It's really hard to make sense of it all. Eleven years ago, Alberta's health regions were hiring nurses from all over the world. Oil and gas were selling at good prices and the economy was humming. Nine years ago, Alberta Health Services was created and local/regional control of health services was amalgamated into a centralized single organization. It was supposed to improve health care delivery by reducing duplication and providing economies of scale. But there are more layers of management than ever before. The people in the C-suite have no connection with the front-line provision of health care but they have total control of it. When the Alberta economy slumped at around the same time, a slump it hasn't recovered from yet, various methods for tightening the belt were developed. Hiring freezes have been instituted several times, dictated in large part by provincial budgets. The people making these decisions are looking through the wrong end of the telescope and think that just reducing the number of nurses in the system will save them money. But like I said, the work still has to be done. Population continues to increase, albeit somewhat less quickly than a decade ago, and people continue to need health care. The federal government has increased immigration with fewer checks and balances on who is admitted - a significant proportion of patients in our hospitals these days are immigrants who arrived in Canada with chronic, serious (expensive) health problems. On the balance sheet, overtime is a separate line item, so the folks who hold the purse strings pat themselves on the back that they instituted a hiring freeze and kept the number of employees static while they ignore the overtime bill in the $millions. They're also putting our tax-paying patients at risk by running the roster so lean... exhausted people don't always work to their peak ability, do they? But in some ways, they're correct. On-boarding costs aren't insignificant; there's a lot of paper work involved, as well as screening, interviewing, checking references and so on. It costs a lot of money to orient a new staff member, no matter what their discipline. Some models suggest it costs roughly $100K to get a new nurse to the point where they're actually useful. They can pay for about 1500 hours of overtime with that money. If you frame it like that, it starts to look reasonable.
Another factor that has to be mentioned is the number of nurses in Alberta whose partners have been laid off or just let go from their jobs in the oil and gas industry who are now working full time to support their families. I know several people who are in that situation. People who might otherwise have retired by now are still working because they have to. It's a multifactorial situation.