More nurses aids staff and patients
Additional staff has led to positive outcomes: nurses union
“We have to provide better care for people who come to hospital, and more nurses means better care.”
Those were the words then Governor, Gray Davis, shared with media, nursing organizations and area nurses when California unveiled the first-in-the-nation minimum nurse-patient ratios January 14, 2002.
Those in attendance erupted into cheers, celebrating the 10-year campaign to reduce the nursing shortage. Like Nova Scotia, emergency units across that state were beset with closures, diversions, long wait times due to staffing shortages, oftentimes nurses.
Today, more than 20 years later, Nova Scotia is setting a new standard in health care with its nurse staffing initiative, positioning itself as the first province in Canada to integrate minimum levels of care into a collective agreement. The province ratified a five-year agreement with nurses in July 2023, signalling an important shift toward improved patient and nurse outcomes.
Enhanced nurse staffing has led to positive outcomes in the few places it has been implemented. Research consistently shows that additional patients assigned to a nurse significantly increases the risk of emotional exhaustion and burnout. Recognizing these challenges, the Nurses’ Union successfully negotiated a framework that closely resembles those seen in regions like California and Australia, where the implementation of similar measures has decreased patient mortality, reduced readmissions, and shortened hospital stays.
In California, the introduction of nurse-to-patient ratios not only improved job satisfaction for nurses but also led to fewer patient and family complaints, a higher likelihood that nurses could take breaks and a reduction in turnover and occupational injuries. Australian models have shown similar success, with guaranteed nurse hours resulting in decreased verbal abuse and increased quality time with patients. Nurses also reported healthier relationships with colleagues and valued the transparency in staffing.
The Nurse Staffing and Skill Mix Framework, as it is currently called in Nova Scotia, will develop specific guidelines on Nursing Hours of Care per Patient Day - a critical metric that quantifies the direct hours of nursing care required per patient. This approach will ensure that nurse workloads are manageable and conducive to high-quality patient care.
Janet Hazelton, president of the Nova Scotia Nurses’
Union, emphasized, “The most important factor contributing to a nurse’s ability to deliver safe, quality care is the number of patients they are assigned.”
She added this new framework aims to enhance patient safety and to also mitigate the excessive workload and overtime that are significant barriers to nurse retention and recruitment.
The success of this framework may serve as a model for the rest of Canada. British Columbia was the first province to negotiate nurse-to-patient ratios with nurses and is currently phasing in these standards across various health sectors, with plans for broader application.
Nova Scotia’s initiative takes a needs-based approach, valuing the expertise of nurses alongside the needs of patients and the resources of the health-care system. This balance is critical to develop a sustainable model that addresses the complexities of health-care staffing while improving the overall health system performance.
As this new framework takes shape, it is expected to bring about muchneeded change in how patient care and nurses’ work environments are managed in Nova Scotia. The anticipated outcomes are not just beneficial for the nurses but are vital to enhancing the quality of care that patients in Nova Scotia receive. By the end of the month, the province expects to unveil further details of the proposed model, marking a significant step forward in addressing long-term staffing needs effectively and compassionately.