British Columbia is set to become the first province in Canada to enact prescribed patient-to-nurse ratios in the health-care system.
The provincial government has announced $750 million over the next three years to address a chronic, provincewide nursing shortage, which has resulted in “different standards, in different places in B.C.,” according to Health Minister Adrian Dix.
The new ratios will be one-to-one for critical care patients, one nurse for every two mental health patients, one-to-three for specialized care patients, and four-to-one for palliative care patients.
“The key part in what is happening is ensuring a standardization of care,” Dix said at the Tuesday announcement.
“These are changes that make British Columbia the number one place for nurses to be nurses.”
Ratios were a crucial piece of the new tentative agreement reached between the BC Nurses’ Union and provincial government last week. The three-year deal with the provincial Health Employers Association of B.C. includes “record-setting compensation” for B.C. nurses and mandatory ratios, according to the union.
A ratification vote is set to take place on April 20.
“We’re very pleased in the government’s investment in nurses to address the nursing staffing shortage, and this goes a long way,” said BCNU president Aman Grewal on Tuesday, adding that she expects some of the new changes will bring some nurses back into the system.
“The impacts of these nurse-patient ratios on the work environment, not only for the members but also for the public, is going to be instrumental.”
It was not immediately clear when the ratios would be in effect uniformly across the province, but Dix said the “first step” is ratification of the deal. A provincial executive steering committee with members from the union’s bargaining association and the Ministry of Health will oversee its implementation.
While B.C. is poised to become the first Canadian jurisdiction to enact nurse-patient ratios, such measures currently exist in Australia and in some American states, including California.
The standards announced Tuesday will be consistent across all health authorities, in all corners of the province. Patient care will not stop if a hospital or other health-care facility cannot meet the ratio, the province added, although it’s unclear what will happen for nurses in those situations.
“Implementation of a standard minimum ratio is a critical component to reduce nursing workloads, increase staff safety, improve nurse retention, and improve access to safe, quality nursing services, and improve patient care,” reads a statement from the B.C. Health Ministry.
Asked whether B.C. was confident it could hit the ratios, given international demand for nurses, Dix said cited previous success in recruiting nurses and increasing staff levels, and a renewed focus on nurse retention.
“We’re actually doing it. Last year, we saw an increase of 6.7 per cent in the number of registered nurses in B.C.,” he told Global News. “In terms of LPNs, for example, it went up 8.4 per cent in the past year, this is according to the Canadian Institute for Health Information.”
Dix said the province has opened up 604 new nurse training positions for 2023. The province and BCNU are also set to work on an international recruiting strategy to lure more front-line health-care workers to the province.
In January, the B.C. government announced it would waive roughly $3,700 in up-front application and assessment fees for internationally educated nurses in order to bolster staffing levels in an already strained health-care system.
It said it would make more than $4,000 in financial support available to cover application, assessment and eligible travel costs for nurses taking assessments in order to re-enter the workforce. Returning nurses, it added, would also be eligible for up to $10,000 in bursaries for any additional education required.
In November, the BCNU told Global News that some health-care facilities in the province are short-staffed by between 50 to 70 per cent. Working conditions and staffing shortages have been exacerbated by the COVID-19 pandemic, it added, and a recent outbreak of other respiratory viruses.
The new deal between the province and BCNU includes funding for career-laddering opportunities, allowing experienced nurses and health-care workers to remain in the system and advance their careers. It also creates a pot of cash for expanding mental health support for nurses who hit the ceiling of their existing benefits plan, and hardship supports for members who have exhausted employment insurance, long-term disability and other programs.
“At the moment, they only have $900 for psychological health support,” said Grewal.
“We welcome all of these additional funds and the investment that is being made in the health and wellbeing of our nurses, to the improvement of the work-life balance as well as the ability to provide the care to the citizens of B.C.”
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