By Lauren Pelley

The supply of nurses in Canada dropped for the first time in two decades, according to a new report from the Canadian Institute for Health Information — with one of the largest declines in Ontario.

The report, released on Tuesday, finds the country’s supply of regulated nurses in 2014 declined by 0.3 per cent over the previous year, raising concern in several national nursing organizations.

Andrea Porter-Chapman, manager of health workforce information at CIHI, said there are several factors at play, including a drop in the number of applicants applying for licensing and an increase in the number of nurses leaving the profession.

Over 12,000 nurses left the profession in Ontario alone, a decline of 2.6 per cent in regulated nurses, said Porter-Chapman.

“One of the factors driving the change in Ontario was a regulatory change (from) the College of Nurses of Ontario,” she said.

Last year, the college introduced a “declaration of practice requirement,” meaning members can only renew their membership if they practiced nursing in Ontario within the last three years or were registered or reinstated within the past three years.

The requirement was put in place both for public safety — previously nurses who hadn’t practised for years could return to nursing without a college evaluation — and to provide a more accurate reflection of the available nursing labour force, according to a college spokesperson.

Diane Clements, interim director of practice and policy‎a Canadian nurse's association, a body representing nurses across the country, said the organization is “concerned” about the CIHI numbers, particularly when it comes to where nurses are working.

The report finds retention rates were highest in hospitals, compared to community health agencies, nursing homes, long-term care facilities and other nursing workplaces.

“Distribution of the workforce isn’t where we’d like it to be, where we know Canadians and seniors are needing care,” said Clements, who has been in nursing over four decades.

Fewer nurses stay within long-term care or nursing homes, yet these settings are more appropriate for seniors rather than acute-care beds in a hospital, she said. Nurses are vital within these community settings: studies show that having a registered nurse leading a care team leads to fewer readmissions into hospitals for chronically ill seniors.

“We know that 14 per cent of Canadians are 65 and older, and it’s a number that’s expected to double by 2036,” Clements said. “Research has shown that age-related conditions, especially chronic diseases, are better managed in the community.”

Funding for an additional 80,000 hours of nursing care is part of the Ontario government’s 2015 budget commitment to increase investments in home and community care by more than $750 million over the next three years, noted a spokesperson for Health Minister Dr. Eric Hoskins.

The Canadian Federation of Nurses Unions is also ringing alarm bells in the wake of the CIHI report and their own numbers, which show nurses worked more than 19 million hours of overtime in 2014 at a total cost of almost $872 million. Nurses’ absenteeism rates also rose last year, according to the CFNU.

“The latest workforce data, coupled with the results of CFNU’s overtime and absenteeism report for 2014, is of concern,” said CFNU president Linda Silas in a statement, which noted a decrease in the nursing supply, an aging workforce and fewer students being admitted to entry-to-practice programs. “To ensure patient safety and a sustainable health care system, we need a national health human resources plan.”

The CIHI report finds the number of regulated nurses actually working in the profession at the time of annual registration grew to nearly 384,000 across Canada — but the number not renewing their registration exceeded the number entering the profession due to factors like career changes, retirement or a move outside Canada.

“Nurses make up the largest workforce in the Canadian health care system, so it’s important for the health care system to watch the trends,” said Porter-Chapman.