Unbalanced: Health human resource planning, the labour market and social changes shaping the Nova Scotia Registered Nursing workforce

The average age of Registered Nurses (RNs) is increasing; mass retirement of older RNs represents a supply crisis. This crisis is widely attributed to 1990s fiscal cutbacks. Could alternate historical health human resource (HHR) policies could have produced a present day Nova Scotian RN workforce of approximately the same size but with a different age distribution?;A multi-method approach incorporated historical qualitative and empirical data and dynamic systems simulation of HHR policy scenarios. Results indicate that the different labour market experiences of each RN cohort from 1968-2007 are responsible for the crisis. Labour market fluctuations were due to distal societal changes, occurring in the absence of age sensitive HHR policies. Simulations demonstrated that age sensitive HHR policies in the 1980s could have ameliorated the present day supply crisis. Conversely, HHR policy intervention in the 1990s would only have delayed, but not averted, the pending RN shortage.