Why are ER nurses leaving Ontario hospitals?

When fifteen ER nurses leave a single Ontario hospital, it is tempting to call it a staffing shortage and move on, but Ontario is registering nurses at a record pace, which makes the real question why the emergency department can’t keep them.

The Short Answer: Emergency nurses are leaving because the job has become hard to do safely, not because people stopped wanting to nurse. Admitted patients wait an average of 17 to 20 hours in Ontario emergency departments for a bed, 95% of nurses in a 2026 national survey faced violence or harassment at work, and support roles are being cut. Ontario has more nurses than ever, so this is a fixable retention problem.

On 24 September, The Globe and Mail reported that fifteen registered nurses have left the emergency department at Oakville Trafalgar Memorial Hospital, with others cutting their hours or not returning from leave. The Ontario Nurses’ Association, the union that represents them, points to burnout from an unsustainable workload and to frequent violence and abuse from patients, and the hospital, whose emergency department sees roughly 80,000 patients a year, is working to rebuild the team.

It would be easy to read this as one hospital having a bad year, and that would miss the point, because nearly everything in that story shows up in the provincial and national data, and most of it is a problem of system design rather than a problem with the people working inside it.

The emergency department has become the hospital’s waiting room

The heaviest load on emergency nurses often isn’t the people coming through the front door, it’s the people who have already been assessed and admitted and still have nowhere to go. Ontario Health’s public reporting shows that in January 2026, patients admitted through an Ontario emergency department spent an average of 20.3 hours there, against a provincial target of eight hours, and only 26% reached a bed upstairs within that target. Ontario Health figures reported in June were better, at an average of 17.2 hours, which is real improvement and still more than double the target.

Every one of those patients needs nursing care for the entire wait, in a space built for assessment and stabilization rather than an overnight stay. When the Ontario Medical Association surveyed 288 emergency physicians in June, about 15% of those practising in the province, 74% described overcrowding as severe or critical, and about three in four said emergency beds were taken up by patients waiting for admission on nearly every shift.

Why the beds upstairs are full

Admitted patients wait in the emergency department because the hospital is full, and the hospital is full partly because the rest of the system can’t take patients when they are ready to move on. People who no longer need an acute care bed but are waiting for long-term care, home care or rehabilitation stay where they are, and the patients behind them back up into emergency. Further upstream, about 5.9 million adults in Canada have no regular primary care provider, according to OurCare’s December 2025 findings, so problems a family doctor might catch early tend to arrive at emergency later and sicker.

That whole chain, from the missing family doctor to the full ward to the patient on a stretcher in the emergency department, ends with the emergency nurse, who is left holding all of it at once.

The job has also become unsafe

A national survey of 4,703 unionized nurses, conducted by Viewpoints Research for the Canadian Federation of Nurses Unions in early 2026, found that 95% had experienced some form of workplace violence or harassment in the past year, and 62% had experienced physical violence. Only 46% said they had reported incidents of violence, and one in three said they feared repercussions for reporting. In Ontario, accepted workplace insurance claims for violence across nursing occupations rose from 406 in 2012 to 1,190 in 2024, according to WSIB data compiled by the federation.

The same survey found that 57% of nurses are regularly responsible for more patients than they feel they can safely care for, 81% of hospital nurses say their workplace is regularly over capacity, and 35% of all respondents are considering leaving their current job or the nursing workforce within the next year. These are national figures from a survey commissioned by a union, and they match what the Oakville nurses’ union has described closely enough that the pattern is hard to dismiss.

Cutting support roles moves the work, it doesn’t remove it

According to the same reporting, the Oakville hospital eliminated its unit assistants earlier in September, the staff who transport patients, clean equipment and keep supplies stocked. Hospitals are under real budget pressure, and decisions like this are usually made to protect clinical positions, but the work doesn’t disappear when the role does. Someone still has to move the patient and restock the cart, and in an emergency department that someone is very often a registered nurse, which means fewer nursing hours at the bedside in the one department that can least afford to lose them.

It’s the same pattern we have written about with doctors, who lose an estimated 18.5 million hours a year to unnecessary administrative work, according to the Canadian Medical Association. Whenever highly trained clinicians spend their shifts on the jobs around the job, patients wait longer and the clinicians burn out faster.

The good news: Ontario isn’t running out of nurses

There’s a genuinely hopeful number in all of this. The College of Nurses of Ontario reports that 190,896 nurses renewed their registration in 2025, up 3.9% from the year before, with the register growing at what the College calls a record-breaking pace. Ontario is training and attracting nurses faster than it ever has, and that progress is worth protecting.

It also changes the diagnosis, because if the province has more nurses than ever and one emergency department can still lose fifteen of them, supply is only part of the problem. The rest is whether the job, in the places where the pressure is highest, is one a skilled person can keep doing for a whole career. In the federation’s survey, 66% of early-career nurses screened positive for burnout, compared with 30% of nurses late in their careers, so recruiting new nurses into a department that can’t keep the ones it has only fills a leaking bucket faster.

Both things are true

Canada’s emergency departments are staffed by some of the most skilled and committed people in the health system, and the public system they work in is worth protecting. Neither of those is the problem, which is a system design that sends every unsolved pressure downhill, from the missing family doctor to the full ward to the cut support role, until it lands on the emergency nurse. Fix the flow and protect the people, and the nurses we already have are far more likely to stay.

What we’d change

1. Get admitted patients out of emergency within the eight-hour target, by building the long-term care, home care and rehabilitation capacity that frees up beds upstairs.
2. Protect the support roles, such as unit assistants, porters and clerks, that let nurses do nursing, and count the nursing hours a cut will cost before making it.
3. Make emergency departments safe places to work, with visible security, violence prevention that is actually enforced, and reporting that never puts a nurse’s job at risk.

Have you waited in an emergency department this year? Healthcare needs to nurse our system to health!

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