Position Statements

BC Nurses’ Union believes that:

• Gender-affirming care is a right that belongs to all persons who access our health-care system.
• Gender-affirming care recognizes the individuality and expression of each person – a uniqueness that is influenced by intersecting factors like age, ethnicity, race, disability, class.  
• Equitable access to health care for transgender people means the right to receive care that is sensitive to, and fully accepting of, their self-described identity.
• Trans people face unique challenges and obstacles when they attempt to access health care. This can lead to an avoidance of formal systems of care.
• Nurses and health-care workers can help to dismantle the obstacles faced by trans people by becoming knowledgeable about transgender health issues.
• Through knowledge and social justice framework, nurses and health-care workers can develop the competencies required to deliver gender-affirming care. 

BC Nurses’ Union believes that:

• Person-centered, culturally safe, evidence and trauma-informed harm reduction practices, policies and services can ensure holistic support and care for people coping with problematic substance use.  
• Harm reduction ‘meets people where they’re at’ – helps reduce stigma, is practical, safe, cost-effective, leads to better health outcomes for people and populations, and saves lives.  
• Harm reduction practices, policies, and services should be evidence-informed, accessible, equity oriented, founded on the expert knowledge of nurses and health-care professionals, and informed by communities and people with lived experience of substance use.  
• Nurses, health-care workers and the people accessing harm reduction services require safe, equitable and inclusive work/care environments that are staffed based on minimum nurse-to-patient ratios, with appropriate practice and education support and in accordance with occupational health and safety regulations.  

BC Nurses’ Union believes that:

• Nurses are autonomous, self-regulating health professionals with a distinct body of knowledge and practice in clinical care, research, administration, and teaching.
• Greater autonomy for nurses improves patient care, patient satisfaction rates and elevates the status of the profession.  
• Nursing autonomy increases when nurses and nursing work are respected and valued. BCNU strives to ensure that all nurses are treated with respect in the workplace and elsewhere.
• Increasing autonomy for nurses is vital and lies at the heart of many concerns related to recruitment, retention, workload, stress, violence in the practice environment and more.
• As a professional group made up of predominantly women, nursing autonomy will be advanced as women in society progress and build unity.
• Unions like ours, working with regulatory, health-care, and educational institutions, as well as social justice movements and other unions, can make great strides for nurses, patients, and the health-care system through coordinated efforts to enhance nurses’ autonomy.

BC Nurses’ Union believes that:

• British Columbians have the right to high quality nursing services in hospitals, residential care facilities and communities. Strong nursing leadership optimizes the care provided by nurses.
• Skilled nurse leaders make a long-term positive impact on nurses’ recruitment, retention, job satisfaction and more.
• Units that are staffed with capable nursing leadership produce more satisfied patients with better health outcomes.
• To optimize the impact of nursing leadership in BC, nurse leaders must have the authority to:
  • Be actively involved in decision making at all administrative levels so that they can determine standards of nursing practice and patient care.
  • Have a key say in resource utilization, contribute to the development of clinical and management information systems, actively participate in the selection of assessment of technologies and shape their own professional development programming.
  • Meet nurses’ needs, in terms of education and quality of work-life.
  • Establish formal mentoring initiatives for new nurse graduates, making mentoring a deliberate, supported, and planned process. 

BC Nurses’ Union believes that:

• The evidence is clear: when nurses have too many patients to care for, both patient mortality and negative outcomes increase significantly. Studies have consistently shown that high patient-to-nurse ratios correlate with poorer patient outcomes and higher mortality rates.
• Ensuring a minimum nurse-to-patient ratio benefits both patients and nurses. Fewer patients per nurse allow nurses to provide the dedicated care patients need and deserve, resulting in quicker response times, improved monitoring, more thorough assessments, and reduced errors.
• Better working conditions for nurses attract more people to the profession and help retain those who might otherwise leave. Over time, this decreases the significant number of nurse vacancies across the province.

BC Nurses’ Union believes that:

• British Columbians need and deserve excellent care at all stages of life, up to and including death and bereavement, and that nurses are central to quality palliative and end-of-life care. BCNU believes that British Columbians should have the right to choose from a full range of quality, publicly funded palliative and end-of-life services in the care setting of their choice. 

BC Nurses’ Union believes that:

• Nurses and other health-care workers should have both easy and timely unrestricted access to appropriate personal protective equipment (PPE).
• Adequate supplies of PPE should be available to meet current and anticipated future needs.
• While employers may determine the minimum level of PPE required, nurses should be allowed to use their clinical judgment to determine if a higher level is required.
• The precautionary principle must always prevail. The highest level of PPE should be available until there is definitive, scientific proof that such PPE is not required.
• Administrative and engineered controls offer superior protection to PPE and should always be considered both ahead of and in concert with the use of PPE.

BC Nurses’ Union believes that:

Nurses advocate for health: a complete state of mental, physical, economic, and social well-being. Community health is rooted in social determinants of health— income and social status are principle roots.

• Nurses play an important role in community development for health.
• Enhanced primary health care contributes to significant improvements in community health status. Nurses are central to this transformation.
• An innovative primary health care system is built on participation of communities and puts the needs of people first, including patients, clients, and residents.
• Health promotion, disease prevention and palliation would play greater roles in this new system.
• Nurses’ work is pivotal when providing integrated, interdisciplinary care for those with chronic conditions, which are on the rise in BC.

BC Nurses’ Union believes that:

• All seniors have a right to health care and social supports that maintain and promote their well-being.
• The health and well-being of seniors can be supported through policies that promote equitable access to the social determinants of health.
• The health and well-being of seniors is enhanced through policies that recognize the diversity of the older adult population.
• Seniors require supportive, age-friendly communities to maintain and enhance their health and well-being.
• Nurses and health-care workers can play a crucial role in promoting the health and well-being of seniors.

BC Nurses’ Union believes that:

• Health is a complete sense of mental, physical, and socioeconomic well-being.
• Socioeconomic factors are the roots of health; amongst other factors, income, and social status determine health.
• When socioeconomic and environmental conditions improve, population health improves, so health advocacy is a vital aspect of the work of health professionals in all areas.
• It is possible to create a healthier BC through social, environmental, and economic justice initiatives such as:
  • eliminating (or at least alleviating) poverty
  • eliminating systemic discrimination based on ability, age, class, ethno-racial identity, sex/gender, sexual orientation, and other categories of difference
  • providing safe housing for all
  • protecting our environment so that air, soil, water, forests, and other parts of our ecosystems are clean and remain in their natural state
  • supporting publicly funded services in health, social services, education, transportation, and more taxation systems that equally distribute responsibility to all taxpayers, including corporations and individuals
  • supporting early childhood development through literacy, food security, high quality, affordable childcare
  • all of the above

• Nurses already play an important role in advocating for British Columbians’ health; nurses in the community, schools, addiction centres, on the streets and elsewhere are working hard to “level the playing field” so that everyone has access to housing, food, income security and so forth. 

• In a redesigned, integrated health- oriented system, an expanded role for nurses in health promotion, prevention and chronic disease management has the potential to have a significant, positive impact on population health. 

• Unions like BCNU play an instrumental role in struggles for social justice and improved community health. 

• BCNU strongly encourages nurses, other health-care workers, and the public to be vaccinated against communicable diseases as a preventive measure and in accordance with the most recent scientific evidence. Vaccination provides an important layer of protection against many communicable diseases, and BCNU believes that education is the most appropriate means of achieving high vaccination rates for nurses, other health-care workers, and the public.
• Like any medical treatment or procedure, each individual must have the opportunity to inform themselves of the potential risks and benefits of immunization, based on their understanding of the evidence and in discussion with their family physician or other care provider.
• Employers should collaborate with nurses and other health-care workers on developing supportive vaccination policies to achieve high vaccination rates in the health-care workforce. Evidence shows that punitive or coercive vaccination policies in workplaces can create conflict, damage trust, and may unintentionally heighten vaccine hesitancy by feeding into false narratives on vaccine safety.
• Employers should also work with nurses and other health-care workers who are unable to be vaccinated to ensure they have access to work that keeps them and their patients as safe as possible.
• Nurses in BC have a unique opportunity to educate the public on the risks and benefits of available vaccines, the importance of ensuring safety and efficacy in the development of vaccines, and the possible outcomes of forgoing vaccination.
• While vaccination is an important element of an overall infectious disease prevention plan, adequate staffing, elimination of hospital over-crowding, adequate handwashing stations and supplies, easily accessible personal protective equipment (PPE) and isolation of those with infectious diseases must also be in place.

BC Nurses’ Union believes that:

• Violence against nurses is unacceptable. *
• No partner, child or parent of a nurse should have to worry that their loved one may be assaulted while they are at work.
• Continued pressure on all employers and all levels of government is required to ensure nurses are safe at work.
• The perpetuated myth that violence is part of a nurse’s job is unacceptable. Awareness of the significant impact of violence in health care must be increased.
• Violence is a complex issue that requires inter-professional, organizational and government approaches to address causes of violence and implement prevention strategies.
• Violence risk is significantly related to organizational factors, such as heavy workloads and unsafe staffing levels. Employers must heed evidence and ensure appropriate work conditions as part of their comprehensive violence- prevention strategy.
• Employers have a legal responsibility to actively include nurses in risk assessments and investigations, and meaningfully engage them in the development of policies and procedures that promote safe environments and safe patient care.
• Nurses are well-positioned to identify risks and develop violence-prevention strategies in clinical practice.
• Nurses are well-positioned to participate in violence-prevention activities via joint occupational health and safety committees and other organizational violence- prevention initiatives.

*BCNU believes that these statements apply to all direct-care staff in health-care workplaces.