More nursing students not necessarily more nurses – Q & A with Dean of Nursing Linda Johnston on the increase in nursing seats

16 June 2023

As part of Ontario Health’s new plan for sustainable and accessible health care, an increase in seats for nursing schools has been rolled out across the province. The University of Toronto’s Lawrence Bloomberg Faculty of Nursing has received a total of 55 additional seats for students in its accelerated BScN program over the past two years.

However, as the health system continues to struggle under the strain of staffing related pressures, such as burnout and retention amid ongoing surges of seasonal illness not limited to COVID19, funding more nursing student spaces is not necessarily an easy solution or fix.

Profile of Linda Johnston

Linda Johnston, Dean of the Lawrence Bloomberg Faculty of Nursing, recently spoke about some of the challenges and opportunities that the increase in seats might have for educational nursing programs like Bloomberg Nursing’s BScN program at the Toronto Academic Health Sciences Network (TAHSN) Nursing Week event. 

Bloomberg Nursing’s Senior Communications Officer, Rebecca Biason spoke with Dean Johnston to get her take on what the increase in seats will mean for the BScN program in terms of education and practice, and what potential impact the increase might have on the nursing profession at large.

What do you feel is the motivation behind this increase in seats for nursing students?

In February 2023 the provincial government released Your Health: A Plan for Connected and Convenient Care with a focus on providing people with a better health care experience including a commitment to growing the health care workforce for years to come. In order to meet this need, the government is investing in nursing education expansion, which includes the increase in student seats. The hope is that an increase in supply of nurses entering the workforce will help meet the demand for nursing staff across health care sectors, including long term care.

Are there any challenges posed by this increase for nursing programs?

The rapid expansion of nursing programs requires a sufficient number of academically- prepared faculty, on-campus classroom capacity, availability of bursaries to support access to programs for students from equity deserving groups, increased staffing in registrarial and student support services, and most pressingly, availability of clinical placements and preceptors. Preceptors are instructors in clinical settings who provide nursing students with supervision, mentorship, and onsite education. They are a necessary component of nursing placement requirements; particularly as students complete their final placements and prepare for transition to the workforce as licensed professionals.

With demand for clinical placements already well beyond capacity we have to radically adjust the way we develop entry -to- practice competencies in our students, in addition to the traditional clinical practica.

An increased reliance on simulation learning is a likely necessity. Many academic programs, by force of necessity during the pandemic and lock out from clinical placement sites, had to provide alternative approaches to developing students’ clinical skills through simulation learning. This included both virtual and traditional in-person laboratory sessions.

The pressure on both clinical placement and preceptor availability is likely to be sustained for some time to come, and academic programs are going to have to invest further in the resources to support simulation learning.

Are there potential positive implications or opportunities from this increase in seats?

The increase in seats will mean more people have the opportunity to enter the Bloomberg Nursing program. As a highly competitive program, there has always been an increased demand for more seats, and so it is wonderful we will be able to welcome more nursing students to campus.

However, the increase in seats will likely not impact retention in the nursing workforce and will not generate the number of nurses needed to address the ongoing gaps in the work force.

What is needed, is a focus on creating sustainable and rewarding careers in nursing that result in functional nursing leadership.

For example, many chronic diseases, including most recently Long COVID, which impact our populations, can be effectively and safely managed by advanced practice nurses and nurse practitioners.

In addition to enhancing equity and access to care, these roles serve as tools to recruit and retain current and new cohorts of talent in the nursing profession.

Developing and maintaining budgets for nurses to pursue continuing professional development is another important tool in the arsenal that should be used to improve the nursing workforce. Often, CPD budgets for nurses-not physicians-are some of the first targets when cost cutting is on the agenda.  Funding for professional development is critical to sustaining, retaining and equipping the nursing workforce with the right skills to protect patient safety.

We have a lot of tools and ideas at our disposal, but we need to be willing to make those changes that go beyond adding more seats in programs.