B.C. nurses negotiate pricey premium designed to force additional hiring

A tentative contract negotiated by the B.C. Nurses’ Union for over 50,000 nurses is rich with bonuses that could far exceed the contract’s $3.99 billion in base costs paid by taxpayer-funded hospitals and other health facilities.

Details of the tentative agreement obtained by Postmedia show significant gains made by the BCNU. The deadline for ratification of the 2019–2022 contract by registered, psychiatric and licensed practical nurses is Jan. 21.

While the base wages stick to the government-framework of two per cent wage increases each year for public sector workers, the new contract compels health authorities to beef up staffing by filling hundreds of nursing positions that have been left vacant.

On average, nurses make about $45 an hour, but there are wide variations depending on experience and training.

If heath authorities do not hire more staff, nurses who are shouldering the burden of working in short-staffed units will be entitled to premiums ranging from $3 to $5 an hour. The premiums could cost taxpayers as much as $100 million a year, according to the union.

The amount is not included in the costs of the contract. It is considered an “unfunded liability” to health employers, so costs would come out of hospital and other budgets allocated by the provincial government.

The “working short premium” as it is called, will kick in on April 1, 2020 and is meant to force health authorities to get their staffing up to “safe patient care” levels and convert many of the 6,000 casual nurses into permanent positions, according to BCNU CEO Umar Sheikh.

“We think we are four million hours short of the proper level of patient care across the province. Health employers will now be the masters of their own fate,” Sheikh said.

While some nurses prefer to have casual positions for their flexibility, Sheikh said 13 per cent of the workforce are casuals, a proportion he maintains is far too high.

Nearly $200 million was paid in overtime to nurses last year and that, according to Sheikh, is a reflection of staffing shortfalls.

HealthMatch B.C., the government-funded agency that recruits health professionals from around the world, lists about 250 nursing vacancies in B.C. this week but that figure does not reflect the entire complement of vacancies since not all positions are posted. HealthMatch said it recruited 79 nurses from outside B.C. last year.

Sheikh acknowledged it may be difficult to find and hire enough nurses. But he said an assessment process will take place in the next year to help determine optimum staffing levels in various settings, based on patient needs. That means that staffing should be higher on units where patient illnesses are more severe.

Management in hospitals and other facilities should be keen to fill vacancies sooner than later if they want to avoid the “unsustainable” hit their budgets could take because of the working short premiums.

Under the tentative agreement, nurses will also be paid for every minute they work. Since nurses say they often do administrative work after their shift ends, a paid end-of-shift bonus will stop the “normalization” of unpaid work. For the first 15 minutes of such work (usually done as nurses are handing off patients to the next shift), nurses will be paid at their straight time rate of pay. When they work more than 15 minutes, they will be paid at an overtime rate.

Michael McMillan, president-CEO of the Health Employers Association of B.C., which negotiated the contract with the BCNU, could not be reached for comment. But Roy Thorpe-Dorward, a spokesman for the association, said no one there would comment until the contract is ratified.

Sheikh said there was more trust and goodwill in this round of  bargaining.

“I wouldn’t call this a scare tactic at all, I would say it’s more of a leap of faith,” he said, referring to the premiums which he said McMillan and health employers agreed to “because they are the right thing to do.”

“I applaud their courage.”

While the new contract mostly rewards those in the nursing profession, there is one nurses’ job benefit that may not be as lucrative in the future — massage therapy.

According to BCNU figures, massage therapy costs have jumped by over 900 per cent in the past 10 years. Nurses and their family members are entitled to unlimited massages and the benefit now accounts for 1.2 per cent of all payroll costs.

Sheikh said the annual cost of taxpayer-funded massages increased from $3 million to $31 million in the past decade. In the past three rounds of bargaining, the government and health employers have raised the issue of skyrocketing massage therapy costs and now the union has agreed to consider a cap or some other formula to bring such costs down.

Nurses will be consulted over the next year on possible changes to their extended health benefit plans. Under one option, they would have a flex benefit plan that would limit how much nurses and their family members spend on massage services while using cost savings there to improve vision, dental and drug benefits.

While nursing is known to be physically and emotionally draining, it is not clear why health employers and the government, many years ago, agreed to fund unlimited massages for nurses’ family members as well.


Twitter: @MedicineMatters

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