B.C. sets nurse-to-patient ratios for 6 areas of hospital care

British Columbia’s Ministry of Health has established nurse-to-patient ratios that will be used in hospitals across the province to improve workload standards.

The new standards set the minimum number of nurses required for six specific areas of care, including general medicine and intensive care.

With this move, B.C. becomes the first province in Canada to implement minimum nurse-to-patient ratios. It also makes good on a provincial commitment to the B.C. Nurses’ Union (BCNU), with minimum ratios a key plank of contract negotiations last year.

Health Minister Adrian Dix says the new ratios will improve the quality of care in hospitals, allow nurses to spend more time with patients and reduce the risk of burnout.

“It’s not enough just to recruit nurses, we have to retain and support the nurses that are in place. They are critical to ensuring a healthy, safe and inspired workplace,” he said.

The six new minimum nurse-to-patient ratios are:

  • Palliative: one nurse to three patients

  • Focused care: one nurse to three patients

  • High acuity/step down: one nurse to two patients

  • Intensive care: one nurse to one patient

  • Rehabilitation: one nurse to five patients during the day and evening, and one nurse to seven patients at night

The ratios were set in collaboration with the BCNU and follow similar models in Australia and California.

Adriane Gear, president of the BCNU, said the standards mark a milestone in B.C. healthcare, adding that ratios should reduce mortality rates and provide nurses with a quality work environment.

“The implementation of ratios in hospitals … will be a game changer for how health care is delivered and will be received,” she said.

The ministry said it will continue to work with the BCNU to set ratios for any remaining hospital settings, as well as long-term care, assisted living and other non-hospital settings.

A man wearing glasses speaks in front of lab coats in the background.
Health Minister Adrian Dix announced new funding to support nurse recruitment and retention efforts in B.C. (Ben Nelms/CBC)

Funding for recruitment and retention

The Ministry of Health has also committed $237.6 million to support the new minimum ratios and help retain, recruit, return and train nurses in B.C.

Gear said the ministry’s commitment to recruitment and retention is significant, adding that nurses have been working in the face of an unprecedented shortage.

Among the measures, the province highlighted its nursing tuition credits, which provide students enrolled in nursing programs in public post-secondary institutions a credit of $2,000 each year. Meanwhile, Indigenous students in a bachelor of science in nursing program will receive an additional credit of $5,000 per year.

The ministry has also launched signing bonuses in certain remote and rural communities to fill high-need vacancies.

As of April 1st, nurses working in these positions will receive up to $30,000 in Northern B.C. and up to $20,000 in other remote and rural areas.

In return, nurses will be required to sign a two-year commitment.

In 2023, the ministry said there were more than 6,500 newly registered nurses in B.C.

The Hospital Employees Union said the new staffing and rural retention incentives are good, but called on the government to extend the measures to include other health-care workers including care aides.

“Only by expanding these investments in improving working and caring conditions across health care can we better ensure all British Columbians have access to high quality care in the future,” said Meena Brisard, the Hospital Employees Union spokesperson.

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