique et certaines variables associées à leur travail et à leur santé. Les Iaux étaient significativement plus jeunes que les PIA, travaillaient un plus grand nombre d’heures et avaient moins d’expérience en soins infirmiers. Ils étaient aussi davantage confrontés à des comportements réactifs d’aînés atteints de démence, comparativement aux PIA. Les PIA et les Iaux plus jeunes rapportaient un épuisement professionnel (burnout, épuisement émotionnel) plus sévère et davantage de problèmes de santé mentale que les groupes plus âgés. Des différences significatives ont également été observées entre les provinces, les régions et les propriétaires exploitants en ce qui concerne les variables démographiques, ainsi que les variables liées au travail et à la santé des PIA et des Iaux. Ces résultats permettront d’informer les décisions politiques importantes à venir et la planification de la main d’œuvre afin d’améliorer la qualité de vie au travail pour le personnel infirmier œuvrant en centres de soins de longue durée.

Copyright

Corresponding author

*La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Janet E. Squires, inf./RN, PhD Ottawa Hospital Research Institute General Campus 501 Smyth Rd., Box 711 Ottawa, ON K1H 8L6 (jasquires@ohri.ca)

Footnotes

Hide All

Anne-Marie Boström’s name was misspelled in the original online version of this article. It has been corrected above and a corrigendum has been published.

Footnotes

References

Hide All
B.C. Regulations. (2009). Community care and assisted living act: Residential care regulations. B.C. Reg. 96/2009.
Bennett, M. K., Ward, E. C., Scarinci, N. A., & Waite, M. C. (2015). Service providers’ perceptions of working in residential aged care: A qualitative cross-sectional analysis. Medical Care, 35(9), 19892010. doi:10.1017/S0144686X14000853
Berta, W., Laporte, A., Deber, R., Baumann, A., & Gamble, B. (2013). The evolving role of health care aides in the long-term care and home and community care sectors in Canada. Human Resources for Health, 11, 25. doi:10.1186/1478-4491-11-25
Boblin, S., Baxter, P., Alvarado, K., Baumann, A., & Akhtar-Danesh, N. (2008). Registered nurses and licensed/registered practical nurses: A description and comparison of their decision-making process. Nursing Leadership, 21(4), 56.
Bryan, S., Murphy, J., Doyle-Waters, M., Kuramoto, L., Ayas, N., Baumbusch, J., … McGregor, M. J. (2010). A systematic review of research evidence on:(a) 24-hour registered nurse availability in long-term care, and (b) the relationship between nurse staffing and quality in long-term care. Retrieved from https://open.library.ubc.ca/media/download/pdf/52383/1.0048546/1
Canadian Institute for Health Information. (2017). Regulated nurses, 2016. Retrieved from https://www.cihi.ca/en/regulated-nurses-2016
Canadian Nurses Association. (2015). Framework for the practice of registered nurses in Canada. Ottawa, ON: Author.
Chu, C. H., Ploeg, J., Wong, R., Blain, J., & McGilton, K. S. (2016). An integrative review of the structures and processes related to nurse supervisory performance in long-term care. Worldviews on Evidence-Based Nursing, 13(6), 411419. doi:10.1111/wvn.12170
College of Nurses of Ontario. (2014). RN and RPN practice: The client, the nurse and the environment. Toronto, ON: Author.
College of Nurses of Ontario. (2016). Nursing education. Retrieved from http://www.cno.org/en/become-a-nurse/registration-requirements/education/
Corazzini, K., Anderson, R., Mueller, C., Thorpe, J., & McConnell, E. (2013). Licensed practical nurse scope of practice and quality of nursing home care. Nursing Research, 62(5), 315. doi:10.1097/NNR.0b013e31829eba00
Dwyer, D. (2011). Experiences of registered nurses as managers and leaders in residential aged care facilities: A systematic review. International Journal of Evidence-Based Healthcare, 9(4), 388402.
Estabrooks, C. A., Squires, J. E., Carleton, H. L., Cummings, G. G., & Norton, P. G. (2015). Who is looking after Mom and Dad? Unregulated workers in Canadian long-term care homes. Canadian Journal of Aging, 34(1), 4759. doi:10.1017/S0714980814000506
Estabrooks, C. A., Squires, J. E., Cummings, G. G., Teare, G. F., & Norton, P. G. (2009). Study protocol for the translating research in elder care (TREC): Building context—An organizational monitoring program in long-term care project (project one). Implementation Science, 4, 52. doi:http://dx.doi.org/10.1186/1748-5908-4-52
Ginsburg, L., Berta, W., Baumbusch, J., Rohit Dass, A., Laporte, A., Reid, R. C., … Taylor, D. (2016). Measuring work engagement, psychological empowerment, and organizational citizenship behavior among health care aides. The Gerontologist, 56(2), e1e11.
Grinspun, D., Harripaul-Yhap, A., Jarvi, K., & Lenartowych, T. (2011). Mind the safety gap in health system transformation: Reclaiming the role of the RN. Toronto, ON: Registered Nurses’ Association of Ontario.
Harris, A., & McGillis Hall, L. (2012). Evidence to inform staff mix decision-making: A focused literature review. Report Prepared for the Canadian Nurses Association. Retrieved from https://www.cna-aiic.ca/∼/media/cna/page-content/pdf-en/staff_mix_literature_review_e.pdf?la=en
Hodgkinson, B., Haesler, E. J., Nay, R., O’Donnell, M. H., & McAuliffe, L. P. (2011). Effectiveness of staffing models in residential, subacute, extended aged care settings on patient and staff outcomes. Cochrane Library, June 15(6), CD006563.
Kanter, R. M. (1993). Men and women of the corporation (2nd ed.). New York, NY: Basic Books.
Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the implementation of evidence based practice: A conceptual framework. Quality in Health Care, 7(3), 149158.
Manning, M. L. (2010). Moral distress among regulated and unregulated care providers employed in long term care settings (Unpublished master’s thesis). Queen’s University, Kingston, ON.
Maslach, C., Jackson, S., Leiter, M., Schaufeli, W., & Schwab, R. (1981). Maslach burnout inventory. Menlo Park, CA: Mind Garden.
Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2, 99113.
Maslach, C., & Jackson, S. E. (1984). Burnout in organizational settings. Beverly Hills, CA: Sage.
McCloskey, R., Donovan, C., Stewart, C., & Donovan, A. (2015). How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study. International Journal of Nursing Studies, 52(9), 14751483.
McGilton, K. S., Boscart, V. M., Brown, M., & Bowers, B. (2014). Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: Perspectives of licensed nursing staff. International Journal of Nursing Studies, 51(6), 917926. doi:10.1016/j.ijnurstu.2013.10.015
McGilton, K. S., Bowers, B., McKenzie-Green, B., Boscart, V., & Brown, M. (2009). How do charge nurses view their roles in long-term care? Journal of Applied Gerontology, 28(6), 723742.
McGilton, K. S., Bowers, B. J., Heath, H., Shannon, K., Dellefield, M. E., Prentice, D., … Mueller, C. A. (2016). Recommendations from the International Consortium on Professional Nursing Practice in long-term care homes. Journal of the American Medical Directors Association, 17(2), 99103. doi:10.1016/j.jamda.2015.11.001
Mueller, C., Anderson, R. A., McConnell, E. S., & Corazzini, K. (2012). Licensed nurse responsibilities in nursing homes: A scope-of-practice issue. Journal of Nursing Regulation, 3(1), 1320. doi:10.1016/S2155-8256(15)30229-5
Ottem, P., & Overton, C. (2000). RN and LPN accountabilities and responsibilities. Nursing B.C., 32(3), 19.
Pyper, W. (2004). Employment trends in nursing. Perspectives on Labour and Income, 16(4), 39.
Schaufeli, W. B., Bakker, A. B., & Salanova, M. (2006). The measurement of work engagement with a short questionnaire: A cross-national study. Educational and Psychological Measurement, 66(4), 701716.
Shields, M., & Wilkins, K. (2009). Factors related to on-the-job abuse of nurses by patients. Health Reports, 20(2), 7.
Spreitzer, G. M. (1995a). An empirical test of a comprehensive model of intrapersonal empowerment in the workplace. American Journal of Community Psychology, 23(5), 601629.
Spreitzer, G. M. (1995b). Psychological empowerment in the workplace: Dimensions, measurement, and validation. Academy of Management Journal, 38(5), 14421465.
Spreitzer, G. M., Kizilos, M. A., & Nason, S. W. (1997). A dimensional analysis of the relationship between psychological empowerment and effectiveness, satisfaction, and strain. Journal of Management, 23(5), 679704.
Ware, J. E., Kosinski, M., Dewey, J. E., & Gandek, B. (2001). How to score and interpret single-item health status measures: A manual for users of the SF-8 health survey. Lincoln, RI: QualityMetric Inc., 15(10), 5.
Woodhead, E. L., Northrop, L., & Edelstein, B. (2016). Stress, social support, and burnout among long-term care nursing staff. Journal of Applied Gerontology, 35(1), 84105.

Keywords

Type Description Title
WORD
Supplementary materials

Squires et al. supplementary material
Squires et al. supplementary material 1

 Word (50 KB)
50 KB
WORD
Supplementary materials

Squires et al. supplementary material
Squires et al. supplementary material 2

 Word (13 KB)
13 KB
WORD
Supplementary materials

Squires et al. supplementary material
Squires et al. supplementary material 3

 Word (85 KB)
85 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

A correction has been issued for this article: