title: Alert--return of 1990s healthcare reform.
abstract: Remember the 1990s? In case you don't, there was a major recession and hospitals found themselves squeezed for funds. A movement called "healthcare reform" was instituted across Canada to reduce costs and balance budgets. Nurses bore the brunt of the so-called reforms, which resulted in * merging of hospitals and loss of nursing positions; * elimination of nurse managers' positions and expansion of the span of control of those who remained, so that they found themselves managing two to four units and responsible for 100 to 200 nurses; * elimination of RN positions and substitution of licensed practical nurses or non-regulated workers; * replacing full-time RN positions with part-time positions without fringe benefits; * absence of nursing positions for new graduates and nurses who had been displaced, driving them to seek employment in the United States (the majority did not return to Canada); * collapse of the applicant pool to schools of nursing, which took a decade to rebound to pre-reform days (the drop in graduates over several years during this period is in part responsible for the shortage of nurses today); * dramatic loss of job satisfaction by nurses, which has still not recovered; and * a prevalent sense that nurses were disposable and mattered little in the broad healthcare system.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Pringle
mesh_terms: D002017:Budgets / Q000639:trends; D002170:Canada; D002321:Career Choice; D003363:Cost Control / Q000191:economics / Q000639:trends; D057172:Economic Recession / Q000639:trends*; D005544:Forecasting; D018166:Health Care Reform / Q000191:economics* / Q000639:trends*; D006801:Humans; D009313:National Health Programs / Q000191:economics* / Q000639:trends*; D009718:Nurse Administrators / Q000191:economics* / Q000600:supply & distribution*; D009741:Nursing Staff, Hospital / Q000191:economics* / Q000600:supply & distribution*; D020415:Personnel Downsizing / Q000191:economics* / Q000639:trends*; D011787:Quality of Health Care / Q000191:economics / Q000639:trends; D013338:Students, Nursing / Q000706:statistics & numerical data