The federal budget contained no significant funds to confront Canada's crisis-level nursing shortage – and that means Canadian patients in hospitals and long-term care will continue to face unnecessary danger every day. It might be helpful to look at this problem from a different perspective. When West Jet was hit with severe COVID-19 staffing shortages, they cancelled 15 per cent of their flights. Compare that to one hospital system in Ontario that had 22 per cent of its staff call in sick on a Monday morning but still tried to operate as usual. Our health system is essentially trying to fly all the planes, but with almost a quarter of the flight crew gone. These shortages pose a risk to patients and delay surgery, tests and treatment to the point that serious problems worsen.Nursing shortages and lack of nursing care put patients in danger. The most obvious example of that, of course, can be seen in the terrible toll COVID-19 took on long-term care residents, where many organizations are dedicated to operating as cheaply as possible. Too few regulated nurses oversee minimal staffs of overstretched patient care workers. This cost us dearly: long-term care residents accounted for 69 per cent of deaths during the first two waves of COVID-19, despite seniors representing 19 per cent of Canada's population.In acute care hospitals, harm occurred to patients in one of every 17 hospital stays. It's understood most harm reflects system failures – meaning most incidents result from a combination of factors, many beyond control of individual care providers. When you look at the types of injuries patients suffer, including infections, falls, pneumonia and pressure ulcers, you see conditions closely tied to good nursing care. So much of patient safety depends on the vigilance of nurses' eyes, noticing things like inflamed skin, confusion or shallow breathing. It's no surprise the 2016 report Measuring Patient Harm in Canadian Hospitals found the most common contributing factor in harmful incidents was “distractions or interruptions.” You don't have time to notice much when you're covering four extra patients – on top of the six you were assigned because there just aren't enough nurses available to work that day.We were already short of nurses when the pandemic began, then its demands drove many people out of the profession. Statistics Canada data show there were 10,575 job vacancies for registered nurses and registered psychiatric nurses in the fourth quarter of 2019. Two years later, the number had more than doubled to 22,955. Job vacancies for licensed practical nurses also soared, growing from 3,710 to 10,765. Overall, there has been a 133-per-cent increase in nursing vacancies.Yet the federal government did almost nothing in the budget (apart from expanding one program that encourages nurses and doctors to work in remote areas). Health care is a provincial responsibility, but there are things the federal government could do, such as setting up apprenticeship-style programs like the ones it already funds in the trades to enable nurses to “earn as they learn.”Another important action the federal government could lead would be a new national health human resources research and planning centre that would get health systems across the country to move beyond the idea that because nurses take an oath to care for their patients, they will never quit. Such a centre could develop policies and models of work that respect nurses' expertise, let them deliver care the way they are educated to do, and give them greater voice in planning. Those are all factors senior nurses have told us would help dissuade them from quitting or taking early retirement. Keeping our most experienced nurses on the job – managing care in the short term and ensuring transfer of knowledge to new nurses for years to come – is essential for both patients and the nursing profession to thrive. Provinces and territories could be offered funding to help them adopt recommended innovations.Canada's nursing shortage is the result of decades of decisions that have cut budgets for educating and hiring nurses. The pandemic laid bare the consequences of those decisions – and made them much worse. This situation is harming patients and needs a fully staffed emergency response.Linda Silas, President, Canadian Federation of Nurses UnionsMichael Villeneuve, retired CEO, Canadian Nurses Association