I work in Ontario hospitals, and my reverence for nurses cannot be overstated.
I see their commitment to patients every day I go to work. I also see their struggles.
Understaffing in Ontario’s hospitals is not new or surprising. It’s kind of just expected. But it’s getting worse.
Patients seem to accept that they will have to wait to have their needs attended to. Families graciously accept these delays, brushing off apologies and expressing empathy for nurses who are worked off their feet. And the nurses keep hustling.
I wanted to tell the story of how Ontario’s healthcare system is, in many ways, failing its most valuable resource: the humans who care for other humans. When the IJB learned about workload reports, I knew we had stumbled upon documents that could illustrate the depth of the crisis.
It wasn’t easy. IJB reporters argued for over a year to gain access to these records; we ended up negotiating for only a fraction of the reports Niagara Health has in its possession. We got eleven – if we wanted more, the cost would have reached well beyond the IJB’s means. But in those reports we felt the frustration of Niagara’s nurses. They would scribble, at the end of a 12-hour shift, lists of harms and deficiencies caused by understaffing. They would fill up the forms, then creep into the margins to tell their managers just how dangerous the situation was.
We spoke to experts – nurses with PhDs and chief financial officers who asked to remain anonymous. The root cause of the problem was clear: hospitals are underfunded and overflowing. There aren’t enough nurses to care for all the patients. In Australia, California and British Columbia, nurses max out at 4 or 5 patients. But in Niagara, it can be double that.
The response from leaders was tone-deaf. Interview requests were swiftly rejected. Niagara Health told us their ratios exceed their peers but wouldn’t show us the numbers. The Ontario Hospital Association rejected calls from experts for improved staffing ratios, implying in a statement that one nurse caring for 10 patients at once is somehow prudent management. Ontario Health simply didn’t respond to our emails.
Since our story on workload reports was published, I’ve heard from dozens of Niagara nurses and doctors, along with workers from across Canada. They tell me the frontline situation is far worse than our reporting reveals. They worry that burnout will push even more nurses away from public hospitals, deepening the staffing crisis.
So we’ll keep on this story. We’ll file more FOI requests, conduct more interviews, and report more solutions as we hold hospitals and governments accountable for patient care.
Because hospitalized patients need nurses. And nurses need all of us.
Blair Bigham MD MSc DTMH FRCPC DRCPSC
Emergency and Critical Care Medicine, Scarborough Health
Assistant Professor, Dalla Lana School of Public Health
- Ontario nurses protest over patient ratios in the wake of IJB investigation - 4 April 2025
- Behind the Reporting: Physician/Journalist Blair Bigham reflects on Ontario nursing investigation - 2 April 2025
- Ontario nurses raising alarm over high patient loads that put patients at risk, internal reports reveal - 27 February 2025