Compensation in a Time of Crisis

Despite unprecedented challenges due to COVID-19, BCNU continues pressuring government to meet contract obligations

Over the course of the past 12 months, BCNU's elected leaders and staff have worked closely with their counterparts in all of the province's health authorities to reach an agreement on a collaborative process that will help implement some of the most important new staffing provisions in the 2019-2022 Nurses' Bargaining Association collective agreement.

The new language, which recognizes the need for a responsive approach to address immediate staffing requirements, was set to take effect on April 1, 2020. 

• Article 60 – Direct Patient Care Assessment, describes a process and tool that helps nurses and managers of a unit, department, or service to jointly determine patient care staffing needs.
• Article 28.04 – Working Short Premium, requires payment of a premium when direct patient care needs cannot be met with the existing staff, and efforts to provide staffing or mitigate the workload fail.

Throughout 2019, progress on the implementation process was being made on a health authority-by-health authority basis. BCNU president Christine Sorensen was cautiously optimistic, however towards the end of the year, it became clear to both the union and health employers that there needed to be one consistent approach to determine staffing requirements province-wide. "What we didn't want, was a patchwork approach that varied throughout the province," said Sorensen. "It shouldn't matter where you work – if a unit is short-staffed, it is short-staffed. The process to determine that needs to be the same for everyone."

Then, in early 2020, as the parties worked towards that new goal, the COVID-19 outbreak began, and by mid-March, the province had declared a state of emergency. The resulting pandemic conditions meant the process to determine patient care and staffing needs as outlined in Article 60 was not completed before April 1, and questions then arose about how and if nurses working on understaffed units would receive the negotiated working short premium.

Disruption

Without a tool in place to determine staffing requirements, BCNU successfully negotiated an agreement with the Health Employers Association of BC on March 31 that temporarily suspended the implementation process and saw the working short premium paid to eligible members for the month of April. Meanwhile, the work of gathering additional data to inform a provincial standardized tool got underway.

With the onset of the global coronavirus pandemic, the province's health-care system moved swiftly to enforce public-health measures and restructure acute-care resources to prepare for a potential wave of infections. The unfortunate timing of the suspended NBA contract provisions scheduled to take effect at the height of the pandemic, and subsequent payment of the working short premium, led some other health-care unions to falsely claim that nurses were being paid a pandemic pay premium while other health-care workers were not. When questioned publicly at the time, Sorensen was quick to counter the erroneous claims. “The fact is, is the premium was negotiated in January 2019 to address the nurse staffing shortage in this province." she said. "For other unions to refer to the premium as ‘hazard pay’ or ‘danger pay’ is unfortunate and uninformed.” 

Soon after, the federal government announced it would be providing pandemic pay to all frontline health-care workers during the pandemic, and thousands of BCNU members were eligible to receive the premium rate of $4 per hour.

Not only were nurses seeing the terms of their contract honoured, they were being recognized nationally for their courage and commitment to care in the midst of a pandemic state.

Implementation Process Continues

On May 22, payment of the working short premium was suspended until July 4 to allow for the development and implementation of an appropriate direct patient care assessment process (PCAP).

By mid-June, nurses working on a number of units around the province began trialing in-patient and critical care tools to support the final agreed-upon version(s) necessary to implement the PCAP. Trials are also ongoing in select long-term care sites and prenatal intensive care units at both BC Children's Hospital and Vancouver Island.

Nurses providing direct care, together with an in-charge nurse, are assessing their patients using a jointly agreed-to set of criteria. A web-based tracking tool that uses an algorithm has been created to assess the information it receives and generate an objective evaluation of the staffing needs on the unit.

Once a PCAP is in place on their unit and it is determined that patient care needs cannot be met with existing staff, nurses will be paid the working short premium as per Article 28.04. “The progress made to date offers great hope that finally, after years and years of dealing with staffing shortages across the province, nurses will no longer bear the cost of a poorly managed system," says Sorensen. “I encourage all nurses to use the PCAP when it is launched.”

Payment of the working short premium resumed July 5 and will continue until an appropriate PCAP is developed and implemented. •