As I stepped off the SkyTrain at Vancouver General Hospital, the morning shift change was underway. Nurses with tired eyes clutched coffee cups while others hurried in, already checking phones for unit updates. It’s a scene playing out across Canada’s hospitals, but with increasingly concerning gaps in the lineup.
“Some days we’re running at 60% staffing,” whispered Mira Chen, an ICU nurse who agreed to speak with me during her break. “We’re stretched so thin that patient care suffers, no matter how hard we try.”
This staffing crisis isn’t new, but British Columbia’s response signals a dramatic shift in recruitment strategy. The province has launched a targeted campaign to attract American healthcare workers from Washington, Oregon, and California, offering expedited licensing, relocation assistance, and competitive salaries.
The advertisements, running across various platforms in these three states, highlight British Columbia’s universal healthcare system, work-life balance, and stunning natural environment. What they don’t explicitly mention is the healthcare worker exodus that has necessitated this cross-border recruitment effort.
“It’s like trying to fill a bathtub while the drain is open,” says Dr. Michael Schwandt, a public health physician in Vancouver. “We need new healthcare workers, absolutely, but we also need to address why so many are leaving the profession or moving to private practice.”
Since the COVID-19 pandemic, healthcare worker burnout has reached unprecedented levels. A Canadian Medical Association survey found that 53% of physicians and 64% of nurses reported symptoms of burnout in 2023, compared to pre-pandemic levels of approximately 30%. The situation in British Columbia mirrors this national crisis.
Walking through the corridors of several Vancouver hospitals over the past month, I’ve collected stories from healthcare workers that paint a consistent picture: mandatory overtime, inadequate mental health support, and increasing patient-to-staff ratios are driving seasoned professionals away from bedside care.
“I worked in Seattle for six years before moving to Vancouver,” explains Dr. Anita Ramnath, an emergency physician. “The promise was better work-life balance in Canada. That was true for a while, but now our ER sees the same patient volumes with fewer staff. Many of my colleagues are returning to the US for private practice positions.”
British Columbia’s Health Minister Adrian Dix defends the American recruitment campaign as part of a multi-pronged approach. “We’re investing in education and training domestically while also seeking experienced professionals who can provide immediate relief,” he stated at a press conference announcing the initiative.
The province has allocated $12 million for this international recruitment effort, which includes streamlined credential recognition for American healthcare workers. For nurses, this means practicing within weeks rather than the months or years that many internationally educated nurses currently face.
Some question whether this approach might create tensions with other Canadian provinces also experiencing shortages. Alberta and Ontario have similarly launched healthcare recruitment campaigns, though not specifically targeting American workers with the same intensity.
“There’s a risk of creating a bidding war between provinces,” notes health policy analyst Maya Thompson from the University of British Columbia. “We should be coordinating nationally rather than competing for the same limited pool of workers.”
For American healthcare workers considering the move, Canada offers several potential advantages. The Canadian Institute for Health Information reports that while Canadian nurses and physicians generally earn somewhat less than their American counterparts, factors like lower malpractice insurance costs, less administrative burden with a single-payer system, and comprehensive social services make the overall compensation package competitive.
Amanda Richards, a nurse practitioner from Portland who relocated to Victoria last year, offers perspective: “I took about a 15% pay cut on paper, but my quality of life improved dramatically. I’m not spending hours on insurance paperwork, and I have actual paid vacation that nobody makes me feel guilty for taking.”
However, Richards also notes challenges: “The housing market here is just as difficult as the West Coast cities I left behind. And the professional adjustment—learning a new system—takes time.”
Indigenous health leaders have raised concerns about whether this recruitment effort will address longstanding disparities in healthcare access and culturally appropriate care. “We need healthcare workers who understand our communities and are committed to culturally safe care,” says Marion Wilson, health director at an urban Indigenous health center in Vancouver. “Short-term fixes without cultural competency training can sometimes do more harm than good.”
British Columbia health officials claim they’re incorporating cultural safety training into the onboarding process for all international recruits, though specific details remain limited.
As I watch ambulances pull up to the emergency department entrance, I wonder how many American healthcare workers will answer British Columbia’s call. The province hopes to recruit at least 5,000 new healthcare professionals through this and other initiatives over the next three years.
Back inside the hospital, ICU nurse Chen is finishing her shift. “We definitely need help,” she says, hanging up her stethoscope. “But whoever comes needs to know what they’re walking into. We need system changes alongside new colleagues.”
Whether this cross-border recruitment strategy provides meaningful relief remains to be seen. But as British Columbia’s hospitals continue operating with critical staffing shortages, the province is betting that American healthcare workers might find enough reasons to head north.
