Nurses across Trinidad and Tobago have entered a new stage of industrial action this week, rolling out a regulated one nurse-to-six-patients staffing ratio as pressure builds on the newly elected one-year-old government to resolve long-stalled wage negotiations. This announcement came directly from Idi Stuart, president of the Trinidad and Tobago National Nursing Association (TTNNA), during a live interview on i95.5 FM on Monday, April 28.
Stuart explained that the industrial action strategy has been rolled out in three planned phases, with this week’s implementation of the standardized staffing ratio marking the second stage of pushback. The first phase, which drew thousands of participating nurses and other healthcare workers, saw a mass public protest march through the streets of Port of Spain in recent weeks. If the government continues to refuse to meet with the association to address nursing demands, Stuart confirmed a third phase – another large-scale mass protest – will be activated.
“After the government declined our repeated requests for negotiations, our executive held a special general meeting and approved three key actions,” Stuart told reporters. “The first, effective April 28, is the rollout of total patient-centered nursing care aligned with international best practice, and that means sticking to this one-to-six staffing ratio. We’re calling it our anniversary gift to the Minister of Health.”
Contrary to framing the action as a disruption to care, Stuart emphasized that the new staffing model is designed to improve the quality of care that patients receive. For years, he noted, nurses have been forced to take on far higher patient loads than international guidelines recommend, working extensive unpaid and unplanned overtime just to keep facilities operational. This overextension has come at a severe cost: nurses’ physical and mental health has declined, while the quality of care has been compromised.
“To deliver care that is safe, efficient, patient-centered and effective, we have to work within our professional job specifications, the same standards that are recognized globally,” Stuart explained. “If we keep pushing ourselves beyond those limits like we have for years, patients end up suffering. Now, every patient will get the high-quality, focused care they deserve.”
Stuart added that the new work rule will remain in place indefinitely, allowing nurses to step back from the unsustainable overwork that has become the norm across the public health system. “Nurses have harmed their own health overworking to keep these facilities running, but our sacrifice has been appreciated neither by patients who deal with overstretched care nor by the politicians who run the system,” he said.
The dispute also centers on specific controversies at the North Central Regional Health Authority (NCRHA), where chairman Dr. Tim Gopeesingh has touted cuts to overtime pay as a major cost-saving measure. Stuart pushed back on that claim, arguing that NCRHA facilities simply cannot function without nurses working scheduled overtime, given the chronic severe understaffing that plagues the system.
NCRHA nurses have been organizing around a slate of grievances beyond wage negotiations, including a freeze on payments for completed extra pool duties, an ongoing audit of what Gopeesingh has called an “overtime racket” – a claim the TTNNA vehemently denies – persistent staff shortages, poor hospital working conditions, and the fact that many nurses are still being paid on 2013 salary scales despite years of inflation and increased workload.
As of Monday, multiple media attempts to reach Health Minister Lackram Bodoe and Dr. Gopeesingh for comment on the new staffing ratio protest were unsuccessful, with no response to calls or inquiries by press time.