Employment Integration of Nursing Graduates: Evaluation of a Provincial Policy Strategy Nursing Graduate Guarantee 2014-2015 Nursing Health Services Research Unit Health Human Resources Series 44 May 2016 Andrea Baumann, RN, PhD Mabel Hunsberger, RN, PhD Mary Crea-Arsenio, MSc
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Employment Integration of Nursing Graduates:
Evaluation of a Provincial Policy Strategy Nursing Graduate Guarantee 2014-2015
Nursing Health Services Research Unit
Health Human Resources Series 44
May 2016
Andrea Baumann, RN, PhDMabel Hunsberger, RN, PhDMary Crea-Arsenio, MSc
1
Employment Integration of Nursing Graduates: Evaluation of a Provincial Policy Strategy
Nursing Graduate Guarantee 2014-2015
Number 44
Andrea Baumann, RN, PhD, Associate Vice President, Global Health, Faculty of Health Sciences & Scientific Director, Nursing Health Services Research Unit (McMaster University site)
Mabel Hunsberger, RN, PhD, Associate Professor, School of Nursing & Research Associate, Nursing Health Services Research Unit (McMaster University site)
Mary Crea-Arsenio, MSc, Research Coordinator, Nursing Health Services Research Unit (McMaster University site)
This research has been generously funded by a grant from the Government of Ontario. The views expressed in this report do not necessarily reflect those of the Government of Ontario.
Background to the Nursing Graduate Guarantee ...................................................................................... 8 CONTEXT ...................................................................................................................................... 9
Overview of Nurse Supply in Ontario ...................................................................................................... 9 The New Supply: RNs and RPNs in Ontario .......................................................................................... 11 Data on New Member Nurses ................................................................................................................. 13 Profile of Healthcare Employment in Ontario ........................................................................................ 14
HEALTH HUMAN RESOURCE PLANNING: NURSING STRATEGIES .............................. 15
NGG: Integrating New Graduates Into The Workforce ......................................................................... 15 EVALUATION OF THE NGG 2014-2015 .................................................................................. 16
Aim and Objectives ................................................................................................................................. 16 Methods................................................................................................................................................... 17
NGG Participation by NGNs .................................................................................................................. 18 Employer NGG Participation .................................................................................................................. 19 Survey and Interview Sample ................................................................................................................. 20 Demographic Characteristics of Survey Respondents ............................................................................ 21
New Graduate Nurses ................................................................................................................................. 21 Union Representatives ................................................................................................................................ 24
Registered Nurse and Registered Practical Nurse Employment ............................................................. 25 Characteristics of Participating and Non-participating NGNs ................................................................ 25 Employment Status ................................................................................................................................. 29 New Graduate Preference for Full-Time ................................................................................................ 31 Comparison to CNO New Member Employment Data .......................................................................... 31
Stakeholder Perceptions of the NGG ............................................................................................ 33
Promotion of the NGG: How Employers and NGNS Were Informed ................................................... 33 Website Design and Functionality: Employer and New Graduate Ratings ............................................ 33 Facilitating NGN Transition to Work: Mentoring and Support for New Graduates .............................. 34
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Benefits ....................................................................................................................................................... 34 Mentorship .................................................................................................................................................. 34 Orientation .................................................................................................................................................. 35 Full-Time Employment ............................................................................................................................... 35 Retention ..................................................................................................................................................... 36 Challenges and Areas for Improvement ..................................................................................................... 36 Bargaining Unit and Employer Collaboration: Where are the Gaps? ........................................... 37
Overall Impact of the Nursing Graduate Guarantee ..................................................................... 38
Table 6. New Graduate Nurse Respondents' Gender .................................................................... 21
Table 7. New Graduate Nurse Respondents' Age Distribution .................................................... 22
Table 8. New Graduate Nurse Respondents' Employment Status ................................................ 22
Table 9. New Graduate Nurse Respondents' Employment by Sector ........................................... 23
Table 10. New Graduate Nurse Respondents' Employment by Practice Area ............................. 23
Table 11. New Graduate Nurse Respondents' Employment by Geographic Region .................... 24
Table 12. Number and Percent of Respondents by NGG Participation 2014-2015 ..................... 25
Table 13. Distribution of NGG and Non-NGG Nurses Across Five Age Groups ........................ 26
Table 14. Distribution of NGG and Non-NGG Nurses Across Sectors 2007-2014 ..................... 28
Table 15. Employment Status of NGG and Non-NGG Nurses Across Employment Sectors ...... 30
Table 16. CNO RN New Member Working Status 2005-2015 .................................................... 32
Table 17. CNO RPN New Member Working Status 2005-2015 .................................................. 32
6
EXECUTIVE SUMMARY In 2007, the Ontario Ministry of Health and Long-Term Care launched the Nursing
Graduate Guarantee (NGG), an employment policy incentive intended to stabilize the nursing
workforce. The NGG provides funds for employers to hire new nurses including registered
nurses (RNs) and registered practical nurses (RPNs), into temporary supernumerary full-time
(FT) positions for three to six months. The impact of the policy on nurse employment has been
analyzed annually using outcome measures such as nurse preferences, FT employment rates and
transition to work. This report presents the results of the 2014-2015 NGG evaluation.
The 2014-2015 analysis demonstrates that the trend in FT and part-time employment for
RNs and RPNs is similar to previous years. The supply of RNs has increased over time and the
rate of FT has stabilized, while RPNs continue to have lower rates of FT employment. For both
nurse categories, the preference for FT has remained high. Participating employers continue to
be predominantly acute care hospitals in large urban centres across the province. While there has
been a slight increase in participation in the long-term care sector, participation by community
care has remained low.
In addition to employment outcomes, the employment portal and the extended orientation
and mentorship component of the NGG were evaluated. Based on the findings, satisfaction with
the Nurses' Career Start Gateway has improved. Results of the current evaluation have been
integrated into an eight-year new graduate employment database that demonstrates the NGG has
significantly affected integration and retention and influenced key dimensions of care delivery
(e.g., decision-making, communication, care management, system integration and commitment).
In 2014-2015, some organizations transitioned new graduate nurses (NGNs) into nursing
resource teams until FT positions became available. Longitudinal analysis highlighted various
reasons why organizations were not able to immediately place graduates into FT positions. For
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example, NGNs choosing to remain in a preferred area of clinical practice and being placed into
a PT position until a FT job became available. Longitudinal analysis also showed a higher rate of
FT employment among nurses who participated in the NGG compared to those who did not.
Participants reported receiving FT employment within two years of entering the nursing
workforce. Data confirm that the retention rate among NGG participants was higher compared to
non-participants. Employers and NGNs reinforced the importance of continued investment in the
policy to support transition to work for future graduates.
RECOMMENDATIONS
1. Design a communication plan that promotes employer participation across sectors and
regions.
2. Conduct an in-depth analysis of RPNs in the healthcare workforce to better understand their
participation, preferences and experiences in the NGG.
3. Examine the effect of employment saturation and actual job availability in Ontario.
4. Analyze nursing employment trends and expand the evaluation framework to include the
impact of the NGG on new graduate retention and quality of patient care.
5. Conduct a longitudinal analysis of the FT nursing workforce across regions in Ontario.
6. Identify best practices that integrate and retain new graduates in the nursing workforce.
7. Investigate and compare the impact of the NGG on selected healthcare organizations.
8. Link NGG data with available information on patient outcomes
8
INTRODUCTION
In the past decade, the Ontario government has made significant investments in health human
resources planning. A number of policies and strategies were formulated based on evidence that
showed maldistribution of nurses and care providers to meet the growing demand for service.
The Ministry of Health and Long-Term Care (MOHLTC) developed the Nursing Graduate
Guarantee (NGG) to encourage full-time (FT) employment of new graduate nurses (NGNs) in
Ontario. New graduate nurses include registered nurses (RNs) and registered practical nurses
(RPNs). The policy has been evaluated annually since its introduction in 2007. This report
presents the results of the 2014-2015 evaluation. It includes background information on the
NGG, describes the policy, reports recent findings and offers conclusions and recommendations.
An overview of nurse education in Ontario is provided in Appendix A.
BACKGROUND TO THE NURSING GRADUATE GUARANTEE
Non-standard work arrangements in the private and public sector are on the rise. The trend
toward precarious employment—jobs with a higher than normal uncertainty around pay, hours
and job security—and its potential negative effect on the health workforce and delivery of care
has become a concern for the Ontario government (Burleton, Goulati, McDonald, & Scarfone,
2013; Lewchuk & Lafleche, 2014).
Healthcare restructuring in the 1990s led to an increase in part-time (PT) and casual
employment of nurses province-wide. The Severe Acute Respiratory Syndrome outbreak in 2003
demonstrated the lack of surge capacity to respond to the epidemic and highlighted the issue of
PT and casual nursing staff throughout the province (Baumann, Keatings, Holmes, Oreschina, &
Fortier, 2006b; Walker, 2004). The long-term effect of institutional downsizing is a destabilized
9
workforce that is often slow to recover post-recession (Alameddine, Baumann, Laporte, &
Deber, 2012). During economic fluctuations, and especially during recessions, precarious
employment is further exacerbated (Caldbick, Labonte, Mohindra, & Ruckert, 2014). Appendix
B provides additional information on labour market trends and factors affecting job availability
for NGNs.
The NGG was launched at a time when 75% of NGNs were seeking FT positions, but
only 35% had FT employment (Baumann, Blythe, Cleverley, & Grinspun, 2006a). It is intended
to fund temporary supernumerary (above staff complement) FT nursing positions for up to six
months. As part of the HealthForceOntario (HFO) health human resources strategy, the goal of
the NGG has been to "provide every New Graduate Nurse with the opportunity to obtain full
time employment in Ontario" (MOHLTC, 2011 p. 4). Ongoing evaluation of the policy provides
evidence of its effectiveness over time.
CONTEXT
OVERVIEW OF NURSE SUPPLY IN ONTARIO
Figure 1 shows RN annual membership renewals with the College of Nurses’ of Ontario (CNO)
and employment from 1994 to 2015. There was a decreased trend in the number of nurses from
1994 to 2001. By 2005, the number of RNs lost was recovered and the number of nurses began
to increase over time. However, in 2014 there was a decrease of approximately 8,000 RNs
resulting in 4,000 less RNs than in 1994. It is important to note that this loss may be a result of a
change in the CNO membership categories.
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Figure 1. College of Nurses of Ontario RN Renewals and Employment 1994-2015
Source: College of Nurses of Ontario (2015) Membership Statistics Report.
In contrast, RPN supply in Ontario has been slower to recover from healthcare system
restructuring (College of Nurses of Ontario [CNO], 2015). Figure 2 shows RPN renewals and
employment from 1994 to 2015. There was a decreased trend from 1994 to 2005, resulting in a
14% loss of RPNs from the workforce. By 2010, the number of RPNs lost was recovered and has
increased to more than the number in 1994.
30000
50000
70000
90000
110000
130000
150000
1994
1995
1996
1997
1998
1999
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2001
2002
2003
2004
2005
2006
2007
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2014
2015
Cou
nt
Renewal Year
Total Possible Workforce Employed in Nursing
11
Figure 2. College of Nurses of Ontario RPN Renewals and Employment 1994-2015
Source: College of Nurses of Ontario (2015) Membership Statistics Report.
THE NEW SUPPLY: RNS AND RPNS IN ONTARIO
Each year the nursing workforce is augmented by NGNs, internationally educated nurses (IENs),
and nurses who re-enter the workforce. This report focuses on 2014 Ontario NGNs. The
following sections present information on the current supply of nurses from two sources:
enrolment and graduate data from the Ministry of Training, Colleges and Universities (MTCU)
and new member data from the CNO registration database.
In Ontario, the MTCU oversees community college and university education. It is
responsible for funding nurse education, with the exception of a few targeted areas (e.g., nurse
practitioner education and investments in clinical simulation equipment). It collects annual
enrolment and graduation data from colleges and universities in Ontario. In 2014, there were
3764 RN graduates and 3562 RPN graduates.
The number of new nurses graduating varies each year. Figure 3 shows the enrolment and
graduation of RNs in Ontario over a 15-year period. The sharp increase and subsequent decrease
05000
100001500020000250003000035000400004500050000
Cou
nt
Renewal YearTotal Possible Workforce Employed in Nursing
12
in the number of graduates between 2004 and 2005 reflects the implementation of the
baccalaureate degree as entry to practice in 2005 (Baumann et al., 2006a). Since 2005, however,
RN enrolment and graduation have increased. As shown in Figure 4, the enrolment and
graduation of RPNs in Ontario have also increased.
Figure 3. Enrolment and Graduation of Ontario RNs 1999-2014
Note. First year intake and graduation numbers are based on FT students entering the first year of the baccalaureate program (includes Second-Entry Programs but excludes post RN programs). Data are collected over a calendar year. 2001-2002 - Last intake of diploma programs; first intake for collaborative programs; first intake of compressed baccalaureate. 2004 - Graduates of last intake of diploma + compressed + PT and diploma and baccalaureate graduates (not collaborative). Source: Ministry of Training, Colleges and Universities (2014) unpublished raw data.
0
500
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3000
3500
4000
4500
5000
Coun
t
Calendar Year
Enrolment
Graduates
13
Figure 4. Enrolment and Graduation of Ontario RPNs 1998/1999-2013/2014
Note. RPN data are collected over an academic year. Source: Ministry of Training, Colleges and Universities (2014) unpublished raw data.
DATA ON NEW MEMBER NURSES
The CNO defines new members as "individuals who have registered with the College after
successfully meeting the requirements for registration as a nurse in Ontario" (CNO, 2014 p 2). In
its reporting on new members, the CNO differentiates nurses educated in Ontario from those
educated abroad or in other provinces. In 2014, there were 9285 new members registered with
the CNO: 4718 RNs and 4567 RPNs. Figure 5 shows the distribution of new members (RNs and
RPNs) by location of initial nursing education (CNO 2014).
Ontario NGNs represent the largest proportion of new members registering with the CNO
annually. In 2014, 84% of new member RNs and 76% of new member RPNs were Ontario
graduates (CNO, 2014). Graduates from other Canadian jurisdictions (6.8% of RNs and 1.9% of
0
500
1000
1500
2000
2500
3000
3500
4000
4500
Coun
t
Academic Year
Enrolment
Graduates
14
RPNs) and IENs (9.0% of RNs and 22.3% of RPNs) made up the remainder of the new member
category.
Figure 5. New Member RNs and RPNs by Location of Nursing Education 1996-2014
Source. College of Nurses of Ontario (2014) New Member in the General Class 2014 Report.
PROFILE OF HEALTHCARE EMPLOYMENT IN ONTARIO
The hospital sector is the main nursing employer in Ontario with 24/7 service and over 35,000
patient beds. There are approximately 1198 healthcare employer organizations in Ontario,
including approximately 155 (12.9%) hospitals, 630 (54.6%) long-term care (LTC) homes and
413 (35%) community organizations (MOHLTC, 2012b, 2016). The latter includes 101
0500
10001500200025003000350040004500
Cou
nt
Registration Year
RNs
Ontario
Rest of Canada
International
0
500
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4000
Cou
nt
Registration Year
RPNs
Ontario
Rest of Canada
International
15
Community Health Centres, 36 public health units, 14 Community Care Access Centres and 262
other organizations. According to the CNO (2015), there are currently 135,118 nurses (96,007
RNs and 39,111 RPNs) employed in nursing in Ontario.
HEALTH HUMAN RESOURCE PLANNING: NURSING STRATEGIES
The nursing labour market is sensitive to government investments and policy decisions. Starting
in 1999, in an attempt to reverse the attrition of nurses, the Ontario government led multiple
initiatives to increase the FT employment of nurses working in acute care hospitals and LTC
homes (MOHLTC, 2012a). Organizations were provided with base funding to support the hiring
of new nurses and the conversion of casual and PT nurses into FT staff.
Between 2004 and 2006, the government invested 30.4 million targeting NGNs
(MOHLTC, 2006b). An additional $17.7 million was invested in fiscal year 2004-2005, $12.7
million was invested in fiscal year 2005-2006 and $26.7 million was invested in fiscal year 2006-
2007 (MOHLTC, 2006a, 2008). The NGG was launched in 2007 with an initial investment of
$89 million (MOHLTC, 2007). The 2014-2015 investment was $84.6 million. Appendix C
provides further information on Ontario government investments.
NGG: INTEGRATING NEW GRADUATES INTO THE WORKFORCE
The MOHLTC offers employers funding to hire NGNs into temporary supernumerary FT
positions for up to six months (MOHLTC, 2014). The NGG uses an online employment portal,
the Nurses' Career Start Gateway, to link NGNs with employers who post available NGG
positions (HFO, 2013). Employers and NGNs must register on the portal to participate.
After a minimum period of 12 weeks but within 26 weeks, the MOHLTC expects
employers to transition NGNs into permanent FT positions (MOHLTC, 2014). Employers
commit to providing an additional six weeks of self-funded supernumerary FT employment for
16
NGNs if they are unable to bridge them into permanent FT positions within 26 weeks. The goals
of the NGG are as follows:
• Provide every NGN with the opportunity to obtain experience in nursing through FT
temporary positions.
• Promote the availability of permanent FT positions for NGNs.
• Enable matching between NGNs and employers.
• Create bridging positions for NGNs.
• Support Ontario NGNs as they transition to practice.
• Improve workforce integration of NGNs
• Facilitate recruitment in all sectors.
• Encourage employers to maximize availability of FT nursing positions.
• Increase the total supply of nurses by providing temporary FT employment opportunities to
nurses who choose to make Ontario their home.
EVALUATION OF THE NGG 2014-2015
AIM AND OBJECTIVES
The overall aim was to determine the impact of the NGG on the FT employment and transition to
work of NGNs in Ontario. The objectives were as follows:
• Identify demographics, employment status and employment status preferences of NGNs;
• Examine trends in NGN employment status over time;
• Describe stakeholder perceptions (i.e., employers, NGNs, mentors) of the NGG, including
barriers and facilitators to participation; and
• Analyze the effect of the extended orientation and mentorship component of the NGG on the
transition to work of NGNs.
17
METHODS
A mixed methods approach was used (Tashakkori & Teddlie, 2003). The use of quantitative and
qualitative methods to evaluate policy ensures that a study is well contextualized and policy
relevant (White, 2008). Table 1 outlines the methodologies and participants involved in the
study. There were four stakeholder groups: healthcare employers, NGNs, mentors and union
representatives.
Table 1. Summary of Methods Triangulation for Stakeholder Groups
Method Stakeholder Group
Online surveys (English and French) • NGN Evaluation of the NGG • Employer NGG Participant Survey • Union Representative Survey
Teleconference focus groups • NGG employers: acute care (large, medium, small, rural), long-term care, public health and community
Total 222(100) 175(100) 224(100) 230(100) 212(100) 214(100) 236(100) 219(100)
Note. All totals as of November 24, 2015. Source: Ministry of Health and Long-Term Care (2015) unpublished raw data.
20
On average, 18% of healthcare employers in Ontario have participated in the NGG since
2007. Table 4 shows participation by sector and over time. In 2014-2015, the acute care sector
(56%) was the highest user of the NGG, followed by LTC (14%) and the community (10%).
Table 4. Within Sector Employer Participation in the NGG 2007/2008-2014/2015
Sector and Participation
2007-2008
2008-2009
2009-2010
2010-2011
2011-2012
2012-2013
2013-2014
2014-2015
Acute Care NGG 97 (62.6)
91 (58.7)
106 (68.4)
104 (67.1)
96 (61.9)
103 (66.5)
97 (64.6)
87 (56.1)
non-NGG
58 (37.4)
64 (41.3)
49 (31.6)
51 (32.9)
59 (38.1)
52 (33.5)
58 (35.4)
68 (43.9)
Long-Term Care
NGG 87 (13.8)
64 (10.2)
86 (13.7)
99 (15.7)
94 (14.9)
82 (13.0)
94 (14.9)
89 (14.1)
non-NGG
543 (86.2)
566 (89.8)
544 (86.3)
531 (84.3)
536 (85.1)
548 (87.0)
536 (85.1)
541 (85.9)
Community/ Other
NGG 38 (9.2)
20 (4.8)
32 (7.7)
27 (6.5)
22 (5.3)
29 (7.0)
45 (10.9)
43 (10.4)
non-NGG
375 (90.8)
393 (95.2)
381 (92.3)
386 (93.5)
391 (94.7)
384 (93.0)
368 (89.1)
370 (89.6)
Total NGG 222 (18.5)
175 (14.6)
224 (18.7)
230 (19.2)
212 (17.7)
214 (17.9)
236 (19.7)
219 (18.3)
non-NGG
976 (81.5)
1023 (85.4)
974 (81.3)
968 (80.8)
986 (82.3)
984 (82.1)
962 (80.3)
979 (81.7)
Note. There are a total of 155 hospitals, 630 LTCs and 413 community organizations in Ontario.
SURVEY AND INTERVIEW SAMPLE
The survey sample included NGNs, employers, mentors and union representatives. Response
rates are provided in Table 5. Participation in the teleconference focus groups and interviews
included the following:
• Seven employer focus groups with 26 healthcare organizations from acute care (large,
medium, small and rural), LTC and community organizations
• Individual key informant interviews with 10 NGNs (7 RNs and 3 RPNs)
• Individual key informant interviews with six mentors
21
Table 5. Survey Response Rates
Survey Number of Surveys Sent
Number of Respondents
Response Rate
NGN survey (English and French)
4230 981 23%
Participating employer survey (English and French)
156 137 88%
Union representative survey (English)
400 46 12%
Note: The NGN survey and participating employer survey focus on 2014-2015, the union representative survey focuses on 2014-2015.
DEMOGRAPHIC CHARACTERISTICS OF SURVEY RESPONDENTS
The 2014-2015 survey data are discussed in the sections below. Comparisons are made with the
CNO registration database where appropriate.
New Graduate Nurses
A total of 463 RNs and 518 RPNs responded to the survey. The majority of RN (91.4%) and
RPN (85.8%) respondents were female (see Table 6). Three-quarters of the RNs (75.8%) and
half of the RPNs (51.0%) were under 30 years of age (see Table 7).
Table 6. New Graduate Nurse Respondents' Gender
Gender Registered Nurse Registered Practical
Nurse
Total
Female 415(91.4) 440(85.8) 855(88.4)
Male 39(8.6) 73(14.2) 112(11.6)
Total 454(100.0) 513(100.0) 967(100.0)
Note: Missing responses N=14.
22
Table 7. New Graduate Nurse Respondents' Age Distribution
Age Registered Nurse Registered Practical Nurse
Total
24 or under 213(46.4) 132(26.6) 345(35.4) 25 to 29 135(29.4) 126(24.4) 261(26.8) 30 to 34 54(12.8) 68(13.2) 122(12.5) 35 to 39 32(7.0) 85(16.5) 117(12.0) 40 or more 25(5.4) 105(20.3) 130(13.3) Total 459(100.0) 516(100.0) 975(100.0) Note: Missing responses N= 6. Table 8 shows the employment status of NGN respondents at the time of survey. A
higher percentage of RNs (83.0%) were employed in nursing positions compared to RPNs
(48.8%). Of those not employed in nursing, 94.9% of RNs and 98.5% of RPNs were seeking
employment in nursing.
Table 8. New Graduate Nurse Respondents' Employment Status
Status Registered Nurse Registered Practical Nurse
Total
Employed in nursing 382(83.0) 252(48.8) 634(65.0) Not employed in nursing 78(17.0) 264(51.2) 342(35.0) Seeking 74 260 334 Not seeking 5 3 8 Total 460(100.0) 516(100.0) 976(100.0) Note. Missing responses N=5. More than half (55.8%) of respondents reported employment in the hospital sector (see
Table 9). However, analysis by nurse category demonstrated that RNs were primarily employed
in the hospital sector (70.7%) and RPNs were primarily employed in LTC (43.4%). Across areas
of clinical practice, RNs were distributed more evenly than RPNs (see Table 10). The most
common areas for RNs were geriatrics (12.5%) and medicine (12.3%). The most common area
for RPNs was geriatric nursing (40.5%).
23
Table 9. New Graduate Nurse Respondents' Employment by Sector
Hospital 256(70.7) 82(33.6) 338(55.8) Long-Term Care 45(12.4) 106(43.4) 151(24.9) Community 50(13.8) 49(20.1) 99(16.3) Other 11(3.0) 7(2.9) 18(3.0) Total 362(100.0) 244(100.0) 606(100.0) Note: Missing responses N=28. Table 10. New Graduate Nurse Respondents' Employment by Practice Area
Area of Practice Registered Nurse Registered Practical Nurse
Note: Values show the percentage of nurses in each employment sector group within each combination of the categories of nurse type, NGG participation status and year of graduation.
29
EMPLOYMENT STATUS
The following section reports on NGN employment status according to participation in the NGG.
Nurses in the NGG category had matched to an employer and completed their NGG position at
the time of survey. Nurses in the non-NGG category did not match to an employer. The data
excludes those respondents who had matched to an employer and who were in an NGG position
at the time of survey.
Table 15 shows the overall distribution of employment status among survey respondents
split by nurse category and NGG participation. Since 2007, the number of NGG participants with
FT employment has exceeded the number of non-NGG participants with FT employment. Full-
time employment rates for participating RNs ranged from a high of 89.8% in 2007 to a low of
51.0% in 2010. Rates for non-participant RNs ranged from a high of 76.3% in 2008 to a low of
28.0% in 2014. Full-time employment rates for participating RPNs ranged from a high of 57.1%
in 2007 to a low of 25.0% in 2014. Rates for non-participant RPNs ranged from a high of 29.0%
in 2008 to a low of 10.7% in 2014.
30
Table 15. Employment Status of NGG and Non-NGG Nurses Across Nurse Groups 2007-2015.
Group Status 2007 2008 2009 2010 2011 2012 2013 2014
Note: Values show the percentage of nurses in each employment status group within each combination of the categories of nurse type, NGG participation status and year of graduation.
31
NEW GRADUATE PREFERENCE FOR FULL-TIME
The majority of NGNs prefer FT employment. However, more RNs (79%) preferred FT
employment compared to RPNs (54%) in 2014-2015 (see Figure 7). Note that preference data
were not collected during the 2007-2008 evaluation.
Figure 7. New Graduate Nurses' Preferences for Full-Time Employment 2008-2014
Note. Preference data calculated based on respondents who indicated they were not employed in their preferred employment status and those seeking employment.
COMPARISON TO CNO NEW MEMBER EMPLOYMENT DATA
Results from the NGN survey were compared to the CNO registration database of general class
new member RNs and RPNs. However, the comparisons do not represent similar points in time.
The CNO collects data at the end of a calendar for the following practice year, NGN
employment data are collected at a point-in time.
The CNO (2015) new member RN employment data are shown in Table 16. According to
CNO pre-policy (2005) data, 39% of new member RNs were employed in FT positions. In each
year following (2006-2015), the percentage of FT employment was significantly higher than the
pre-policy level. In 2015, FT employment for new member RNs was 47%, a 7% decrease
compared to the previous year.
0%10%20%30%40%50%60%70%80%90%
100%
2008 2009 2010 2011 2012 2013 2014
% P
refe
rring
FT
Year of Graduation
RN
RPN
32
Table 16. CNO RN New Member Working Status 2005-2015
Full-time 1700(39) 1116(47)* 1231(59)* 2294(76)* 2456(79)* 2236(71)* 1644(58)* 2010(61)* 2049(56)* 1667(54)* 1759(47)* Part-time 1947(44) 966(40)* 702(34)* 624(21)* 509(16)* 706(23)* 948(33)* 1041(32)* 1343(37)* 1164(38)* 1598(43) Casual 773(17) 318(13)* 158(8)* 114(4)* 133(4)* 196(6)* 254(9)* 245(7)* 287(8)* 228(8)* 351(9) Total 4420(100) 2400(100) 2091(100) 3032(100) 3098(100) 3138(100) 2846(100) 3296(100) 3679(100) 3059(100) 3708(100) †First cohort of NGG new member RNs. *Statistically significant at p<.05 level based on chi-square. All testing in reference to 2005 pre-policy survey employment data. Source: Baumann et al. (2013); College of Nurses of Ontario (2015).
For new member RPNs, pre-policy employment data (2007) showed 24% were employed in FT positions (see Table 17). For
the years 2008 to 2013, there was a significant increase in the percentage of FT employment compared to the pre-policy level. In 2014
and 2015, no differences were found regarding FT employment for new member RPNs. In 2015, 25% of new member RPNs reported
working FT, a 1% decrease compared to the previous year.
Table 17. CNO RPN New Member Working Status 2005-2015
†First NGG cohort of new member RPNs. *Statistically significant at p<.05 level based on chi-square. All testing in reference to 2005 pre-policy survey employment data. Source: Baumann et al. (2013); College of Nurses of Ontario (2015).