In between 12-hour shifts and emails about urgent staffing needs across three Vancouver Island hospitals, Kat, a Victoria RN, almost missed messages from her union with important updates about the future of her employment contract.
These emails, sent by the BC Nurses’ Union to workers across the province, direct them to an employees-only portal with information about bargaining talks coming up with the province this fall.
A copy of these internal communications shared with PressProgress shows a strike vote is officially one of the options facing workers, if the province insists on putting limits on the nurses’ benefits package — particularly targeting massages and physiotherapy — which is currently 100% covered by the province. This comes after a June Castanet report of nurses at one BC hospital saying they would be willing to go on strike over cuts to their benefits.
“For nurses with chronic pain… it would be kind of a cruel move to take that away,” said Kat, whose name has been changed upon request, to prevent potential backlash from her employer for speaking to media. “They’re going to have more nurses with injuries and pain and [taking] sick time.”
PressProgress spoke to BC union leaders representing a variety of healthcare workers at the bargaining table in nearly every role and type of facility, from hospital pharmacists and lab techs, to care aides and nursing assistants, janitors and cooks to security guards.
Again and again, they emphasized the same priorities: the need for an employment contract that includes wage increases and benefits that make working in healthcare as attractive as possible, amid severe staff shortages across the board.
At the same time, both the provincial and federal governments are implementing cuts. In the last month, BC’s Provincial Health Services Authority cut 57 jobs and eliminated 61 vacant positions, while the Vancouver Island Health Authority axed 117 non-union workers. Meanwhile, federal health spending could drop by $1 billion by 2027 after funding for some programs expires.
For nurses, specifically, the government in B.C. has for years wanted to reduce massage and physiotherapy expenses — which have been rising and amounted to $98.4 million last year, according to a union message to members. Nurses say these employer-paid benefits are crucial to keep intact, if the province wants to retain workers and reduce the turnover rate.
“It’s an extremely physical job … having the massage and physio [covered] really allows nurses to keep working,” said Kat, describing the challenges of long shifts where, among other tasks, nurses help patients who can’t always move themselves.
“You are getting on the ground, emptying catheter bags. You are in all sorts of funny positions, helping to cast people in, helping the doctor set bones. Lots of older nurses end up with back injuries, rotator-cuff tears, or their shoulders are super messed up.”
The province wants nurses to switch to a different kind of benefits plan called a “joint benefits trust” (JBT), according to the union.
This is the same type of benefits package that is currently causing problems for around 21,000 other health workers who, among other jobs, support seniors and people with mental illnesses and addictions.
Health insurance for health workers
According to Paul Finch, president of the BC General Employees’ Union (BCGEU), the status of one of these JBTs is “the single biggest issue for community health [workers].”
Both employers and employees are supposed to pay into JBTs to maintain health insurance coverage for employees. The BCGEU is currently at the bargaining table on behalf of thousands of health sector workers who have JBTs in their contracts.
“We’re now in a situation where the [community health employers] owe the trust two years of back payments,” Finch told PressProgress in a phone interview.
The exact amount is a point of “disagreement,” said a subsequent BCGEU statement, but the two parties will be “discussing a potential resolution in the coming months.”
According to Finch, low wages for community health workers serving vulnerable populations have forced some union members to work multiple jobs and experience periods of homelessness, and have led to high turnover rates.
“Across the sector, the employers’ wage offer isn’t sufficient,” Finch said. “We’ve seen that in the public service and also what they’ve tabled at the bargaining table [for health workers] … falls below what our members will accept.”
(From Aug. 11 to 29, over 35,000 BC public sector workers represented by BCGEU are taking a strike vote after reaching an impasse with the province over wage increase negotiations. This vote doesn’t involve healthcare workers represented by the same union, as talks for those contracts are underway.)
When the nurses’ union representatives reach the bargaining table this fall, they will have four options to negotiate for benefits coverage, according to the message to members: a joint benefits trust, which they say is the province’s preference; a “flex” benefits account which, in practice, would limit the total per-employee benefits expense to about $2,000; a thus-far-undetermined expense limit on massage and physiotherapy; and finally, to “take a strong stance” by turning down the other options, which would “require members to provide a strong strike vote and may require all members to prepare to take job action.”
A video from the BC Nurses’ Union offering members the lay of the land ahead of the upcoming benefits negotiations
In memoranda attached to the most recent collective agreement, the union agreed to study flex benefits and expense limits, with the understanding that a new model would be adopted by January 1, 2026.
As it stands, Kat estimates the employer-paid benefits, if fully taken advantage of, could amount to upwards of $10,000 per person — a component of the nurses’ employment package that is now a staple.
Asked if they intend to push for nurses’ benefits to be scaled back when they reach the bargaining table, BC’s Health Ministry shared a statement on behalf of the Ministry of Finance: “Out of respect for the collective-bargaining process, we will not respond to specific questions about discussions at the bargaining table. Please see information from the Ministry of Health on BC’s recruitment and retention efforts.”
‘Chronically challenging’ staff levels
Across the health sector, short staffing is a problem in BC.
“We do have a shortage of pharmacists,” said a hospital pharmacist in the Lower Mainland, who also requested to remain unnamed for fear of workplace repercussions for speaking to the media. “Sometimes it makes it hard to fill roles, and obviously the work piles up.”
According to the hospital pharmacist, turnover among nurses is constant and has a noticeable impact on his job as well. “We get a lot of questions from nurses sometimes that our more experienced nurses probably wouldn’t have asked … like how to do certain things on the computer … which takes away time for us to do the other things that we’re meant to do,” he said.
“Every single time that we go to a new worksite … the consistent message is that the understaffing is chronically challenging,” said Sarah Kooner, president of the Health Sciences Association of BC, whose membership includes over 23,000 trained workers.
“They’re the ones running the tests, delivering the treatment, helping people recover, but are very much stretched to their absolute limit. Some of them are completely burnt out and thinking about leaving healthcare altogether.”
Lynn Bueckert, secretary-business manager of the Hospital Employees’ Union, is negotiating on behalf of workers that run healthcare facilities across BC, like cooks, lab and nursing assistants, administrative staff and security guards.
In June, after 10 weeks of bargaining, the province proposed a general wage increase of up to 3.5% over two years. This was rejected by the union, as it falls below inflation.
“From the [bargaining association’s] perspective, this opening offer fails to address the core challenges facing BC healthcare workers today — recruitment and retention — and we are preparing our counter offer, which will include protections from future economic instability and wage comparability to ensure equal pay for equal work,” said Bueckert in an email to PressProgress.
Negotiations for the facilities workers’ new contract are continuing, but the province announced on Thursday that the parties have agreed on “all of the compensation increases” that will be in the new collective agreement. The exact amount is not yet known.
Years of staffing crisis
In 2023, BC pledged $750 million to become the first province in Canada to mandate minimum nurse-to-patient ratios by requiring a maximum of four patients per nurse for most departments. More patients per nurse, which is common without mandated ratios, has been known to cause burnout among nurses.
Kat, like other nurses who have talked to journalists, says she hasn’t seen these ratios implemented yet, particularly in emergency departments where the need is high.
“It’s been a year or two, and it’s still desperately understaffed,” she said. “There’s still ratios of [one nurse to] five or six [patients] on certain very high-acuity floors.”
Cost-cutting measures have also begun across BC’s health authorities, where at least 174 jobs have been lost.
“They promised they wouldn’t cut the front line … but I lost a mentor, educator-type person in my department who directly helps the front lines,” Kat said.
Island Health also introduced a no-overtime policy that has been widely decried by workers for worsening the staffing crisis, according to CBC News. And CTV News found that two of the largest regions, the Fraser and Vancouver Coastal health authorities, have implemented the same policy.
“I think the intention there was to reduce the likelihood of burnout, to keep people working and able to work in their positions,” said Kooner. “But the reality is that, unfortunately, when you’re not allowing people to work overtime, it does burn out the rest of the staff because you’re shorting the rest of the department.”
Meanwhile, data uncovered by CTV shows the province has spent over $500 million in the last two years hiring nurses from private agencies just to keep hospitals and healthcare facilities running.
“We understand the fiscal situation of the province,” said Finch, referring to BC’s $7.3 billion deficit last year. “We don’t want to see the government balance their budget on the backs of frontline workers.”
Earlier this year, the BCGEU negotiated a new contract with wage increases of up to 20% for LifeLabs workers after its members spent 10 weeks on strike.
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