Hundred of thousands of patients in Northern B.C. are facing safety risks due to a lack of nurses in the region, B.C. Auditor General Carol Bellringer has found.

Bellringer's office focused on the recruitment and retention of registered nurses and nurse practioners in rural and remote parts of the Northern Health Authority, which spans from just south of Quesnel to the B.C.-Yukon border.

Bellringer said, with the exception of Prince George, every part of the region is considered either rural or remote.

Every community in Northern B.C. aside from Prince George is considered rural and remote under the Minstry of Health's definitions. (Office of the Auditor General of B.C.)

As of April 2017, 15 per cent of registered nurse positions and more than 25 per cent of nurse practitioner positions were vacant in the health authority's rural and remote locations.

Bellringer warned the lack of staff could contribute to patient safety risks, burnout among existing nursing staff and higher costs to the health care system overall due to paid overtime and hiring nurses from outside agencies at higher costs.

Patient safety

The report said it found multiple instances of nurses unable to monitor patients adequately — to check on medications and to ensure equipment is operating properly.

It also found nurses in Northern B.C. often worked longer hours than in other parts of the province, leading to decreased ability to function and a higher risk of making an error.

Patients sometimes have to wait weeks to get appointments, and often face rescheduling and delays, the report says.

Bad management discouraging nurses

The report said there are many factors beyond Northern Health's control leading to the shortage, including people being unwilling to live in isolated communities or colder climates.

However, it also found a number of factors within Northern Health's control that could lead to more effective recruitment and retention of nurses.

"[Registered nurses] described cases where they chose one community over another because the hiring manager was quick and attentive throughout the recruitment process," the report reads.

"They also told us about RNs [registered nurses] who left due to poor management."

David Williams, manager of human resources for Northern Health, said he recognizes the importance of strong hiring managers, and that the organization is interested in training managers to be more supportive of their staff.

Training needed in northeastern B.C.

The report also pointed out that there is no registered nurse program in place in northeastern B.C., despite a significant shortage of nurses in the region.

"A low supply of local [registered nurses] is correlated with low numbers of [registered nurses] at nearby hospitals," the report said.

The city of Fort St. John has been discussing the need for a nursing school in the region, as students now have to travel to either Prince George or Grande Prairie, Alta. to receive training as a registered nurse.

Though the auditor general found Northern Health was engaged in some good practices for recruiting people from northern communities to become medical professionals, the report said there was not enough focus on nurses specifically, and there was no effective monitoring of recruitment and retention efforts.

The report also recommended that Northern Health work with local governments and the province to improve affordable housing options in rural and remote communities.

The full report is available from the auditor general's website.