Across Ontario and Canada, we can recognize that our systems need more healthcare professionals, especially primary care and specialty providers like Nurse Practitioners (NPs) and physicians.
This is important, and should continue to be something we work towards. A question that my peers and I have been asking is: how can we make the healthcare professionals we already have stay – and more specifically, how can we prevent burnout before it is visible?
A very common experience for many healthcare professionals, we often talk about burnout once someone is already at their breaking point, or making noticeable changes in their schedule, workplace environment, and personal life.
The usual response is to ask what support could have helped that person manage better, but we should all evolve our thinking to ask what was happening around them before they reached that point.
For NPs, that means we should be looking at their workload, patient roster, role stability, whether there have been jobs cut around them, appropriate remuneration, administrative demand, and much more.
Burnout is Not an Individual Failure or a Lack of Resilience
NPs are used to carrying significant responsibility – they diagnose, prescribe, manage complex chronic conditions, coordinate care, support families, lead teams, mentor colleagues, and often take on substantial administrative work that happens outside the “traditional” view of the work NPs do. But there is a difference between demanding work that carries responsibility and work that becomes impossible to sustain.
Recent Canadian research offers a useful window into what is driving that pressure. In a 2025 study published in the Canadian Nurse Practitioner Journal, Dr. Heale spoke with NPs from four Canadian provinces about their experiences with burnout. What they described went well beyond being busy or having a difficult day at work. NPs spoke about feeling that their professional contribution was undervalued, not having enough autonomy in their roles, and dealing with organizational and system pressures that made their work harder to sustain.
These results ought to change our perspective on who is responsible for burnout. We cannot expect individual NPs to become more resilient while ignoring the circumstances that are causing that pressure.
When a Position Disappears, the Work Does Not
This becomes especially clear when healthcare positions are reduced or eliminated. A position may disappear from a budget, but the need for care does not disappear with it. Patients still require follow-up, test results still need to be reviewed, prescriptions still need to be managed, chronic conditions still need monitoring, and families still need answers. When a role is removed, that work has to go somewhere, and in many cases it is absorbed by the healthcare professionals who remain.
I have heard from many of you that your workplaces are making cuts to NP positions, and it does not go unnoticed.
For an already overloaded workplace, the implications can go far beyond the loss of a single position. Remaining clinicians may be assigned more patients, administrative obligations, and follow-up work while maintaining their current caseloads. Over time, responsibilities become higher, and the flexibility that allows people to deal with extremely stressful moments begins to fade.
Burnout is frequently caused by an accumulation of events rather than a single dramatic incident. Over time, what began as a temporary solution might become the norm, with the system increasingly reliant on healthcare professionals to absorb stresses that were never intended to be permanent.
Funding Shapes Working Conditions
Funding is part of this conversation too, but not only because it determines whether a position exists. Funding shapes the conditions around that position. It affects whether organizations can plan beyond the next budget cycle, replace departing staff, provide administrative support, and match growing patient needs with growing capacity.
We need to be thoughtful about what we mean when we say an NP position is “funded”. Employee and self-employed funding options are both warranted, but funding a position alone does not make the role sustainable. NPs also need appropriate administrative and clinical support, realistic workloads, fair remuneration, time for non-clinical responsibilities, mentorship, and access to the resources required to care for increasingly complex patients.
The Canadian Federation of Nurses Unions’ 2026 Pressure Points by Dr Zeigler study found that 37% of NPs surveyed intended to leave their current position, while 41% were dissatisfied with
the combination of salary, paid time off, and benefits. Expanding access only works if we retain the NPs already providing care, which means addressing the cumulative pressures of growing caseloads, administrative demands, and uncertainty around staffing and funding.
Burnout Prevention Has to Start Earlier
Wellness supports have an important place in healthcare workplaces. NPs should have access to mental health resources, peer support, flexibility, and environments where it is acceptable to ask for help. But those supports should not be mistaken for solutions to the structural pressures that contribute to burnout in the first place.
Ontario is rightly focused on improving access to care and strengthening the healthcare workforce. That effort must also include making sure the roles we create are properly supported, sustainably funded, and designed so healthcare professionals can realistically remain in them over the long term.
If we only respond once someone is already burned out, we have missed the most important opportunity. That is where collective advocacy matters. When NPs speak about what they are experiencing, and when patients speak about what NP care has meant to them, those stories help make visible what can otherwise be reduced to staffing numbers and budget lines.
