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British Columbia will be the first province in Canada to implement minimum nurse-to-patient ratios, helping nurses deliver the life-saving care patients need.

More nurses equals better patient outcomes

The evidence is clear: minimum nurse-to-patient ratios save lives. When nurses have too many patients to care for, patient mortality increases significantly, as do a number of negative patient outcomes across a wide range of measures. In fact, a study from 2021 found that patient mortality increased by 16% for every additional patient in the nurses’ assignment.

Minimum nurse-to-patient ratios allow nurses to do what they're educated to do: provide the care patients need and deserve. California introduced nurse-to-patient ratios in 2004. A large study ten years later found that hospitals with ratios close to the state mandate reported significantly more favourable outcomes. The implementation of ratios allowed nurses to spend an additional three hours a day with each patient. 

An appropriate nurse-to-patient ratio is also linked to fewer incidents of missed care, a decrease in patient re-admissions, reduced hospital-acquired infections, and shortened patient stays.

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Healthy ratios add up to healthier nurses

It's simple: Implementing ratios will ensure there are enough nurses to support each other in providing care. When there are enough nurses in the health-care system, workloads are more balanced, workplace injuries are reduced, and fewer days are lost to psychological distress or leaves of absence. Nurses who are less stressed, overworked, and exhausted are healthier, happier nurses that are more likely to stay in their career for the long term.

When nurses have team members to back them up on shift, their relationships with colleagues, physicians, and non-nursing staff improve, making them better able to provide patients with the dedicated care they deserve. In California, the implementation of nurse-to-patient ratios decreased nurse occupational injuries and illnesses by 32%. If we see a similar reduction here in BC, WorkSafeBC data suggests we'd save over $195 million in injury and illness claims over the next decade.

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Improved working conditions will attract more nurses to the profession

When we make working conditions better for nurses, we can recruit more nurses to the profession and retain those who might otherwise leave. Over time, this will help lower the dramatic number of nurse vacancies around the province. When we retain experienced nurses, we keep valuable knowledge, skills, and real-life experience in our health-care systems – a win-win for nurses and patients.

When nurses feel supported in their work, fewer of them leave the profession due to burnout and distress. Research shows that two-thirds of working nurses say they’re more likely to stay in their jobs if minimum nurse-to-patient ratios are implemented. Shortly after implementing nurse-to-patient ratios in California, many hospitals saw nurse vacancies drop below 5%, well below the national average. In the state capital of Sacramento, vacancies decreased by 69% in four years. Similarly, within a few years of the implementation of nurse-to-patient ratios in Australia, nurse vacancies were almost entirely eliminated, with more than 7,000 inactive nurses returning to the profession.

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Implementing nurse-to-patient ratios will save our health-care system money

By mandating the minimum number of nurses necessary to care for a maximum number of patients, everyone will be protected from the dangerous outcomes that result from not having the appropriate number of nurses to support all of the people in need of care.

BC’s long-standing nurse shortage has caused frequent emergency room shutdowns and health service disruptions across the province. The cost of avoiding these problems has been massive: between 2018-2022, the province has increased spending on recruitment agencies and temporary placements by over 8x. These band-aid solutions are not sustainable in the long run. 

The cost to BC taxpayers for temporary staffing has skyrocketed, rising from approximately $8.7 million a year in the 2018-2019 fiscal year to over $64 million in 2021-2022. This approach drains much-needed dollars from other health care initiatives and investments. 

A 2021 study in the peer-reviewed medical journal The Lancet showed that the implementation of mandatory minimum nurse-patient ratios is a net cost savings to the health-care system. In fact, the article noted that the savings resulting from fewer patient readmissions and shorter lengths of patient stay is more than twice the cost of the additional nurse staffing.

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Nurses know that ratios save lives

The implementation of minimum nurse-to-patient ratios has been—and will remain—a nurse-led solution to the current health-care crisis.

As part of the agreement negotiated with the Ministry of Health in April of 2023, minimum nurse-to-patient ratios throughout the province will include input from BCNU along with the Nurses’ Bargaining Association, health authorities, and the provincial government. 

BCNU’s participation in this important work ensures BC nurses will continue to have a role to play in advocating for patient needs in hospitals, long-term care and assisted living, and community and non-hospital care settings around BC.

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