The real story behind compensation for Alberta nurses

Last week, the United Nurses of Alberta held information pickets in multiple communities throughout Alberta, including here in Lethbridge.

The union is in the process of negotiating with the province on a new collective agreement, and it made me curious what the track record of the 3 most recent provincial governments has been on the topic of nurses.

So, I combed through the last 10 annual reports on Alberta Health Services’ website and found the number of nurses employed by AHS each year, as well as how much AHS spent on salaries and benefits.

Each annual report has a schedule 2, a consolidated schedule of salaries and benefits. The schedule categorizes nurses into two groups: registered nurses, psychiatric nurses, and grad nurses in one and licenced practical nurses in the other. I’m refer to these 2 categories as “RNs” and “LPNs” for this article.

First, let’s look at the number of nurses in each category over the last decade:

Fiscal year	RNs	LPNs	Total
2009–2010	16,764.59	3,307.90	20,072.49
2010–2011	16,819.47	3,349.88	20,169.35
2011–2012	17,524.41	3,679.70	21,204.11
2012–2013	18,044.91	3,869.85	21,914.76
2013–2014	18,082.40	3,940.43	22,022.83
2014–2015	18,553.48	4,212.33	22,765.81
2015–2016	18,773.62	4,691.76	23,465.38
2016–2017	18,966.63	4,836.11	23,802.74
2017–2018	19,137.97	4,987.54	24,125.51
2018–2019	19,566.39	5,233.39	24,799.78
2019–2020	19,930.49	5,432.11	25,362.60

And here it is in graph form.

So, the good news is that Alberta has seen an increase in the total number of nurses every year during this period.

But let’s look at the numbers a bit more.

	RNs	LPNs	Total
2009–2010	16,764.59	3,307.90	20,072.49
2019–2020	19,930.49	5,432.11	25,362.60
Change	3,165.90	2,124.21	5,290.11
% change	18.88%	64.22%	26.36%
Average per year	316.6	212.4	529.0

Alberta saw just shy of 5,300 more nurses over that period, with an average increase of 529 per year. That’s a 26.36% increase overall, with LPNs making up the bulk of that increase, at 64.22%.

Now, let’s look at compensation.

AHS shows only how much they pay out in total for all nurses. The amounts I’m reporting include salaries and benefits.

Not only do we have more nurses now than 10 years ago, but we’re paying more collectively to them than we were 10 years ago, too.

	RNs	LPNs	Total
2009–2010	$1.825 billion	$0.236 billion	$2.062 billion
2019–2020	$2.594 billion	$0.485 billion	$3.079 billion
Change	$0.769 billion	$0.248 billion	$1.017 billion
% change	42.14%	104.99%	49.35%
Average per year	$76.9 million	$24.8 million	$101.7 million

So, AHS is paid out a little over $1 billion more in salaries and benefits to all these nurses last year than they did a decade earlier, increasing about $102 million a year.

And that $102 million a year sure sounds like a lot, especially when it adds up to over a billion after 10 years.

But, we need a bit of context. Because while $1 billion sounds like a lot, we have to remember that we also are paying an extra 5,300 nurses, too.

Let’s look at the compensation per nurse then. The table below shows the total compensation divided by the total number of nurses.

Fiscal year	Comp. per worker	Change	% change
2009–2010	$102,733.64	—	—
2010–2011	$103,245.42	$511.78	0.50%
2011–2012	$107,528.54	$4,283.12	4.15%
2012–2013	$112,236.82	$4,708.28	4.38%
2013–2014	$113,194.85	$958.03	0.85%
2014–2015	$118,453.59	$5,258.74	4.65%
2015–2016	$119,464.76	$1,011.17	0.85%
2016–2017	$121,216.09	$1,751.33	1.47%
2017–2018	$121,031.31	-$184.78	-0.15%
2018–2019	$121,353.82	$322.51	0.27%
2019–2020	$121,430.65	$76.83	0.06%

The average salary increased from $102,733.64 per nurse to $121,430.65 per nurse, an increase of $18,697.01, or about $1,900 a year.

Now keep in mind that this is an average, which can be misleading when it comes to wages and benefits. If there are a handful with unusually large compensation amounts, it can throw off the average, giving the impression that people are making more than they are. Median would be a better metric—with half of the wages being above that amount and half being below it—but the median wasn’t available.

For example, the Alberta Learning Information Service website says that the overall median wage for an RN is $46.38 an hour, which works out to around $96,500 a year for a 40-hour workweek. That’s just the base salary. It doesn’t include overtime, tips, benefits, bonuses, or any other type of compensation. But again, half of the nurses make less than that for their base salary.

The overall median wage for an LPN, according to ALIS, is $31.04 an hour, or about $65,000 for a base annual salary. ALIS doesn’t include historical amounts.

Now let’s look at the changes for all 3 metrics: nurses, compensation, and compensation per nurse.

Here we see that AHS hasn’t been that consistent in increasing the number of nurses it hires each year, with 3 of the 10 years being near or below only 100 nurses. According to AHS’s website, they operate 108 hospitals, which means in those 3 years, AHS basically hired enough new nurses that each hospital got one new nurse, on average.

The average increase is about 490 more nurses each year, but the numbers have been trending down since 2011–2012. In the first 3 years since that point, the average was 618 additional nurses per year. In the second 3 years, the average was 593 per year. In the final 3 years, the average was 520 per year.

So even though we hire new nurses every year, the number of new nurses keeps getting lower.

Same goes for compensation. Even though overall compensation paid out to all nurses by AHS has increased every year since 2009–2010, that increase has been getting smaller and smaller since 2012–2013.

And here is the change in average compensation per nurse.

During the first half, the average compensation per nurse wasn’t too bad, averaging a little more than $3,100 more per nurse per year, but getting as high as just under $5,300 per nurse.

The last half has been another story, however. The average over the final 5 years was just shy of $600 per nurse per year. That’s only $50 a month. And one of those years, AHS was paying out less per nurse than they were the previous year.

Now, let’s look at the percentage increase.

There isn’t much to show here, given that all 3 of the charts look the same as their sibling charts showing absolute figures. I do find it interesting that 6 of of the 10 years in the final chart saw an increase in compensation per nurse of less than 1% and 1 year, the increase was barely above 1%.

Next, I’d like to show you what population growth and inflation looked like.

If your population increases, then you should be spending more so that you are providing the same service for more people. And if inflation increases, then the price of delivering that service goes up (materials, logistics, contracting out, etc). Plus, if inflation increases, it also increases the cost of living for the nurses you’re paying.

And in table form:

Fiscal year	Population	Inflation	Combined
2009–10	1.75%	0.99%	2.74%
2010–11	1.41%	2.44%	3.85%
2011–12	1.88%	1.11%	2.99%
2012–13	2.49%	1.42%	3.91%
2013–14	2.79%	2.56%	5.35%
2014–15	2.14%	1.13%	3.27%
2015–16	1.31%	0.07%	1.38%
2016–17	1.15%	2.39%	3.54%
2017–18	1.21%	2.04%	3.25%
2018–19	1.45%	1.57%	3.02%
2019–20	1.65%	1.90%	3.55%

Now let’s compare the increases in the combined amount with the increases for compensation per nurse.

Fiscal year	Compensation per nurse	Population & inflation	Difference
2010–11	0.50%	3.85%	3.35%
2011–12	4.15%	2.99%	-1.16%
2012–13	4.38%	3.91%	-0.47%
2013–14	0.85%	5.35%	4.50%
2014–15	4.65%	3.27%	-1.38%
2015–16	0.85%	1.38%	0.53%
2016–17	1.47%	3.54%	2.07%
2017–18	-0.15%	3.25%	3.40%
2018–19	0.27%	3.02%	2.75%
2019–20	0.06%	3.55%	3.49%

What we see is that in every year but 3, the increase to the compensation per nurse was less than the combined increase to population and inflation. So, while AHS was paying more per nurse, on average, every year, most years that increase wasn’t enough to accommodate the increase to population and inflation.

And this isn’t just a UCP issue. This is a systemic, long-term issue.

Since we’re talking about parties, let’s look at the compensation per nurse again, but organize the years by the party who was in government at the time.

What we see is that AHS was paying more out in increases to salaries and benefits per nurse under the PCs than the NDP or the UCP. And while increases to compensation per nurse fell dramatically under the NDP, it wasn’t quite as low as the UCP.

Here’s the average increase per year under each party:

Party	Average increase ($)	Average increase (%)
PC	$3,143.99	2.90%
NDP	$725.06	0.61%
UCP	$76.83	0.06%

As you can tell, increases to average compensation per nurse under the PCs was way higher than under the NDP or UCP, but at the same time, the NDP increased compensation per nurse nearly 10 times as much as the UCP did in their first year. The data for the UCP’s second year still isn’t out.

Here’s what average increases to the number of RNs and LPNs look like under each party:

	RNs	LPNs
PC	1.68%	4.87%
NDP	1.34%	5.63%
UCP	1.86%	3.80%

It seems that the UCP had the highest average increase of RNs, but the lowest average increase of LPNs. Contrastingly, the NDP had the lowest increase in RNs and the highest increase in LPNs.

And the increase in total compensation paid under each party, on average, each year:

	RNs	LPNs
PC	5.46%	8.30%
NDP	2.18%	9.07%
UCP	1.97%	4.35%

In both cases, the UCP increased total compensation by the least amount. The PC increased compensation the most for RNs, and the NDP increased compensation the most for LPNs.

One thing is clear, nurse in Alberta have been getting the short end of the stick for years.

And let’s not forget that while Alberta nurses are paid “5.6% more than in other comparator provinces”—according to Travis Toews, the finance minister—Alberta workers make between 10% and 15% more than the workers in the 3 provinces larger than it is, plus over 11.5% more than Canadian workers in general.

If anything, Alberta nurses are underpaid. And have been for years.