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The Nova Scotia Nurses’ Union believes staffing language negotiated last summer for acute care nurses will alleviate shortages and longstanding
issues impacting nurses.
Soon, Nova Scotia will be the second province in Canada with language that addresses staffing shortages. Earlier this year, British Columbia became
first to implement minimum nurse-to-patient ratios. For instance, adult medical and surgical units, where the ratio will be one nurse to every four patients, and high-acuity units where it will be one nurse to two patients.
While participating at the NSNU’s annual general meeting, members of the union and other nurse advocates heard from the Minister of Health and
Wellness, Michelle Thompson, a nurse herself, about the government’s assessment of the changes to come.
In this province, details have yet to be hammered out, but I am hopeful these guidelines will eventually improve the delivery of quality patient care, enhance working conditions for nurses and create a stronger health-care system throughout Nova Scotia.
This staffing approach is new to Canada. It’s about numbers but also flexibility to keep our hospital units appropriately staffed – including other disciplines of care providers. To echo the words of our B.C. counterparts, this commitment is a bold step for the government and a willingness to listen and invest in nurses. This initiative will improve job satisfaction, create safer and healthier workplaces for nurses, and improve patient care.
How will it work? In short, the delivery of patient care to a simple, clear formula that transparently indicates nurse staffing requirements throughout a facility. A nurse’s workload will be determined by the ratio of Nursing Hours of Care per Patient Day (patient ratios). Nova Scotia Health and the IWK will provide a profile of all units and the current number of nurses working on each shift as an agreed upon starting point.
The Employers and Union will then develop a framework that determines the appropriate number of nurses for each unit across the province.
This approach recognizes that not all units are the same, and that different patient populations require different levels of nursing care provided by specific skill mixes while also providing a guaranteed level of nursing staff.
When those numbers are not met nurses will be able to formally report staffing deficiencies which will be brought to the newly established Nurse Staffing Advisory Committee. The joint committee will then determine the appropriate number of nurses for the unit.
New language and changes to the Clinical Capacity Reports would then be escalated to a newly established Nurse Staffing Advisory Committee in each zone if issues are unresolved by the labour management committee. Further escalation will include the Senior Management Representation and the Joint Nurse Staffing Steering Committee.
Minister Thompson says government looked for guidance from the committees tasked to develop the staffing formulas, expecting that the new model will eventually be implemented incrementally across the acute care system.
For this new staffing scheme to be successful, this initiative must be implemented in tandem with safety, retention and recruitment and other policies that will improve work-life balance and job satisfaction for nurses.
Formal nurse-patient ratios have long been in place in Australia, California, Ireland and other jurisdictions in Europe and Asia. In May, again in June, I will travel to nursing conferences in the United Kingdom to present the background and framework of Nova Scotia’s new staffing policy.
