Mandatory Nurse Ratios in Ontario Hospitals

Summary#

This bill would set clear limits on how many patients each nurse can care for in Ontario hospitals. The goal is to make care safer and give nurses enough time with each patient. The Ministry of Health would be responsible for making sure hospitals follow these limits. The rules would take effect 12 months after the bill becomes law.

• Sets maximum patient-to-nurse ratios by type of care.
• Requires the government to enforce these ratios in hospitals.
• Says the mix of nurse practitioners, registered nurses, and registered practical nurses will be set by regulation (future rules).
• Gives hospitals one year to get ready after the bill receives Royal Assent (becomes law).

Key ratios:

• 1 patient per nurse for ICU patients on ventilators.
• 2 patients per nurse for ICU patients not on ventilators, and for highly dependent mental health patients.
• 3 patients per nurse for specialized care.
• 4 patients per nurse for inpatient and palliative care.
• 5 patients per nurse for rehabilitation during day/evening shifts.
• 7 patients per nurse for rehabilitation at night.

What it means for you#

• Patients and families

  • More time and attention from a nurse at the bedside.
  • Potentially fewer mistakes and faster response when needs change.
  • Some services could see delays or fewer available beds if hospitals need time to hire enough nurses.

• Nurses (NPs, RNs, RPNs)

  • Smaller patient loads and clearer staffing rules.
  • Could see less burnout and overtime if more staff are hired.
  • The exact skill mix on each unit will be set by future regulations.

• Hospitals and long-stay units inside hospitals

  • Will need to adjust schedules and hire enough nurses to meet the ratios.
  • May limit admissions or slow down discharges if staffing is short while changes are made.
  • Must plan for compliance within 12 months of the bill becoming law.

• Communities and taxpayers

  • Hospitals may need more funding to hire and keep enough nurses.
  • Training, recruiting, and onboarding costs could rise in the short term.

Expenses#

Estimated cost: No publicly available information.

• No publicly available information.

Proponents' View#

• Safer care: nurses will have enough time to monitor patients and act quickly.
• Better outcomes: fewer errors, infections, and complications, especially in critical care.
• Workforce stability: clearer limits can reduce burnout and help keep nurses in the profession.
• Consistent standards: patients get similar staffing levels across hospitals and units.
• Mental health recognition: sets stronger support for highly dependent mental health patients.

Opponents' View#

• Cost pressure: hiring more nurses could strain hospital budgets.
• Staffing shortages: hospitals may struggle to find enough qualified nurses, especially in rural or northern areas.
• Reduced flexibility: fixed ratios may not fit every shift or patient mix and could limit managers’ ability to adapt.
• Access concerns: to meet ratios, hospitals might close beds, delay procedures, or divert patients, increasing wait times.
• Implementation risk: the one-year timeline may be hard to meet without strong recruitment and training plans.