Wisconsin lawmakers have introduced legislation that would establish minimum nurse-to-patient ratios in hospitals and prohibit mandatory overtime for registered nurses.
The Nurse Staffing and Patient Protection Act, co-written by Sen. Melissa Ratcliff, D-Cottage Grove, and Reps. Francesca Hong and Lisa Subeck, Democrats who both represent Madison, would set unit-specific staffing ratios ranging from 1-to-1 in operating rooms to 1-to-6 in psychiatry units.
Hospitals would be required to submit an annual nurse staffing plan to the Wisconsin Department of Health Services. The plan must be developed and approved by a nurse staffing committee, with a majority of members consisting of nonsupervisory registered nurses.
The legislation would also ban mandatory overtime for nurses, with limited exceptions, and allow nurses to refuse assignments if, in their professional judgment, the assignment would compromise patient safety or their license. Mandated shifts would be capped at 12 hours in a 24-hour period, and retaliation against nurses who exercise rights under the bill would be prohibited.
Supporters say the measure is aimed at addressing workforce shortages and improving retention. According to state workforce projections cited by bill sponsors, Wisconsin could face a shortage of up to 19,000 nurses by 2040.
The Wisconsin Federation of Nurses and Health Professionals supports the proposal, according to a Feb. 25 news release from the union.
The Wisconsin Hospital Association said in its recently released 2026 workforce report that hospital employment has grown 23% over the past decade and vacancy rates have improved from a pandemic peak of 10% in 2022 to 7.2% in 2024, though staffing shortages remain more than double pre-pandemic levels. The association has called for reducing regulatory and payer burdens and expanding training pathways to address workforce pressures.
“Federal and state regulations already require Wisconsin hospitals to maintain appropriate staffing levels, including qualified nursing and other allied staff, to care for patients. Additionally, hospitals are required to provide nursing care to all patients and ensure the immediate availability of a registered nurse for the care of any patient,” Ann Zenk, BSN, RN, WHA senior vice president for workforce and clinical practice, said in a statement to Becker’s. “Creating arbitrary staffing ratios in state law without contemplating the very different workforce and care delivery needs that exist across Wisconsin is a dangerous path that risks the closure of critical services.”
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