'Insult to injury': B.C. Nurses Union calls out professional college over fee increase

As their union negotiates with the provincial government on a new contract, B.C. nurses are also pleading with their professional college to reconsider a significant hike in registration fees.

The board of the B.C. College of Nurses and Midwives approved the college's fee schedule for 2023-24 last month, raising the cost of registration for each type of college member by at least 15 per cent.

Practicing registered nurses, for example, are expected to pay an additional $78.29, for a total of $600.24 for the year, which begins April 1. And that total doesn't include the cost of liability protection (which is required), or membership in a professional association (which is optional).

More than 6,000 people have signed an online petition against the college's fee increases, and the BC Nurses Union has also come out against them. 

In a bulletin sent to its members last week, the BCNU called the increase "extraordinary" and "staggering."

It also highlighted that fees have been increasing rapidly for years.

According to the union, registration fees for registered nurses and registered psychiatric nurses were $351.36 in 2015-16, meaning they've risen by nearly 71 per cent over the last eight years.

Registration fees for licensed practical nurses were even lower in 2015-16. They've more than doubled from $270 eight years ago to the same $600.24 RNs and RPNs must pay this year.

"The high cost of registration adds further strain to nurses already feeling overwhelmed, having worked critically short-staffed and under the extreme demands of a crumbling health-care system," the bulletin reads.

"This additional financial strain only adds insult to injury for nurses."

The bulletin also noted that BCNU president Aman Grewal has requested a meeting with the BCCNM board "to better understand the justification" for the increase, which the union says will generate an additional $4 million in revenue for the college.

COLLEGE RESPONDS

For its part, the BCCNM offers a variety of reasons for the fee increases on its website. 

"We understand that nurses and midwives may be frustrated that our fees are increasing this year, particularly when working in health care is so challenging," reads a section titled "Why are fees going up?" that is posted alongside the announcement of each fee increase.

The college lists the following seven factors it says made this year's increase necessary:

• Inflation
• Savings in reserve: Last year, the BCCNM used savings to cover costs and mitigate fee increases, but savings are now "running low."
• Cultural safety and humility: The BCCNM says it "upheld its commitment to making our health system more culturally safe for Indigenous clients, including the publication of a new practice standard and learning resources to support registrants."
• Pandemic costs: The BCCNM says there are increased costs associated with orders and directives from the provincial health officer.
• Government directives and requests: Costs have gone up because of "new legislation, initiatives, and revised nursing and midwifery regulations, including policy work regarding medical assistance in dying, medical aesthetics, and RN/RPN opioid agonist treatment (OAT) prescribing."
• More complex investigations and files: The BCCNM says it has seen an increase in complaints about college members, which has made its role enforcing professional standards more expensive.
• Amalgamation: The BCCNM says it "continues to transition policies, processes and IT systems to support the amalgamation of four colleges."

Asked for a response to the petition and the BCNU's concerns, a spokesperson for the college said in an emailed statement that the BCCNM always appreciates feedback from registrants and respects everyone's right to voice their opinion.

"Our senior leadership and board spent a great deal of time discussing this increase and did not make the decision to raise fees lightly," the statement reads, in part.

"We are very cognizant of the challenges facing nurses and midwives, and we are so grateful for their hard work and dedication during these unprecedented times."

The college also said it has received the BCNU's letter and "will be responding."

"We respect the union’s work of advocating for nurses and bargaining with the provincial government to ensure nurses receive appropriate compensation for their work, as well as improvements to their work environments," it said.