California Safe RN-to-Patient Staffing Ratios

Nurses hold signs calling for safe staffing

About California safe staffing ratios

Currently, California is the only state to enact an RN-to-patient staffing law, thanks to the determined, multi-year efforts of members of the California Nurses Association. Ratios, coupled with nurses’ powerful voice of advocacy, protect our patients from complications that arise from missed care such as medical errors, health care disparities, infections, and so much more.

California RN-to-Patient Safe Staffing Ratios graph

What does the California ratios law actually require?

A.B. 394, the CNA-sponsored safe staffing law, has multiple provisions designed to remedy unsafe staffing in acute-care facilities. California’s safe staffing standards are based on individual patient acuity, of which the RN ratios is the minimum.

Crowd outside of CA capitol holding signs calling for safe staffing ratios

Learning from the California experience

In 1999, the registered nurses of the California Nurses Association successfully sponsored and lobbied the California Legislature to pass A.B. 394, the historic bill that made minimum, specific numerical staffing ratios the golden standard in the Golden State.

Resources

Group of nurses inside hopsital hold signs "Safe Staffing Saves Lives"

The science of ratios

Decades of studies have shown that more nurses equate to lives saved and fewer complications. Researchers have been focusing on what exactly is the mediating link between increasing RN staffing and improved outcomes.

Nurses inside hospital hold signs "Staff Up for Safe Care"

RN Staffing Ratios: A Necessary Solution to the Patient Safety Crisis in U.S. Hospitals

NNU/CNA’s proposal for minimum, mandated, nurse-to-patient staffing ratios protects our patients’ right to nursing care. Read our booklet to learn more.

Protecting Our Front Line: Ending the Shortage of Good Nursing Jobs and the Industry-created Unsafe Staffing Crisis

In this report, National Nurses United describes how the hospital industry has driven registered nurses from the bedside.

Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act

Read our fact sheet on legislation that would protect patients and improve health care by setting mandated, minimum, registered nurse-to-patient staffing ratios.

RN Staffing Ratios Whitepaper

Learn more by reading NNU's staffing ratios whitepaper.

Videos

Safe staffing ratios protect patients and nurses

Safe RN ratios have been proven to improve the quality of care and nurse recruitment and retention in California hospitals.

California Nurses Association organized—and won safe staffing ratios

California’s historic first-in-the-nation safe staffing ratios took 13 years to win and have been in effect since January 2004 despite continued efforts of the hospital industry to overturn the law.

Safe staffing ratios help nurses address disparities in health care

Studies show that staffing ratios save lives, yet understaffing is a major issue RNs struggle with every day. Together, we can change that.

Press releases

Saint Joseph nurses say Providence is violating California’s safe staffing law, which mandates safe RN-to-patient staffing ratios. Ongoing payroll errors have resulted in missing pay for hundreds of nurses.
Registered nurses at Providence Saint John’s Health Center will hold an informational picket to protest the administration’s refusal to address chronic short staffing, which jeopardizes patient safety.
RNs at PIH Health-Good Samaritan Hospital will highlight their deep concerns about patient safety, including chronic short-staffing, declining patient care standards, and the ongoing intimidation of RNs and local community allies.
Nurses have been in contract negotiations with AHMC since December 2021. AHMC management is impeding any real progress by refusing to address the nurses’ concerns and by canceling scheduled meetings at the last minute.