Nursing Job Stability in Ontario: Comparing Long-Term-Care Homes with Other Health Care Sectors

Claims of high turnover, reflecting worker dissatisfaction, in the long-term-care home (LTCH) sector have been common during the coronavirus disease 2019 pandemic. Using a census of registered nurses (RNs) and registered practical nurses (RPNs) in Ontario from 2014 to 2020, we compare LTCHs and other health care sectors in terms of (a) worker and job characteristics and (b) job turnover (distinct from occupational turnover). RNs in LTCHs are older, have lower levels of education, and are more likely to be trained outside of Canada compared with the provincial average, whereas RPNs are more similar to that norm. LTCH jobs are more likely to be rural and to involve casual contracts and irregular hours than those in most, but not all, sectors. Pre-pandemic, RNs in LTCHs were in the middle of the sectoral turnover distribution, whereas RPNs were lower than all sectors except hospitals. Among nurses who changed jobs, LTCH sectoral retention was similar to that in other sectors. Overall, turnover measures do not suggest lower job satisfaction in LTCHs than other sectors. During the first year of the pandemic, small changes in turnover were observed, but it is difficult to disentangle pandemic restrictions on holding multiple jobs from other causes.