National safe staffing bill reintroduced in Congress
Bill would mandate RN-to-patient ratios
Staff report
National Nurse magazine - April | May | June 2025 Issue
On May 12, National Nurses United (NNU) applauded the reintroduction of federal legislation to mandate minimum registered nurse-to-patient ratios in every hospital across the country. The bill is sponsored by Rep. Jan Schakowsky and new Senate sponsors, Sen. Alex Padilla and Sen. Jeff Merkley.
Throughout National Nurses Week, nurses have been given hollow praise and “appreciation gifts” by hospital employers, but nurses across the country are standing up to say: Keep your pizza, give us safe staffing ratios. The hospital industry claims that ratios are unattainable because of a so-called “nursing shortage.” There is no shortage. Over 1 million RNs with active licenses are not working as nurses, and unsafe staffing conditions created by hospital management is a top reason.
“Nurses are constantly forced by our employers to care for too many patients than is safe. Yet, during National Nurses Week, those same employers hang banners or give out a free cookie to show their appreciation of us. It’s a slap in the face,” said Nancy Hagans, RN and NNU president. “Our patients deserve high-quality care, and nurses have always stood up to protect our patients. It’s time hospital managers are mandated to staff our units safely for our patients’ sake and to actually give nurses the resources and respect we deserve.”
The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act would establish minimum RN-to-patient ratios for every hospital unit, effective at all times. The bill also provides whistle-blower protections to ensure that nurses are free to speak out for enforcement of safe staffing standards.
“I am proud to reintroduce the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act with Senators Padilla and Merkley that will establish registered nurse-to-patient ratios in hospitals, provide whistle-blower protection for nurses who advocate on behalf of their patients, and invest in training and career development to retain hardworking nurses in the workforce," said Rep. Schakowsky. “It is past time that we act on the evidence, give nurses the support they deserve, and put patients over profits. Let’s get it done!”
“Every patient deserves access to quality care, but the registered nursing staffing crisis across the country is putting patients at risk and leading to preventable health complications, especially in communities of color,” said Sen. Padilla. “The numbers are clear: California’s mandatory minimum nurse-to-patient ratio is saving lives. Extending safe staffing at hospitals across the country is long overdue and is essential to retaining our nursing workforce and improving health outcomes.”
“As the husband of a nurse, I’ve seen how our health care heroes give so much to keep communities in Oregon healthy every day,” said Sen. Merkley, cochair of the Senate Nursing Caucus. “I am committed to fighting for safe staffing levels for both nurses and patients, to enhance the quality of patient care, reduce medical errors, and increase nurse retention.”
For years, NNU has surveyed thousands of nurses, who have consistently reported that staffing has worsened over the years and that they have considered leaving nursing because they do not want to risk their patients’ safety nor their own license.
The federal bill is mirrored after a seminal California law, fought for and won in 1999 by the California Nurses Association/NNU. The law, which took effect in 2004, has saved patient lives, improved patient outcomes and the quality of care, attracted nurses back to direct-care nursing, and reduced nurse burnout, keeping experienced RNs at the patient bedside. A 2021 study by leading nurse staffing researcher Dr. Linda Aiken showed that if New York state had the same staffing mandate as California, at least 4,370 lives would have been saved that year alone.
Decades of studies have shown that more nurses equate to lives saved and fewer complications. Studies have also found that registered nurse staffing levels in hospitals that serve communities of color are often lower, contributing to these disparities in care. Setting a single standard of nursing care across hospitals will improve outcomes for patients of color, including reduced readmission rates, increased satisfaction, and better obstetrical outcomes.
The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act is also endorsed by the American Federation of Teachers (AFT), Service Employees International Union (SEIU) Healthcare, the American Federation of State, County, and Municipal Employees (AFSCME), and Alliance for Retired Americans.