Recruiting qualified nurses is a constant priority for hospitals to ensure safe, high-quality care. But simply filling vacancies as they arise isn’t enough–recruitment must be strategic, and many hospitals are now turning to incentives to retain nurses in the long term. Offering financial incentives are one strategy being explored to attract top talent, reduce staffing shortages, and strengthen Canada’s healthcare system. 

Traditionally, signing bonuses have been more common in white-collar sectors, where competition for skilled talent is fierce. However, they are becoming increasingly widespread in healthcare, particularly as a way to recruit nurses in regions with critical shortages. These incentives offer nurses additional compensation for committing to work in high-need areas for a specified period. Across Canada, several programs offer such bonuses, including Northern Health in British Columbia, where nurses can receive up to $30,000 for two years of service, and the Nursing Recruitment Incentive Program in Prince Edward Island, which targets recent graduates.

As the vice-president of clinical services and chief nursing executive at Pembroke Regional Hospital (PRH) in Ontario, I’ve seen firsthand the profound impact of the nursing shortage. Our medium-sized acute care hospital, located 150 kilometres northwest of Ottawa, serves about 100,000 residents across Pembroke and the surrounding rural communities. In 2021, during a severe staffing crisis, PRH joined the Community Commitment Program for Nurses (CCPN), an initiative supported by the Ontario Ministry of Health. We turned to the program as the COVID-19 pandemic had significantly intensified our staffing challenges, including staff burnout, illness-related absences, and a surge of retirements. 

Staff shortages have a direct impact on patient care, often leading to insufficient nursing coverage for consecutive days. This puts immense pressure on both nurses and patients, as nurses are frequently required to take on additional shifts to fill the gaps. Proper staffing ensures that nurses have the time needed to follow protocols, deliver high-quality care, and facilitate smooth handovers between shifts.

In response, the CCPN program provides financial incentives to nurses who commit to working for two years in communities facing staffing shortages. To qualify, nurses must not have worked in Ontario for at least six months prior and must hold a registration certificate from the College of Nurses of Ontario (CNO). Through the program, we welcomed 21 new nurses over four years. However, the CCPN was only one part of a broader strategy to ensure adequate staffing and uphold high standards of patient care.

While the number of nurses registered with CNO increased in 2024 compared to the previous year, a significant shortage remains in our province. According to the Ontario Nurses Association (ONA), data from the Canadian Institute for Health Information (CIHI) shows that Ontario has the lowest registered nurse-to-population ratio in the country. In 2021, we turned to nursing agencies to fill some gaps, but this ultimately led to less consistency in care delivery. Consistent staffing is essential for staff to familiarize themselves with patients, the care setting, and policies—and to fully integrate into the team.

Recognizing these issues, Health Canada released a nursing retention toolkit in 2024 addressing factors contributing to nurse turnover, such as heavy workloads, burnout and stress. The toolkit highlights various financial incentives for nurses, including pay boosts for mentors, and those working nights and weekends. For instance, the British Columbia Nurses Union Job Sharing and Full-time Incentive Program offers higher hourly wages for less coveted shifts. These incentives aim to promote work-life balance, flexibility, and the development of nursing leadership.

Patients also feel the impact of staffing inconsistencies. Without a stable, cohesive team, patient care coverage fluctuates. This issue is compounded by the fact that, in recent years, patients have been arriving with more severe conditions and greater care needs—particularly in emergency departments and inpatient units. This trend is partly driven by a shortage of family doctors and gaps in preventive care, both of which face significant staffing challenges.

But signing bonuses can play a valuable role in gradually easing staffing shortages. Beyond improving workflow, they encourage nurses to relocate to new areas, including rural communities they may not have considered otherwise. With sufficient staffing, hospitals can also invest in robust mentorship programs that support the professional growth of newer nurses. Effective mentorship and structured onboarding not only fill vacancies but also integrate nurses into the team, boost their confidence, and promote long-term retention.

Since joining the initiative, the nurses hired through the program have strengthened the continuity of care and contributed to a more consistent workforce. Currently, 15 nurses are employed, with nine of those having completed the two-year commitment. However, seven participants did not complete the two-year commitment, showing that signing incentives alone are not a complete solution to our staffing challenges. 

To keep evolving, the eligibility criteria for programs like the CCPN should be less restrictive, as current rules exclude local nurses who may otherwise stay long-term. For example, to qualify, nurses must “not have been employed as a nurse in Ontario in the six months prior to being hired”.  The requirement can prevent local nurses–who are often deeply rooted in their communities and more likely to stay–from participating.  With the right support, these individuals can support long-term staffing stability.

Beyond financial incentives, we must also strengthen partnerships with universities and colleges–the true pipeline for the future nursing workforce. Introducing recent graduates and young nurses to new communities can expose them to opportunities they may not have previously considered. With the right support for community integration, their chances of staying increase significantly 

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Becoming a nurse is a long and demanding journey. Nurses work under intense, around-the-clock demands. Through hands-on care, education, and emotional support, they build meaningful relationships with both patients and their families.

We need these nurses–and we need them to stay. Since 2024, the CCPN grant program has helped us phase out agency hires, stabilizing our staff. But to meet the growing demands of healthcare, both our workforce and hiring processes must evolve. Signing bonuses like these attract talent to nursing and underserved communities, but they cannot be the only solution.

– As told to Rowan Flood