Ontario nurses eye B.C.’s plan to cap nurse-to-patient ratio, ease workload

Nurses in Ontario and British Columbia say the western provinces’ plan to set minimum nurse-to-patient ratios could help burnt-out nurses elsewhere in Canada by encouraging more provinces to adopt similar measures that promise to reduce workloads and improve patient outcomes. Safety.

Angela Preocanin, one of dozens of rain-soaked nurses who gathered near Queens Park this week to protest “unsafe working conditions,” said she wouldn’t be surprised if nurses from Ontario were lost to British Columbia .

“But I’m hopeful, very hopeful, that this negotiated (plan) will be helpful to all of us across the country,” said Preocanin, first vice-president of the Ontario Nurses’ Association.

British Columbia developed a plan to become the first province to introduce a minimum nurse-to-patient ratio and better retain and recruit nurses, all backed by $750 million in funding over three years.

The BC Nurses Union said it worked with the government on the proposal.

Preocanin said it would be a “great win” for nurses in the western provinces, which could affect demands for better working conditions for unionized nurses in Ontario, who are set to work next week after contract talks collapsed in March. months to arbitration.

Across the country, many nurses who were hailed as heroes early in the pandemic continue to care for more patients than is considered safe, said Linda Silas, president of the Canadian Federation of Nurses Unions .

That includes many who work in intensive care units, where the standard ratio of intensive care is one nurse to one patient, Silas said.

The standard is often not followed during chronic staff shortages, creating unsafe conditions for nurses and patients, she said.

“This shortage is creating chaos in the intensive care unit,” said Silas, who wants to see the lowest rates nationwide.

“We’re going to keep pushing the (ratio) legislation. BC is still making the big strides they’ve been working on over the next three years.”

British Columbia’s efforts come at a time when other provinces are offering incentives to retain and attract nurses. Last month, Nova Scotia Premier Tim Houston announced that nurses who worked full-time in the province last year would receive $10,000 this year and another $10,000 next year if they sign an agreement to continue working through 2026.

Nova Scotia is also offering $10,000 to nurses who leave the public system on the condition that they return to full-time employment for two years. A Nova Scotia Health spokeswoman said it was unclear how many nurses signed up by the March 31 deadline.

BC Nurses Union interim CEO Jim Gould said the union is part of a committee that will work with the government to implement the rates across the province.

In a hospital, the recommended ratio would be set to 1One-to-one for critical care patients on ventilators, one-to-two for non-ventilated critical-care patients or those requiring high-dependency mental health care, one-to-three for skilled care, one-to-four for inpatient and palliative care patients, and one-to-five rehabilitation care.

For example, Gould said, rates could be increased in areas such as pediatrics and spinal rehabilitation.

“The beauty of this is that it gives the public an opportunity to see how many nurses there should be,” he said. “This simplicity of accountability will make the system safer and better.”

“We’ve been pushing this for 25 years,” he said of a plan modeled on California, which introduced nurse-to-patient ratios in 1999, and parts of Australia that introduced similar ones two years later. measure.

Gould said these jurisdictions have seen fewer workplace injuries and improved quality of care, adding that the BC plan will also go further by adopting minimum rates in long-term and community-based care facilities.

Gould said it’s unclear how many nurses the province needs to make that rate possible. Neither he nor the health ministry could say when the measures would take effect.

In January, Premier David Eby said B.C. would pay for international nurses, help fund former nurses who want to return to health care, and spend $1.3 million to create a new pathway for internationally trained nurses, as well as support Apply for an expedited evaluation.

“This has to work,” Gould said of the proposal. “This is a historic moment for health care in British Columbia, and I believe in Canada.”

“We hope we can be a role model for the rest of Canada.”

But Gould is concerned about British Columbia’s ability to attract more nurses, as all provinces compete for professionals.

“I’m concerned. There’s no doubt about it. The government is concerned,” he said, adding that he would like nurses who leave to return to safer, job-satisfying workplaces.

He described a “crisis situation” in which the ratio could be as high as “8, 9 or 10 patients to one nurse”.

“This causes moral fatigue and psychological harm to nurses who are unable to provide adequate care.”

Peggy Holton, an emergency room nurse and field leader at a hospital in the Greater Vancouver area, said families have been frustrated by the lack of nurses, especially as patients became sicker during the pandemic.

“With the acuity of our patients, who knows what the future holds? But (taking care of) seven seriously ill, delirious, delirious patients is out of the question.”

The minimum rate allows nurses to spend valuable time with patients, asking how they are doing at home and whether they need recovery or other support, she said.

“Right now, it’s hard to do that when you have a 1-to-7 (ratio), and you have some very sick patients, but you just do your basics.”

The rate, which Silas calls a “blunt instrument,” has been considered nationally for at least 20 years but has not materialized anywhere except in a few pilot programs, including in Quebec and New Brunswick, she said.

“California doesn’t have a hiring problem at all, and they don’t have a retention problem because they were the first state to legislate a nurse-to-patient ratio. It’s proven to be the best recruitment and retention model for nurses.”

Camille Baines, Canadian Press

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