The union representing Ontario hospital workers plans to propose new mandatory nurse-to-patient ratios during bargaining talks next month after a new study showed that doing so would help address the staffing crisis in health-care facilities.
The peer-reviewed study was published on Aug. 8 and was conducted in collaboration with the Ontario Council of Hospital Unions/Canadian Union of Public Employees (OCHU/CUPE). It was based, in part, on interviews with 26 Ontario healthcare workers.
Michael Hurley, the president of CUPE’s Ontario Council of Hospital Unions (OCHU), said the study underscores the need for a “fundamental change” in the form of staffing ratios despite the ongoing opposition by hospital managements.
“Ratios will bring thousands of nurses who have left the profession in despair back to work. Adopting ratios in bargaining will push the provincial government to fund and staff its hospitals properly. For patients and for nurses, it is time for this fundamental change,” Hurley said, claiming that hospitals reject ratios as they will restrict their ability to understaff.
The Ontario Nurses Association has previously called for a ratio of one nurse to every four patients for acute medical and surgical units and a one-to-one ratio for intensive care units.
The study states that improved nurse–patient ratios “would help to alleviate burnout, thus reducing attrition and improving the quality and timeliness of patient care.”
The authors looked into existing research on staffing levels, conducted interviews with many Ontario hospital nurses and examined other jurisdictions with staffing mandates in coming to the findings.
“The evidence shows that nurse-patient ratios save lives,” Dr. Jim Brophy, who co-authored the study, said in a statement.
“Assigning nurses a manageable workload ensures patients receive appropriate care, which in a high-stakes hospital environment can mean the difference between life and death.”
He added that ratios result in a positive impact on patient care with lower levels of medical errors, decreased risk of infections and lower readmission rates.
Another author, Dr. Margaret Keith, noted that nurse-to-patient ratios would address the nursing shortage in the province, as they would reduce injury rates and burnout and reduce the moral stress of not being able to provide proper care.
“Addressing these factors would tremendously improve the retention and recruitment problem in Ontario’s hospitals,” Keith said in a statement.
“We know that attrition rates are very high in Ontario, and this solution could help stem the bleeding.”
According to the union, nurse vacancy rates in Ontario climbed to 43 per cent between 2022 and 2024.
Authors also found that having nurse-to-patient ratios could result in savings by reducing reliance on for-profit staffing agencies. A separate study released in May showed that hospitals have paid $9.2 billion over the last decade to those agencies.
OCHU represents about 45,000 workers employed in hospitals and long-term care facilities, including registered practical nurses, one of whom is Rachel Fleming. She said inadequate staffing ratios have taken a devastating toll on patients and nurses.
“Every day, we’re being forced to make choices that go against everything we believe as caregivers,” said Fleming. “When you can’t give medication on time, when a patient goes without a bath or the comfort of someone simply listening to them, when you can’t even answer a call bell because you’re torn between other patients in desperate need—it breaks your spirit,” Fleming said.
She added that many nurses are leaving the job because it’s become “unbearable.”