FAQ

mNPRs are a critical policy solution aimed at addressing the severe nurse staffing shortage in BC's health-care system. mNPRs represent the maximum number of patients that nurses can be assigned to care for on a given unit, and provide a simple, clear formula that transparently indicates staffing requirements for licensed practical nurses, registered psychiatric nurses and registered nurses throughout the province.

mNPRs will drastically improve patient care across the province and make BC the best place in the country to be a nurse. mNPRs will allow nurses to do what they were trained to do: devote time and attention to patients' needs and provide the health care everyone deserves. Addressing the staffing shortage will see patients benefit from reduced medication errors and hospital-acquired infections as well as a measurable and significant reduction in patient mortality.

The evidence shows mNPRs save lives. They reduce patient mortality, as well as nurse occupational injuries, incidents, and missed care. They help create the safe, healthy and supportive workplaces required to retain the nurses we have now, return nurses who have left, and recruit the new nurses we need to address the staffing shortage.

For years, BC's nurses have struggled to provide safe patient care while facing a reality that sees them running from patient to patient, working short-staffed and juggling multiple duties on every shift. These untenable working conditions are leading to high levels of nurse burnout and significant moral distress, forcing many nurses to leave the profession altogether. BC now has an unprecedented number of nurse vacancies—more than 4,000 according to Statistics Canada.

This severe staffing shortage has also resulted in a growing frequency of temporary emergency room closures and service disruptions in the health-care system. Health employers have responded by spending tens of millions of dollars on expensive for-profit staffing agencies to bring nurses to the bedside and fill the staffing gap. This costly and unsustainable health human resources strategy has resulted in a 24-fold increase in spending on agencies between 2016 and 2024. Research has linked the use of agency nurses to increased staff turnover, deterioration of the quality of care, inequities in working conditions and salaries, and destabilization of health-care teams.

For the first time in a generation, we have a solution in mNPRs that has the potential to help heal the chronic staffing crisis in our health-care system and help chart a path forward so that patients can finally receive the care they need and nurses can practice their profession under safe and sustainable working conditions.

BC is the first jurisdiction in Canada to adopt mNPRs. California and Australia have had have them in place since the early 2000s, and Oregon most recently implemented mNPRs in 2024. Experience in these jurisdictions has shown that mNPRs create safer care and more satisfied nurses. Since BC's commitment in 2023 to implement minimum nurse-to-patient ratios, Manitoba and Nova Scotia's provincial governments have also made commitments and begun the process toward implementation.

BCNU has advocated for mNPRs for over 25 years. Provincial governments had resisted the move until April 2023, when the Nurses' Bargaining Association signed an agreement with the Ministry of Health to introduce mNPRs in hospitals, long-term care and assisted living, and community and non-hospital care settings.

Nursing unions in California and Australia engaged in years-long campaigns to achieve ratios for their members. In 1999, the nurses of the California Nurses Association successfully lobbied the California Legislature to pass a bill that made mNPRs a requirement throughout the state, and they were implemented in 2004. mNPRs were first implemented in Victoria, Australia, in 2000.

The evidence from California and Australia, where mNPRs are currently in place, clearly demonstrates positive outcomes for patients, nurses, and health-care organizations. After the implementation of mNPRs, California hospitals saw nurse turnover and vacancy rates fall below five percent, well below the national average, and nursing vacancies in Sacramento, California, decreased by 69 percent. The results of California's mNPR mandate show that it has enabled three more hours a day more nursing care to each patient. In Victoria, Australia, the number of employed nurses grew by 24 percent, with more than 7,000 inactive nurses returning to the workforce after mNPRs were implemented.

The provincial government allocated $200 million in 2023-2024, $250 million in 2024-2025, and $300 million in 2025-2026 to implement mNPRs. To support implementation, the province announced in March 2024 an investment of $237 million in one-time funding initiatives to help retain, return, and recruit new nurses into the health-care system. This includes $169.5 million for the expansion of provincial rural retention incentives and $68.1 million for training and licensing investments.