British ColumbiaAs bargaining discussions continue this week between the B.C. Nurses’ Union and the province, one key issue the union hopes to push is B.C.’s commitment to nurse-to-patient ratios.Health minister says implementation of nurse-to-patient ratios remains a focusEmily Fagan · CBC News · Posted: Nov 17, 2025 5:40 PM EST | Last Updated: November 18Listen to this articleEstimated 4 minutesThe audio version of this article is generated by text-to-speech, a technology based on artificial intelligence.BCNU president Adriane Gear, seen here at a 2024 press conference, says nurse-to-patient ratios remain a key bargaining issue. (Ben Nelms/CBC)As bargaining discussions continue this week between the B.C. Nurses’ Union (BCNU) and the province, one key issue the union hopes to push is British Columbia’s commitment to nurse-to-patient ratios.While B.C. was the first to embrace the initiative in Canada, BCNU president Adriane Gear says work has stalled on applying these ratios in emergency departments across B.C. at a time when ERs are facing long wait times and closures.Gear says the province is already implementing these ratios in intensive care units and general medical and surgical departments, as part of the first phase of the rollout this summer. The emergency department ratios were finalized in September 2024, she said, but work on figuring out how to apply them across different hospitals has slowed since May.“That’s concerning when you think about the fact that … it’s difficult to access emergency care and a lot of that is because emergency rooms are chock-a-block full of people, patients needing care, and there’s not enough nurses and doctors,” Gear said.“There just seems to be a delay and I worry that we’re not keeping with the momentum.”Through bargaining, Gear says the union hopes to secure measures to hold the government accountable for nurse-to-patient ratios – through potential measures like additional pay for nurses when their unit falls below set ratios – and provide greater transparency to allow patients to know when a unit is understaffed.Two years ago, B.C. became the first province to establish rules for how many patients a nurse can take care of, in an effort to address burnout among health-care workers. Gear says the province has already started to see the impacts of implementing the first phase of the nurse-to-patient ratios, but worries that delays could undercut the work done so far to improve care and nurse retention.B.C. Health Minister Josie Osborne said that working toward the implementation of nurse-to-patient ratios is a continued focus, though she did not respond to concerns about delays to the rollout.“Work is underway to do the staffing,” she said, noting success in the recruitment of health-care workers from the United States.“At a time when we have these workforce challenges and we’re seeing shortages across the system, that’s why it’s incumbent on us to do everything that we can to invite nurses who perhaps have left the workplace for a while, or who have moved to part-time or casual positions, to come back into the system.”B.C. Health Minister Josie Osborne tours the Saanich Peninsula Hospital. Osborne has said the province has had success in recruiting health-care workers from the U.S. (Island Health)The Ministry of Health did not provide details prior to publication on how many net new nurses had been hired since the ratios were announced, or the anticipated timeline for the full implementation of the nursing ratios.Premier David Eby said B.C. has seen success hitting nurse-to-patient ratios at some hospitals on Vancouver Island. The province is talking to the union about creating incentives for nurses to help the province hit the ratios it has committed to, he said.“It took a decade in Australia to hit ratios they were working on with nurses,” he said. “We all want to move much faster in British Columbia on this.” BCNU looks to maintain benefits, address workplace violenceGear says the BCNU’s top priority in this bargaining process is to maintain benefits for its workers. At a time when the province is looking to cut costs, she worries they could be under threat.“It’s such a physically demanding and psychologically demanding job, and nurses have been working incredibly short through the pandemic and beyond, that takes a real toll on somebody,” she said. “Until we’re at ratios, which we’re not, then like, hands off the benefits.”BCNU president Adriane Gear says that maintaining benefits will be one of the union’s priorities at the bargaining table. (Eric Foss/CBC)She also noted the continued violence faced by nurses from patients is “completely unacceptable,” something she hopes will be reflected in the next collective agreement.Osborne said that B.C. intends to continue its relational security officer program, which staffs security guards in hospitals to prevent and de-escalate violent situations.“We’re actually seeing a decrease in the number of lost work hours and the number of incidents of violence, and we have to continue that trend,” she said.
Accountability, transparency around nurse-to-patient ratios a key bargaining issue, says B.C. Nurses’ Union
