Minimum Nurse-to-Patient Ratios

Minimum Nurse-to-Patient Ratios Are Coming to BC

Members can get involved in shaping minimum nurse-to-patient ratios in British Columbia. Put your name forward to have your say in focus groups or surveys and help monitor ratios at your worksite.

HAVE YOUR VOICE HEARD

British Columbia will become the first province in Canada to establish minimum nurse-to-patient ratios (mNPR), setting a global precedent with a staffing standard of one nurse for every four patients in medical/surgical units, 24/7.

BCNU has championed this initiative, and nurses know that this is a significant step toward improving health care for nurses and patients. Establishing proper nurse-to-patient ratios will allow nurses to dedicate more time to delivering life-saving patient care.

The Ministry of Health and BCNU has begun the work with health authorities to implement the first phase of establishing the first set of hospital-based ratios announced on March 1. An announcement on mNPRs for remaining hospital settings and non-hospital settings, such as long-term care and health authority community settings will be announced later this year.

ratios save lives

Ratios Implementation

The following ratios will be applied in acute care settings (hospital-based) beginning in fall 2024:

SETTING	RATIO
General Medical / Surgical Inpatient	1:4 24/7
Rehabilitation	1:5 Day/Evening 1:7 Night
Palliative	1:3
Focused (Special) Care	1:3
High Acuity / Step Down	1:2
Intensive Care	1:1
Pediatric Medical / Surgical	1:4
Pediatric Focused (Special)	1:3
Pediatric Intensive Care Units	1:1
Pediatric High Acuity Units	1:2
Neonatal Intensive Care Unit (NICU)	1:1 to 1:3
Post-Anesthesia Care Unit (PACU)	2:1 to 1:2
Maternity Care - Antepartum	1:3
Maternity Care - Labour & Delivery	1:1 during active labour; 2:1 at birth
Maternity Care - Postpartum	1:3 for dyad care (nurse for both parent and newborn); 1:4 for birth parent only
Maternity Care - Newborn Care Nursery	1:3
Operating Room (OR)	2.5:1
Alternative Level of Care	1:7
Emergency Department - General Emergency	1:3
Emergency Department - Short Stay Observation	1:4
Emergency Department - Medical/Surgical Short Stay	1:4
Emergency Department - Trauma	1:1
Emergency Department - Critical Care	1:1
Emergency Department - Fast Track	1:4
Emergency Department - Waiting/Triage	Visits per year

Government Commitment and Funding

In April 2023, the Nurses' Bargaining Association (NBA) and the Ministry of Health signed an agreement to enhance nursing support across the province by implementing minimum nurse-to-patient ratios in hospitals, long-term care and assisted living facilities, as well as community and non-hospital care settings.

To fund the implementation of this model, a total of $750 million has been allocated: $200 million for 2023/2024, $250 million for 2024/2025, and $300 million for 2025/2026.

In March 2024, the province announced an investment of $237 million in funding initiatives to help retain, return, and recruit new nurses into the health-care system.

Joint Regional Implementation Committees (JRICs)

To support the implementation of minimum nurse-to-patient ratios (mNPRs) across British Columbia, Joint Regional Implementation Committees (JRICs) have been established within each health authority. These committees play a critical role in ensuring that mNPRs are consistently and effectively applied across all hospital-based care settings.

Each JRIC is composed of six core members, evenly split between representatives from the BC Nurses’ Union and the health employer. The health employers’ members include the Chief Nursing Officer, a senior operational leader with a nursing background, and a senior labour relations leader. On the BCNU side, the committee includes one elected representative, a senior labour relations leader, and an additional BCNU representative.

Below, you will find the list of JRIC members for each health authority:

Please note that this list is for your awareness only. If you would like to bring any matters forward to the JRIC members, please connect with your regional council member.

Fraser Health

Julie Fraser (Co-Chair) - Chief Nursing and Allied Health Officer
Ken Casorso – Executive Director, People Services
Rich Dillon - Executive Director, Ridge Meadows Hospital
Peggy Holton – Council Member (BCNU)
Wendy Gibbs - Council Member (BCNU)
Carolin Bleich - Labour Relations Coordinator (BCNU)
Wendy Newson – Executive Director, mNPR (Ex-Officio)

Vancouver Island Health

Krista Allan (Co-Chair) - VP-Quality, Safety, Research Chief Nursing and Allied Health Officer
Marko Peljhan - VP-Clinical Services Acute Care
Anne-Marie Rousselle - Executive Director, Employee Relations
Kelley Charters - Council Member (BCNU)
Cait Jarvis - Council Member (BCNU)
Louise Laroche - Labour Relations Coordinator (BCNU)
Joanne Maclaren – Executive Director, mNPR (Ex-Officio)

Vancouver Coastal Health

Lorraine Blackburn (Co-Chair) – VP Professional Practice, Chief Nurse and Allied Health Officer, CCIO
Wayne Balshin – VP People
Gail Malenstyn – VP Richmond Acute Services
Angela Crawford – Council Member (BCNU)
Anastasia Brown – Labour Relations Coordinator (BCNU)
Chris Rutherford – Labour Relations Team Lead (BCNU)
Braden Davie – Executive Director, mNPR (Ex-Officio)

Providence Health Care

Becky Palmer (Co-Chair) – Chief People, Nursing and Health Professions Officer
Katie Twaites – Executive Director, Human Resources
Amanda Harvey – Executive Director, Acute Care
Madelene Fraser – Council Member (BCNU)
Meghan Friesen – Council Member (BCNU)
Dan Desmarais – Labour Relations Coordinator (BCNU)
Sara-Grey Charlton – Executive Director, mNPR (Ex-Officio)

Provincial Health Services Authority

Natasha Prodan-Bhalla (Co-Chair) – VP, Quality, Practice & Clinical Informatics, CNAO
Susan Wannamaker – EVP, Clinical Service Delivery
Jennifer Martin – Executive Director, HR
Claudette Jut – Council Member (BCNU)
Dan Desmarais – Labour Relations Coordinator (BCNU)
Dwayne MacKinnon – Labour Relations Team Lead (BCNU)
Tina Costa – Executive Director, mNPR (Ex-Officio)

Northern Health

Angela De Smit (Co-Chair) – VP Professional Practice, Chief Nursing Officer and Allied Health
Natalie Kulyk – Executive Director, UHNBC
Emily Plummer – Executive Director, Strategic LR and mNPR
Danette Thompson – Council Member (BCNU)
Teri Forster – Council Member (BCNU)
Russell Hnatiuk – Labour Relations Coordinator (BCNU)
Sandra Barnes – Executive Director, mNPR (Ex-Officio)

Interior Health

Cheryl Whittleton (Co-Chair) – Chief Nursing & Allied Health Officer & Professional Practice Leader
Diane Shendruk – VP, Clinical Operations, IH North
Vickie Horton – Manager, Labour Relations
Shalane Wesnoski – Council Member (BCNU)
Denise Nelson – Council Member (BCNU)
Russell Hnatiuk – Labour Relations Coordinator (BCNU)
Donna Mendel – Executive Director, mNPR (Ex-Officio)

Nurses Know, Ratios Work

Nurse-to-Patient Ratios Improve Nurse Job Satisfaction and Retention

Ensuring a minimum nurse-to-patient ratio benefits both patients and nurses. Fewer patients per nurse allow nurses to provide the dedicated care patients need and deserve, resulting in quicker response times, improved monitoring, more thorough assessments, and reduced errors.

Better working conditions for nurses attract more people to the profession and help retain those who might otherwise leave. Over time, this decreases the significant number of nurse vacancies across the province.

California: Implementation led to hospital vacancies dropping below 5%, well below the national average. In Sacramento, vacancies decreased by 69% in four years.

Australia: Nurse vacancies almost entirely eliminated, with over 7,000 inactive nurses returning to the profession in response.

Nurse-to-Patient Ratios Improve Patient Outcomes and Save Lives

The evidence is clear: when nurses have too many patients to care for, both patient mortality and negative outcomes increase significantly. Studies have consistently shown that high patient-to-nurse ratios correlate with poorer patient outcomes and higher mortality rates.

2021 Study: Found that for every extra patient assigned to a nurse, the risk of patient mortality increased by 16%.
2023 Study: Found that Canadian hospitals with inadequate staffing saw a 20% rise in patients’ urinary tract infections and pneumonia, a 25% rise in aspiration pneumonia, and a more than 50% increase in pressure ulcers.