Good morning. Wendy Cox in Vancouver today.
The British Columbia government has upped the ante in the cross-country challenge to recruit nurses by making working and compensation conditions so attractive, nurses far and wide – professionals in critical shortage in all provinces – would be unable to resist.
On Tuesday, B.C. announced nurse-to-patient ratios would be written into nurses’ collective agreements, the first such commitment of its kind in the country. In addition, the province will be providing $750-million in funding over three years – over and above wage increases – to ensure the targets are met.
Alberta has launched a visually gorgeous campaign aimed at attracting workers of all sorts to a province that touts high wages, low taxes, relatively affordable housing prices and spectacular scenery. In February, the province announced $15-million to train and support more internationally educated nurses. The plan includes bursaries and money to create 600 new seats for nurse bridging programs at Bow Valley College and Mount Royal University in Calgary and NorQuest College in Edmonton.
But British Columbia’s move to hardwire in nurse-to-patient ratios is meant to be a significant selling feature to lure more nurses into the province and entice the ones that are here to stay. As Andrea Woo writes today, the new model is being called “transformative” by the union.
“Usually nurses are trying to prioritize whose needs are the most at that time, so this will give that nurse that little bit of time that they can give extra care to those patients that they so deserve and that the nurses are always striving to provide,” said BC Nurses’ Union president Aman Grewal.
Proposed nurse-to-patient ratios, which are subject to change, include 1:1 for patients in ventilated critical care; 1:2 in non-ventilated critical care, high-dependency mental health, and high acuity; 1:3 in special care; 1:4 in inpatient and palliative care; and 1:5 in rehabilitation. Ratios are still being developed for other units, including operating rooms and emergency departments.
Exactly what this will mean for the number of nurses working in the province is unclear.
Although the health ministry released rough targets for the ratios under development, neither Health Minister Adrian Dix nor Ms. Grewal could say what the current nurse-to-patient ratios actually are in any of those categories. Minister Dix said staffing numbers have not been applied across facilities and health authorities in a standard way, so the baseline of what’s being improved upon is currently unknown.
Ms. Grewal said those numbers are being worked out, but in general, she said “because of the shortages, they are seeing increased numbers of patients so you could have one nurse to eight patients.”
How many nurses will need to be hired to meet the ratios is also unclear.
At the end of 2022, British Columbia had about 3,800 nursing vacancies, according to the most recent figures from Statistics Canada. Minister Dix said meeting the ratios will be about hours, not positions. This is, he said, because different authorities, from Statistics Canada to provincial health authorities, use different metrics to measure nursing positions.
“We’ll have goals to add hours,” he said.
What happens if the province fails to meet the nurse-to-patient ratios that are eventually included in collective agreements?
Minister Dix said only that the province will “ensure that all of the money committed goes into nursing. So it’s not a savings to government or able to put anywhere else.”
With nurses in demand across Canada, British Columbia is banking on a two-pronged strategy. One is to increase the number of nurses available by training more of them and smoothing the path for foreign-trained nurses to work here. Other provinces are doing the same.
The second gambit, though, is the hope that a collective agreement that gives nurses a heavy say in what their working conditions look like – the more nurses hired, the lighter the workload – will make B.C. the contender to beat in the competition among provinces to attract the workforce currently available.
The details – and the actual costs – will get worked out later.
This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief Mark Iype. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.
Wendy Cox