B.C. announces new minimum nurse-to-patient ratios province-wide

The B.C. government is rolling out new minimum nurse-to-patient ratios after it says it already established a one-to-four balance at the majority of hospitals across the province.

Premier David Eby and Health Minister Adrian Dix made the announcement at a press event Wednesday for a new recruitment strategy and new mandates for staffing.

Also present was BC Nurses’ Union President Adriane Gear, who has been campaigning for the ratios, including at a massive rally in the streets of Vancouver in May.

“Nurses in B.C. do an incredible job taking care of us in our time of need — whether in the community, a hospital, or in a care home,” said Eby. “Setting a minimum nurse staffing standard means more time to deliver the life-saving care.”

Minister Dix broke down how the new ratios will be applied to the various units and departments.

“Ratios for emergency departments are unique and will be based on a calculation to determine the minimum number of nurses per shift. It’s expected that nurses will continue to support all areas of emergency as a highly qualified, dynamic team we know them to be,” said Dix.

The new ratios break down per department as follows:

• General emergency: one nurse to three patients (1:3)
• Short-stay observation: one nurse to four patients (1:4)
• Medical/surgical short stay: one nurse to four patients (1:4)
• Trauma: one nurse to one patient (1:1)
• Critical care: one nurse to one patient (1:1)
• Fast track: one nurse to four patients (1:4)
• NICU: 1:3 for Tier 3 sites, 1:2 for Tier 2 sites, use of historical average patient levels of care for Tiers 5 and 6 sites
• PACU: following the National Association of PeriAnestheisa Nurses of Canada (NAPAN) standards, two nurses to one patient, or one patient to two nurses (2:1 or 1:2)

In maternity departments, new ratios break down as follows:

• Antepartum: one nurse to three patients (1:3)
• Labour and delivery: one nurse to one patient (1:1 active; 2:1 birth)
• Postpartum: one nurse to three dyads (birth parent and newborn) 1:3
• One nurse to four birth parents only (1:4)
• Newborn care nursery: one nurse to three newborns (1:3)
• Operating Room (OR): two-and-a-half nurses to one patient (2.5:1)
• Alternative Level of Care: one nurse to seven patients (1:7). Alternate level of care is specific to patients assessed and awaiting placement for seniors’ long-term care or discharge to community services.

The province says implementing minimum nurse-to-patient ratios is critical to ensuring healthy and safe workplaces and supporting a stronger workplace culture.

In May, Gear suggested to CityNews that minimums would likely also improve nurse retention, thanks to better working conditions overall.

Dix says the province also recently launched an international recruitment campaign targeting and expanding incentives for internationally trained nurses starting in emergency departments.

The province says the full suite of minimum nurse-to-patient ratios, including the ones announced in March 2024, will be implemented over a four-year period, with the target of hiring more than 8,000 nurses.