States mull nurse staffing ratios: 6 updates from coast to coast

Mandated nurse-to-patient staffing ratios are on trial in legislative sessions nationwide — stalling in some states, clearing hurdles in others. Here are six updates from across the country: 


1. New Jersey:
A coalition of New Jersey labor unions representing nurses has called for mandated nurse-to-patient ratios, the Asbury Park Press reported. On March 20, leaders gathered outside the State House to advocate for a bill — currently in the state's legislature — that would heighten staffing standards in hospitals and surgery centers. Their next rally is planned for May 11. 

The New Jersey Hospital Association opposes the bill. They say hospitals require flexibility, as staffing needs change with every shift. 

2. Washington: The state's Senate has passed Senate Bill 5236, which will legally mandate nurse-to-patient staffing ratios — if it survives the entire legislative process. Currently, the bill is in committee in the House. 

The precise ratio would be determined by each hospital's nurse staffing committee, made up of 50 percent nursing staff and 50 percent hospital administration. The state could investigate and penalize hospitals that are less than 80 percent compliant with their designated ratio.

3. Minnesota: The state's House health committee and Senate labor committee have both passed the Keeping Nurses at the Bedside Act — HF1700 and its companion, SF1561. The Senate file was re-referred to the Judiciary and Public Safety Committee on March 15, while the House file was re-referred to Labor and Industry Finance and Policy on March 16. 

If the act survives, committees of hospital management and direct care workers would collaborate on safe staffing practices for individual units, including nurse-to-patient ratios. On March 21, nurses rallied at the state capital in support of the legislation, according to Fox9

4. Connecticut: On March 22, the state Senate will hold a public hearing on SB1067, titled "An Act Concerning Adequate And Safe Health Care Staffing." Members of the Connecticut Nurses Association plan to testify. 

The bill, introduced Jan. 23, has drawn support from federal lawmakers and criticism from the state hospital association. 

5. Oregon: In the final days of February, front-line workers and hospital leaders took the floor to discuss HB2697, which would use fines to enforce nurse staffing plans. Allison Seymour, RN, said current staffing conditions left her feeling "exhausted, demoralized, worthless," according to NBC affiliate KGW8

However, Becky Hultberg, president and CEO of the Oregon Association of Hospitals and Health Systems, called nurse staffing ratios a "dangerous experiment at the worst possible time." Ms. Hultberg claims the bill needs to be modernized and will not work as written. 

HB2697 is scheduled for work sessions in the House on March 28 and April 3. 

6. Massachusetts: H.2196, titled "An Act promoting patient safety and equitable access to care," still sits in the state's joint committee on public health. If passed, the law would mandate nurse-to-patient staffing ratios. 

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