B.C. to become first province in Canada to mandate nurse-to-patient ratios

In what's being touted as a Canadian first, B.C. will introduce mandatory nurse-to-patient ratios throughout the province's health-care system.

The move was announced Tuesday by Premier David Eby and Health Minister Adrian Dix at a news conference releasing the details of a tentative collective agreement that will impact the province's 51,500 registered, psychiatric and licensed practical nurses.

"This new staffing model will transform the way people are cared for by nurses as they will spend more dedicated time with patients," Eby said.

The BC Nurses' Union said the announcement was a welcome one, noting standards for nurse-to-patient ratios is something it has long advocated for.

"BCNU has been calling for nurse-patient ratios for more than two decades and believes they increase quality of care and decrease patient mortality," said Jim Gould, the union's interim CEO.

Gould added the agreement represents "an unsurpassed and historical set of investments."

A timeline for implementation was not provided but ratios will be set for nurses in community-based practice, hospitals, and long-term care. 

In critical care settings, the proposed ratios are 1:1 for ventilated patients and 1:2 for non-ventilated patients. In mental health and high-acuity units, the ratio prosed is also 1:2. For other inpatient units and palliative care settings, the ratio is 1:4, and in rehab units it is 1:5. These ratios, the Health Ministry told CTV News are "proposed and subject to change."

Settings for which no ratio has yet been proposed include operating rooms, emergency departments, and outpatient clinics.

Dix was asked several times about when patients could expect to see changes. He didn't directly answer.

"The work is continuing but clearly assuming if this agreement is ratified this will give extraordinary momentum to those changes," he said.

BCNU president Aman Grewal said she and other members would be pressuring the government to act, noting it would take "some time."

"The hope is as our nurses who left the system -- either went casual or completely left the system -- when they see working conditions are improving...that they will want to come back to a profession that they love," she added.

Liberal healthcare critic Shirley Bond called the lack of specifics, frustrating.

"The announcement today has the potential to make a difference but until we see details and outcomes, I'm going to continue to be skeptical," she told reporters.

Acknowledging the significant and ongoing challenges recruiting and retaining health-care workers, the announcement says that efforts to find the number of nurses required to achieve these ratios will be ramped up nationally, and internationally – supported by $750 million in new funding over the next three years.

The union also said the hope is that these new standards will help attract workers to British Columbia.

"We believe today's announcement will encourage the levels of recruitment and retention necessary to significantly improve the current working conditions for nurses and quality of care for patients in this province," Grewal said in a media release

"Nurse-patient ratios will result in better patient outcomes, better working conditions for nurses and will have a positive impact on our nurse recruitment and retention strategies making B.C. the best place in North America to work as a nurse.”

Union members will vote on the tentative agreement later this month. 

The #BCNursesUnion says a new, transformative staffing model will drastically support nurses & improve patient care across the province. Read more here: https://t.co/LCSJjMvkZI pic.twitter.com/jahGrx6ULE

— BC Nurses’ Union (@BCNursesUnion) April 4, 2023