High workload and burn-out rates, long hours, wage inequity across sectors, and perceived inefficiencies in providing home care services are serious challenges to recruitment and retention of community nurses, concludes a recent study by the Nursing Health Services Research Unit at the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. These barriers were identified in the Sector Specific Components that Contribute to Positive Work Environments and Job Satisfaction For Nurses (SSC) study as contributing to a shortage of community nurses which could negatively impact the future care of their clients.

Study results suggest if the identified retention and recruitment challenges are not addressed by the time these nurses start retiring over the next 10 years, Ontario may find itself unable to meet the needs of clients in the community sector. With fewer nurses in this sector, patients who do not require hospitalization may have difficulty accessing and receiving nursing care in their homes. This could potentially further affect the health-care system because if home care is not available, system back-ups in acute care may occur since patients cannot be discharged. .

Various work environment concerns for nurses working in the community and public health sectors were identified in this study and require attention from nursing employers and policy makers. The following recommendations are based on the study findings:

• Review current competitive bidding processes and the organization of home care services in the Province of Ontario.
• Consider a targeted marketing campaign for high school students that profiles nurses working in all sectors.
• Increase exposure of nursing students to various sectors of employment as part of the undergraduate nursing curricula.
• Address the issue of wage inequity across sectors.
• Establish a system for determining
appropriate/manageable nurse workload in community nursing sectors.
• Fund further research to increase the understanding of the sector specific work environment concerns and contributors to job satisfaction for nurses.