B.C. nurse-patient ratios unveiled as gov’t announces signing bonuses

The province is taking steps to recruit more nurses. It is offering signing bonuses -- up to $30,000 -- to attract and retain more medical professionals.

As B.C.’s health-care system continues to face staffing challenges, the government says it’s making good on a deal it reached with the BC Nurses Union’ last year around nurse-to-patient ratios.

The ratios will determine the maximum number of patients for each nurse on shift.

The province says the new staffing model will be the “first of its kind in Canada,” and will allow nurses to spend more time with patients.

“Most importantly, ratios will ensure that nurses have the ability to adequately care for their patients, their residents, and their clients,” said BC Nurses’ Union President Adriane Gear.

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“Ratios reduce length of stay in hospital settings, ratios reduce readmission rates, and ratios improve the overall patient experience for the nurses that I represent. Minimum nurse-patient ratios will result in better retention and recruitment of nurses, and returning nurses to the profession. Why? Because ratios offer … a quality work environment, improved jobs, job satisfaction, and a significant reduction in occupational health and injury.”

In an update Friday, Health Minister Adrian Dix said these kind of ratios have been shown to improve experiences and “save lives” in places like Australia and California.

He says putting the ratios together required time to “sit down and work through and get this right.”

“When you’re first with something, you got a lot of work to do. And we were not going to impose our vision of this. We were going to work with the BCNU to see that it happen. That will make it stronger. You see that it’s associated with significant measures, which are largely in terms of the incentives and the support and, especially, for rural nurses but nurses everywhere, that are going to come in place on April the first. So we did the work required with the BC Nurses’ Union to see that this is successful, and I think we’re there and I think it’s great news,” Dix told reporters.

The ratios, he explains, will allow for a higher standard of care, resulting in the best possible outcomes for patients.

For hospital-based care settings, the nurse-to-patient ratios will be as follows:

  • General medical/surgical inpatient: 1:4 at all times
  • Rehabilitation: 1:5 day/evening, 1:7 night
  • Palliative: 1:3 at all times
  • Focused (special) care: 1:3 at all times
  • High acuity/step down: 1:2 at all times
  • Intensive care: 1:1 at all times

No specific date was provided for implementation. However, the province says an update would come in June.

The B.C. government says it plans to support these ratios by investing $237.6 million in retention, recruitment, and training of nurses. The money is part of funding announced in April 2023.

“The program’s either in place now or will be starting April 1. So, the work we’re going to do to recruit nurses, that’s starting now. There’s not a specific moment, but we expect progress, and you can bet the BCNU expects progress, I expect progress. I think we’re going to start to see a difference certainly by the fall of 2024. Fall of this year, we’ll see some significant difference here,” the health minister said.

“There are places where the ratios we have in place reflect the situation now. So there, you’ll see a maintenance, the continuation there, but in the places where it doesn’t, you’ll start to see a difference and we expect to see a difference by this fall. Then that difference will grow over time.”

He adds the province is “very confident” that its plans are “the right course of action,” and that “nurses from around the world and across the country are going to look at British Columbia and say, ‘want to work in nursing in a place where the government and the union are working together to make fundamental improvements to the workplace and lives of nurses.'”

Signing bonuses

To help bolster the number of health professionals in the system, the B.C. government is announcing signing bonuses for difficult-to-fill positions across the province.

“It’s not just enough to recruit nurses, we have to retain and support the nurses who are in place,” Dix said.

The province says eligible nurses could receive up to $15,000 for urban and metro positions, as of April 1, with a focus on nurses who are new to the B.C. health system, as well as nurses who may be returning to the system.

For positions in rural areas, bonuses could be up to $30,000.

“The reality is that our hardest to fill and most challenging positions are in rural and remote areas. That’s the reality. And there are other circumstances that make it more challenging. So we negotiate collective agreements with the BC Nurses’ Union and those have made significant improvements in the wages and working conditions of nurses in the last round of bargaining, in particular. I think it’s fair to say and that’s why it was approved by the government and by the union, because we wanted to do that. But it the situation in the north is unusual in a number of respects,” Dix explained.

Meanwhile, the BC United Party was not impressed, saying in a statement there are nearly 6,000 nursing vacancies in the province, adding, “B.C. has Canada’s longest walk-in clinic waits, one-in-five British Columbians lack a family doctor, and cancer care wait times are now the worst in the country. British Columbians have no confidence that NDP promises like we’ve seen today will ever be delivered upon.”

But Health Minister Adrian Dix says B.C. is doing better than other provinces, pointing to new data from the Canadian Institute of Health Information, which suggests from 2020 to 2022, B.C. was second among the provinces in total nursing workforce growth. However, he did acknowledge there is room for improvement.

“It is not enough to be better than Alberta or better than Manitoba,” Dix said. “What is important is making things better for patients and for nurses in every workplace in British Columbia.”

He says that’s why the new measures are being rolled out, adding British Columbians should start to see their impact by the fall.

With files from Monika Gul.

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