Newfoundland and Labrador has the oldest demographic in Canada, due in part to the outmigration of younger adults. As a result, the needs of the growing population requiring gerontological care is not being met with a similar influx of qualified care personnel, particularly nurses.
Although RNs are paid at parity with RNs working in acute care, it is harder to recruit and retain them in the long-term care (LTC) sector. In LTC, the average age of the province’s RNs is 48, compared to 42 in acute care. RNs working in this area need to broaden their scope of practice and take on stronger leadership roles, in part due to the increasing importance of LTC, and the expanding complexity and type of interventions it requires.
Recognizing these issues, the Newfoundland and Labrador Nurses’ Union, the Newfoundland and Labrador Department of Health and the Central Regional Health Authority (CRHA) proposed the adoption of an 80/20 RN staffing model, an idea developed by the University Health Network in Toronto. (Bournes and Ferguson-Paré, 2007) This model has been shown to enhance nurse satisfaction and respond to calls for patientcentered care.
Carmelite House (CH) was chosen as the implementation site for the project. The 64-bed LTC facility is located in Grand Falls-Windsor, a town of about 15,000 in the Newfoundland interior. The 80/20 staffing model at CH provided project participants with the opportunity to spend 80% of salaried time in patient care and 20% in various professional development activities such as distance-based learning and clinical skills training.