Fenómenos de geodinámica externa

There are four sources of data measuring the flow of RNs, RPNs, and LPNs across provincial borders but no readily available data on migration to other countries. Unfortunately, all of these sources have their drawbacks.

1. The census measures interprovincial flows broken down according to the occupation of the migrant but only if they are working in the destination province. These data, besides being somewhat out of date, do not include flows out of the country. And published data from the census are limited to the “health occupation” category which includes physicians and other health professionals as well as RNs/RPNs and LPNs.

2. The Saskatchewan Registered Nursing Association (SRNA) and the Registered Psychiatric Nursing Association of Saskatchewan (RPNAS) track interprovincial and international flows of RNs and RPNs by maintaining administrative records of requests for verification of registration. Besides the fact that they cover only RNs/RPNs registered in Saskatchewan or other provinces, these data may count persons who are thinking of leaving but do not actually do so. No

equivalent data are available for LPNs.

3. In 1994, the Canadian Institute for Health Information (CIHI) published RN/RPN data on the province of registration according to the province of education. This produces a reliable picture of long term migration patterns in the years leading up to 1994 but there have been no equivalent data since then that would bring the information up to date or indicate trends. No equivalent data are available for LPNs.

4. The graduate follow-up surveys conducted annually by SIAST measure short-term migration flows. The surveys are done six months after graduation so longer term migration patterns are not available from this source.

Origin or

destination province

Incoming to Sask

Outgoing

from Sask Net flow

1991 to 1996 East 750 825 (75) Alberta 530 1,155 (625) B.C. 235 820 (585) North 0 70 (70) Total 1,515 2,870 (1,355) 1995 to 1996 East 200 200 0 Alberta 270 225 45 B. C. 105 140 (35) North 20 10 10 Total 595 575 20

Source: Statistics Canada Census

Table 2.8 Inter-provincial Migrants Working

in the Health Occupations

(2,000) 0 2,000 4,000 6,000 Atlantic Quebec Ontario Manitoba Sask Alberta B.C. North

Figure 2.17 Net Flow among Persons Employed

in Health Occupations, 1991 to 1996

Census Migration Data

As part of the census, Statistics Canada records changes in the province of residence from the previous census and from the previous year. These data can be combined with the respondent’s current occupation to determine what proportion of those living in other provinces (and working in health

occupations in 1996) lived in Saskatchewan in 1991 or 1995. Conversely, the number of those working in health occupations in Saskatchewan in 1996 who lived in another province in 1991 or 1995 can be measured. Table 2.8 summarizes the results; more detail on interprovincial flows are available in Appendix 2.

From 1991 to 1996, there was a net flow from all of the provinces westward and northward and Saskatchewan was no exception. Over the five years, Saskatchewan lost 625 health workers to Alberta and 585 to B.C. The net outflow over the period averaged 270 persons per year. Flows to and from Saskatchewan to points East of the

province were relatively minor and in balance with flows into the province (see Figure 2.17).

Between 1995 and 1996, however,

Saskatchewan was a net recipient of health workers. The main conclusion that can be drawn is that the outflow from 1991 to 1996 was more pronounced in the early part of that five-year period and had, in fact, reversed by the last of those five years.

No conclusions can be drawn about the nursing component of these flows except to note that RNs/RPNs made up 36% of the health occupations in 1996.

Incoming to Sask

Outgoing

from Sask Net flow

1988 124 544 (420) 1989 129 607 (478) 1990 140 553 (413) 1991 141 569 (428) 1992 98 461 (363) 1993 82 444 (362) 1994 93 371 (278) 1995 126 315 (189) 1996 78 345 (267) 1997 112 350 (238) 1998 165 353 (188)

Source: SRNA Annual Reports

Table 2.9 Inter-provincial Registration Data, Saskatchewan Registered Nursing Association 0 100 200 300 400 500 600 700 1988 90 92 94 96 1998 Out migration In migration

Figure 2.18 In and Out Migration Figures from SRNA Registrations

SRNA Migration Data

The Saskatchewan Registered Nurses Association keeps track of the number of persons who are registered in other provinces and come to work in Saskatchewan. They also keep track of the number of requests from other provinces to verify registrations for

Saskatchewan nurses. These data, from SRNA annual reports, are shown in Table 2.9 and Figure 2.18.

The out-migration numbers may include persons who are thinking of leaving but do not actually do so.

The pattern confirms the observations from the other data sources, namely a decreasing rate of out-migration since the early 1990s. There is also evidence of an upward trend for in- migration since 1996.

Incoming to Sask

Outgoing

from Sask Net flow

1993 3 22 (19) 1994 4 17 (13) 1995 7 18 (11) 1996 1 18 (17) 1997 4 9 (5) 1998 3 4 (1)

Source: RPNAS Annual reports

Table 2.10 Inter-provincial Registration Data, Registered Psychiatric Nurses Association of Saskatchewan

RPNAS Migration Data

Although the absolute numbers are much smaller, the reciprocity data from the RPNAS shows a similar pattern. Out migration was higher in the early 1990s and is on a downward trend whereas in-migration is lower and relatively stable (see Table 2.10).

Those who are leaving Saskatchewan are not particularly inclined to be going to Alberta. Of the 88 verifications requested by other

associations over the last six years, 29 were from Alberta, 24 were from Manitoba, and 35 were from British Columbia.

Alta 18% BC 12% Man 3% Ont 4% Other 2% Sask 61%

Total number of graduates registered = 11,727

Figure 2.19 Where Saskatchewan Graduates

were Working in 1994 (among those registered as RNs) Sask 81% Other 1% Ont 3% BC 1% Man 5% Alta 6% Foreign 3%

Total number of registered RNs = 9,047

Figure 2.20 Where RNs working in

Saskatchewan Received their Initial Education

CIHI Migration Rates

By comparing the province of registration in 1994 with the province of graduation, the 1994 CIHI report measured the long-term effect of migration. In effect, we are measuring where RNs who were still registered in 1994 received their initial education. (More detail on these data are contained in Appendix 3.)

Given Saskatchewan’s history of out-migration, it is no surprise that we have exported a

significant number of RNs. In fact, 11,727 Saskatchewan graduates were working as RNs in 1994 whereas there were only 9,047 registered RNs working in Saskatchewan. Up to 1994, we had exported, on a net basis, 2,700 RNs. The most common destinations were Alberta and British Columbia (see Figure 2.19).

Saskatchewan also employs RNs who received their education in other provinces. Of the 9,047 RNs working in nursing in 1994, 81% received their initial education in Saskatchewan. The next most common province was Alberta with 6% (see Figure 2.20).

These figures confirm the earlier observations that Alberta and British Columbia are the main destinations for Saskatchewan RNs who migrate to other provinces. The data do not, however, shed any light on recent trends in out-migration.

0% 5% 10% 15% 20% 25% 30% 1988 1990 1992 1994 1996 1998* RNs/RPNs LPNs

* 1998 data are preliminary

Figure 2.21 Proportion of Graduates Working

in Training Related Employment Working Outside the Province

Graduate Follow-up Surveys

SIAST has conducted graduate follow-up surveys for all of its programs for a number of years and these can be used to measure short-term migration patterns. Because we are measuring the

graduate’s situation six months after graduation, this is effectively a measure of out-migration immediately following graduation.

Figure 2.20 summarizes the results of these surveys for graduates of the RN/RPN programs and for the LPN program. More detail is provided in Appendix 5.

The pattern of out-migration in these data support the information from the previous sources. Among those who found training- related employment, the proportion working outside the province:

Y is generally higher for RNs/RPNs than it is for LPNs; and

Y has been on a general downward trend over the last ten years.

0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988

Source: Statistics Canada

Out Migration In Migration

Figure 2.22 Interprovincial Migration, All Saskatchewan Residents, 1988 to 1998

Summary

Although there are no conclusive data sources that measure the extent of inter-provincial flows of RNs, RPNs, and LPNs, the information presented here does paint a consistent picture.

This picture can be summarized as follows:

• net out-migration has declined since the late 1980s and early 1990s; and

• the most common destinations for out-migrants are Alberta and, until recently, British Columbia.

This pattern is consistent with the patterns of inter-provincial migration seen for the province as a whole, namely high levels of net out-migration in the early 1990s and a decline since then (see Figure 2.22). And we also find Alberta and British Columbia being the most common destination for nursing staff moving out of the province, an observation that can also be made for the province as a whole.

In other words, the out-migration of nursing staff may be seen as just another aspect of