A escalating standoff between nursing leadership and regional health authorities in Trinidad and Tobago has plunged the country’s public healthcare system into crisis, with patient safety now hanging in the balance following the rollout of targeted industrial action by the nation’s nursing body. On April 28, the Trinidad and Tobago National Nursing Association (TTNNA) launched the second phase of its campaign to push for long-overdue wage adjustments, advising all 1,800+ of its nursing and midwifery members to adhere strictly to an evidence-based one-nurse-to-six-patient ratio — a standard aligned with global best practices for safe care. Nurses across the public sector have remained frozen on 2013 salary scales, making their pay among the lowest in all of Trinidad and Tobago’s public service, prompting the industrial action to force government negotiators back to the table.
According to TTNNA president Idi Stuart, the North Central Regional Health Authority (NCRHA) — already the most understaffed regional health body in the country, operating with less than half of the required nursing and midwifery personnel — has responded to the action with aggressive retaliation. Stuart claims NCRHA management has systematically forced single nurses and midwives to cover entire hospital wards, creating potentially life-threatening conditions for patients. The authority has long relied on undercompensated “pool” nurses, who work extra shifts for a flat rate rather than overtime pay, to fill crippling staffing gaps. When nurses pushed back to uphold the new ratio mandate, management responded by cutting staffing rather than adjusting allocation.
Stuart highlighted specific dangerous understaffing cases across NCRHA-managed facilities. At Caura Hospital, a facility dedicated primarily to treating communicable diseases, one single nurse was left responsible for two full wards. At Mt Hope Women’s Hospital, one of the nation’s largest dedicated maternity care centers, just three registered midwives were assigned to cover six separate wards spanning antenatal care, postnatal care, labor and delivery, and the emergency department. The overstretched team was forced to rely on unlicensed pupil midwife students to meet basic care needs, putting expectant mothers, unborn fetuses, and newborn infants at direct risk. On understaffed wards that should normally carry three registered nurses, Stuart said facilities are now operating with just one or none at all.
The staffing crunch has already disrupted care across multiple regions. On the first day of phase two action, the Barataria Health Centre under the North West Regional Health Authority (NWRHA) was forced to turn away patients entirely after no nurses reported for scheduled duty, requiring emergency staff reallocation from other facilities to restore operations. When journalists from the Express visited the center days later, on-site staff confirmed Tuesday’s disruption but declined further comment, noting operations had returned to normal by Wednesday. Additional complaints of service disruptions have poured in from nurses across eastern and southwestern Trinidad, according to the TTNNA.
Despite the disruption to everyday care, the nursing body has reported overwhelming public support for its campaign. A recent poll conducted by local broadcaster CCN TV6 found that more than 75% of respondents back the nurses’ demands for wage adjustment and safe staffing ratios. Interviews with patients and visitors at the Eric Williams Medical Sciences Complex reflected this solidarity: most respondents agreed that nurses deserve a long-overdue pay raise, and many noted that safer staffing would ultimately improve care outcomes for all patients. One patient from Arima, Sandra James, who has three nurses in her immediate family, noted that even new graduate nurses face years of unemployment before securing public sector posts, arguing that sustained pressure will force authorities to hire more staff. Another respondent, Thomas, pointed out the injustice of politicians approving their own salary increases while denying nurses a long-promised raise.
Stuart confirmed that the phase two action will remain in place indefinitely, framing the one-nurse-to-six-patient ratio not as a temporary protest tactic but as a permanent best practice that the TTNNA will continue to uphold until government officials address the wage dispute and formalize the standard across all regional health authorities. As of press time, repeated attempts to contact chief executives and board chairs for both the NCRHA and NWRHA for comment on the allegations have gone unanswered.