nurses and doctors in Nova Scotia

A story went by about a looming nurses shortage in Nova Scotia. 45% of the nurses in Nova Scotia are over age 50. which is basically right in the baby boom nurses coming to the end of their careers. Can anything be done about it. that is, could the supply or demographics of the nurses be changed meaningfully in the next few years.

while nurses demographic reflects that of the population, this problem has been made much worse than it could have been due to a terrible policy decision around a generation ago. for a century the hospitals in Nova Scotia had a 2 year nurses residence program where a person would emerge after the 2 years as a fully qualified nurse. in the early 1990s these 2 year hospital nurse programs were force shut by the provincial governments of the day in favor of 4 year university nursing programs.


what a disaster that decision was. so the time to become a nurse was then artificially doubled from 2 years to 4 for no reason. raising the barriers and cost to becoming a nurse chokes off the supply of new nurses. perhaps that was the intent a generation ago? also with the hospital residence scheme a person could finish with minimal debt. so it was a bizarre and nonsensical decision to shut down the 2 year programs. the correct move then and now was to shutter the 4 year university nursing programs and insist that in Nova Scotia it takes only 2 years to become a nurse.

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over with the doctors the Lacewood Medical Centre is closing. the owner said he has 20,000 patients and only three family doctors and was losing money. that was actually my clinic although luckily I was a rare visitor. will have to sign up somewhere else I guess. Dr. Power said he's lost Drs and was having trouble recruiting replacements.

let's take Dr. Power at his word that there's a general shortage of Drs in at least some situations. it's been documented about rural Drs certainly being a challenge to recruit. 

so maybe the thing with drs is the same as with nurses. if the time to become a nurse was artificially doubled by fiat from 2 years to 4, then maybe the same has also been true with drs. maybe the 8-12 years we've been told to become a doctor is also artificially inflated for political and certain special interests. if we know it actually takes 2 years to become a nurse then how much more intense should it be to become a doctor? offhand twice as hard sounds about right. so even if it was twice as much then it should be doable in 4 years to become a doctor right out of high school. even 5 years is 2.5 times as long. I wonder in "the past" how long it took to become a doctor.

if the time to qualify "good enough" doctors could be reduced to say 4-5 years direct out of high school then that would fix a lot of problems. the dr only has to be good enough to help grind a 20k patient caseload. writing standard prescriptions, routine situations and treatments, and managing well understood chronic conditions. and it's not like the current doctors are all that special. every day there's stories about misconduct and malpractice and drs being named on suicide notes (after being suspended earlier for misconduct), so I doubt these optimized track educated doctors would be materially worse.

The failure of the United States

Oh no another doom post on the United States. Everything there looked right. My fave was #13.

If the US eventually fails then my belief is the failure can be traced to two events around a century ago.

• the elected Senate
• introduction of the income tax

with the elected Senate then the house and the Senate are now aligned in their agenda. with the appointed Senate there was proper balance between the common sense of the common people, and the wisdom of the elites. when Senators were appointed by and answered to the governor then states rights were respected and there was a natural check on the spendthrift and expansionist house. with the elected Senate there becomes a natural alliance between the house and the senate with no counterbalance as they answer to the same constituents and pursue the same agenda which can be reckless and irresponsible


the income tax is the other key and related part of it. before federal income tax there was a natural financial boundary on what the federal government could do so it was limited to responsibilities enumerated in the constitution such as the common defence, and foreign embassies. the constitution was designed this way for a reason with prohibition on the taxation of individuals as a natural check and limit on the growth and expansionist tendencies of the federal government. alas after the income tax there was now vast revenue, and combined with an elected senate, the 10th amendment effectively went out the window decades ago. today the vast majority of the federal budget is spent on programs that have no constitutional basis to exist.

despite the enormous revenue generated by the income tax spendthrift congressmen and senators have of course grown spending and promises of spending even faster and now the result is catastrophic debt and unfunded liabilities

bought new car

I got a new car over the Christmas break. An expensive present to myself I guess. It was to replace my 2005 Honda Civic which was old with over 200,000 km and needed $2,000 of work from the mechanic's estimate.

It was new to me anyway a 2013 Nissan Sentra with only 19,000 km. Salesman said it was one owner coming off lease. It had some new type features such as 2 years and 40,000 km of full warranty left.

I got it at O'Regan's Green Light in Dartmouth. I bought from O'Regan's because they sponsored Dartmouth North baseball where my kids played.

It was a good buying experience. I identified some candidates in my budget range which was late model quality used with low mileage to replace the Honda. Their website was well designed to narrow the search. With a shortlist I booked an appointment and arrived for the test drives on a Saturday morning.

I drove the Sentra, a 2013 Ford Focus, and a 2012 Toyota Corolla. It was a close decision with the Corolla but I went with the Sentra as it was a year younger and had the best fuel economy.

I got dealer financing as there was a special where they offered either winter tires or a $500 gift card to the store of your choice if you use their financing. I went with the winter tires. So I'm all set there.

They threw in a welcome coupon for a free oil change and $10 off the next 4 oil changes. So I got my first minor service for free. With the coupons the cost of an oil change is the same as my regular garage so I'll be treating myself to dealer service for a little while at least. Maybe until the warranty wears off. will see.


The car is running well so far. The Civic ran well for 8 years and 205,000 km. I hope this vehicle can be as successful. One good thing is work from home starts next week so that will cut thousands of km a year and save a lot of wear and tear and hopefully extend the vehicle life.

happy new year

wow January 5th already. back to work tomorrow, ugh. still it's good to have a job to go to. much better to face back to work tomorrow than to have to face pounding the pavement.

on new years eve I didn't have the kids for the first time in a few years. they're getting older on me. I went down to the casino to fill in the time. kids in the next day so I didn't want to drink. it was fine there. the countdown passed and everyone went back to their slot machines and table games.

figured it would be busy so I just took the bus down. the city had a nice thing with free buses and extended service so you could stay till midnight and still get home. so that's what I did, caught the bus at 12:45 and home around 1:30. It was nearly a half hour wait for the bus. I was very happy when it rode up the hill to the stop. It was freezing cold out.

sitting on the bus I thought how nice it was to be out of the cold with a nice seat and a free ride nearly to my place. how glad I was that the service was extended and it did arrive after the half hour and I was able to catch the ride home.

most years I don't do resolutions and I don't really have any this year. I guess it's just to notice and appreciate the positive little things a bit more. like when a bus arrives from the cold. and having a warm place to return to. and a job to go to on Mondays. and being paid to stay home on vacation for a few weeks over Christmas.

there's a lot of unknowns heading into 2014 and this time next year stuff that isn't on the radar screen today may end up being important. so whatever happens will happen. I can just try to do the right things and appreciate the positive and good results will follow.

Nova Scotia demographic problems and solutions

In my previous post I discussed the severe problems and bleak future Nova Scotia faces due to a rapidly aging and shrinking population.

The greatest concern is the loss of 2,145 children from a group of 134,000. That's a horrible 1.6% lost in only the last year. If you project the 2,145 forward then in only about 62 years, around 3 generations, there will be no children left in Nova Scotia.

The loss can be attributed to children outmigrating from Nova Scotia with their parents among the 4,300 persons under age 65 who voluntarily left in the last year. Another problem is a low birth rate with more 14 year olds turning 15 than new babies being born.

The thing is, this youth group isn't the baby boomers or the children of baby boomers. So it's a distinct issue from that other major problem of the baby boom population aberration now aging and dying.

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So what to do about it? Well I did promise solutions in the title. I got thinking about it the last couple of days and I realized I've actually already offered some solutions here on this site in earlier posts. So here they are.

here's a youth strategy and some ideas to increase the birth rate

here's a plan to shake off the malaise and reinvigorate the population

probably the biggest reason young working people are leaving Nova Scotia and taking their children with them is the severe lack of stable high paying blue collar jobs. here's a plan to reverse that and reestablish industrial and trades employment

Farewell to Nova Scotia

I'd heard a while ago that Nova Scotia lost over 4,000 people in just the last year. I knew that was bad.

But it's more than bad. The base statscan data is just awful. The loss of 4,300 people leads the nation. There are also more deaths than births in Nova Scotia each year.

But it gets even worse if you look at it by age group. The -4,300 is much worse than it looks. As the senior 65+ age group gained 6,400. So among the non-seniors under age 65 Nova Scotia shed 10,700 persons.

Using the statscan age group breakdowns we can see that there are around 774,000 people under age 65 in Nova Scotia. That means the under 65 lost 1.4% in just the last year. This is horrible. Those feel like Detroit numbers.

Now some of the loss is older middle aged graduating into the 65+ group. So if we estimate the net 6,400 new seniors as coming from the previous 64 year olds then there's still the 4,300 who voluntarily left Nova Scotia. They voted themselves off the island. So 0.55%, or about 1 in 180 people under age 65 just chose to leave in the last year.

I don't have the data on how many 65+ seniors died in the last year vs how many 64s became seniors vs net seniors moving to or leaving Nova Scotia from other areas vs births and new people moving to Nova Scotia. I believe the estimate of 4,300 under 65s choosing to leave Nova Scotia is close.

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So Nova Scotia is in decline. Possibly terminal decline. I'm not going to speculate why in this post. I don't really have a strong theory. In the last generation the PC, Liberal and NDP have all elected solid majorities. So the voters have definitely been willing to make changes. The results just haven't been there. But again I said I wouldn't attempt to understand why Nova Scotia is going extinct.

This isn't a recent development. I remember back around the millennium 1999 there was a remarkable statistic published. From 1970-2000 the number of births in Nova Scotia declined every single year. That's incredible, not even once in that span was there an increase. Well of course if you play that out long enough then eventually there will be a year when the number of births finally declines to zero. And a few decades after that final child is born then you just go voluntarily extinct.

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Can it be turned around? Will Nova Scotia eventually find bottom and stabilize its population at some lower point? What would that point be 700,000, 500,000, 300,000? Again probably not to speculate on in this post. Right now it doesn't look good. As long as deaths outnumber births and people leaving outnumber people moving in then it won't stabilize, it will just eventually wind all the way down.