Minimum Nurse-to-Patient Ratios

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Have Your Voice Heard

Direct care nurse engagement is critical for the planning and implementation of minimum nurse-to-patient ratios in BC. We’re consulting with members through surveys and focus groups, and seeking nurses’ participation in monitoring and evaluating nurse-to-patient ratios at worksites across the province.

Put your name forward today

After years of advocacy, a significant step toward improving health care for nurses and patients was taken on March 1, 2024, when BCNU welcomed the government’s announcement outlining the province’s commitment to implement minimum nurse-to-patient ratios (mNPRs) in hospitals across BC, marking an important milestone on the path to become the first jurisdiction in the world to have a minimum staffing standard of one nurse for every four patients in medical/surgical units 24 hours per day, seven days per week.

The Ministry of Health and BCNU will begin work with health authorities to implement the policy directive issued in support of this first phase of establishing mNPR. An announcement on mNPRs for remaining hospital settings and non-hospital settings, such as long-term care and health authority community settings, is scheduled for June 2024.

Minimum nurse-to-patient ratios are being established in the following care areas within the acute hospital setting:

Setting Ratio
General Medical/Surgical Inpatient (Adult/ED/Pediatric) 1:4 24/7
Rehabilitation 1:5 Day/Evening
1:7 Night
Palliative 1:3 24/7
Focused (Special) Care (Adult/Child) 1:3 24/7
High Acuity/Step Down (Adult/Child) 1:2 24/7
Intensive Care (Adult/Child) 1:1 24/7

The province has also announced 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.


In April 2023, the Nurses’ Bargaining Association (NBA) and the Ministry of Health signed an agreement to support nursing in the province by adopting minimum nurse-to-patient ratios in hospitals, long-term care and assisted living, and community and non-hospital care settings.

Funding to begin implementation of the model includes $200 million in 2023/2024, $250 million in 2024/2025 and $300 million in 2025/2026.

A provincial executive steering committee, comprised of members of the BC Nurses’ Union, the NBA, the Ministry of Health and health authority leaders was established in the fall of 2023 to facilitate the introduction of the new staffing model. This committee operates by consensus, and provides provincial recommendations to the Ministry of Health on the multiple investments outlined within the agreement.

All parties agree that the work of the executive steering committee will be guided by existing provincial nursing workload standards policies and objectives, which see the Ministry of Health—in consultation with the NBA—developing, implementing, and evaluating:

  • minimum nurse-to-patient ratios (excluding charge designations) in hospital-based care with a bed baseline of 10,000 beds, as well as an expanded direct care supervision model for charge designations to support safe nursing practice.

  • a nurse-to-client case management ratio or workload tool to support a standardized staffing approach for community and non-hospital care services.

  • a standardized staffing approach for clinical supports and supervision excluded from the hours-of-care per day in long-term care and assisted living settings.

Following the April 2023 agreement, four working groups comprised of leaders and staff of BCNU, the NBA, the Ministry of Health and the Health Employers’ Association of BC began meeting regularly in the fall of 2023. These committees are focused on the following topics:

  • Planning

  • Implementation

  • Monitoring, Reporting and Evaluation

  • Recruitment and Retention

Minimum nurse-to-patient ratios is a critical policy solution that will improve patient care by helping retain the nurses we have now, return nurses back to the bedside and recruit the nurses we need. Visit this page regularly for progress reports and additional information about this breakthrough staffing model.

UPDATED: May 02, 2024

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