Nurse-to-patient ratios to be introduced in British Columbia, Canada
British Columbia aims to be the first Canadian province to establish rules for how many patients can be under the care of a single nurse.
As Canada makes efforts to crack down on the healthcare staffing crisis, including Pierre Poilievre's proposed Blue Seal testing standard, a nurse-to-patient ratio mandate is another means to expedite the hiring of trained nurses, reduce turnover rates, and create an overall higher quality of healthcare.
According to the World Health Organization's Global Health Workforce Statistics, the global average ratio of nurses per 1000 patients in 2018 was 4. For Canada in 2020, that number was 11.1.
As it becomes clear to officials that the healthcare staffing crisis is largely a result of poor healthcare infrastructure, Canadian leaders are beginning to make changes. This includes pledging almost C$200 billion toward Canada's "ailing" healthcare system over the next 10 years, according to BBC News, Toronto. Approximately $750 million of that is projected to go toward hiring nurses to enact patient ratios.
Labeled "groundbreaking" by the B.C. Nurses' Union, the mandated nurse-to-patient ratios are as follows, as reported by the Vancouver Sun:
1-to-1 for critical care on ventilators
1-to-2 for critical care without ventilators or patients needing high-dependency mental healthcare
1-to-3 for specialized care
1-to-4 for palliative and in-patient care
1-to-5 for rehabilitative care
While these ratios will be standard throughout British Columbia, they will not be set in stone. They represent a "mandated minimum," as called for by National Nurses United (NNU), and are subject to change depending on the time of day. Queensland, Australia, for example, has a patient ratio policy in place that requires at least a 1-to-4 ratio in the morning and a 1-to-7 ratio at night. California employs a similar mindset when approaching patient ratios, as they staff facilities according to patient acuity.
Although California faced significant backlash from the hospital industry, it prevailed in passing A.B. 394. This means that hospitals have been required to implement standard, minimum nurse-to-patient ratios since 2004, just five years following the signing of the law. A study by the NNU has found that "the number of actively licensed RNs in California has increased by nearly 130,000 following enactment of the staffing ratios law in 1999." Along with a 60% increase in applications, vacancies decreased by 69%, with a turnover rate falling far below the US national average.
The study also showed that no cuts were made to other hospital staff members, nor were any hospital closures reported in response to the law. With a fully staffed hospital system, mortality significantly decreased. RNs reported fewer patient complaints, more time to tend to each patient, and a greater ability to keep track of patient needs and changes in patient conditions.
While B.C. Health Minister Adrian Dix currently has no timeline for when a patient ratio law may be rolled out, citizens can take assurance in the fact that those in power are actively seeking to make Canada's healthcare system the resource it should be.