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Current Fights

Large crowd of nurses hold sign "Ratios, Rights, Representation" at state capitol building.

Nurses and patients deserve safe staffing ratios, no matter where they live and work. That’s why National Nurses United nurse members are passionate about winning staffing laws modeled upon California’s in the other 49 states and the District of Columbia, working at both the individual state and at the federal level to propose and pass safe staffing legislation.

At the federal level, NNU joined with U.S. Sen. Sherrod Brown and U.S. Rep. Jan Schakowsky to introduce in spring 2019 the Hospital Patient Safety and Quality Care Act, known as S. 1357 in the Senate and H.R. 2581 in the House. These bills would establish uniform national professional standards for nursing, including the following:

  1. Patient advocacy duty and right
  2. Minimum, specific, numerical, unit-specific, direct-care, RN-to-patient staffing ratios for acute-care hospitals, with additional staff required based on individual patient acuity
  3. Whistle-blower protection
  4. Prohibition against averaging of ratios
  5. Prohibition against mandatory overtime
  6. Protection for refusal of unsafe assignments
  7. Tough monetary fines for violations of ratios and employee and patient rights
  8. Registered nurse workforce initiative that includes a preceptor and mentor demonstration project

Clearly, safe staffing ratios laws are proven as an effective check against hospital industry profiteering. That’s exactly why the American Hospital Association, hospital executives, the hospital industry, and its management allies do everything in their power to block passage of ratios legislation, even going so far as to propose similar-sounding but toothless, loophole-ridden measures to provide cover for politicians who want to appear like they are tackling the problem, but not actually disturbing the status quo (or jeopardizing their hospital industry campaign contributions!).

These approaches make vague and undefined references to “appropriate” staffing levels without actually giving a number. Acuity-based staffing or “staffing plans” -- using tools developed by hospital industry consultants -- is presented as an alternative to mandated minimum ratios.

Don’t be fooled. Demand real ratios.


TAKE ACTION to pass federal and state ratios legislation


The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - S. 1357 (Brown)

Send a Letter to Congress Urging their Support for this legislation!

This bill establishes requirements for acute-care facilities to provide registered nurse staff based on the acuity of patients provided that minimum nurse-to-patient ratios for each unit are met at all times. Registered nurses shall also have the obligation to act in the exclusive interest of their patients, and the right to be patient advocates.

Take Action on this Bill


The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act - HR 2581 (Schakowsky)

Send a Letter to Congress Urging their Support for this legislation! 

Nurses are increasingly put into impossible situations by hospital managers who demand they care for more patients than is safe. There is a proven method to save patient lives and save hospital money — mandated minimum nurse-to-patient staffing ratios. In Congress, Rep. Jan Schakowsky (D-Ill.) introduced her The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act to improve patient quality of care by establishing a requirement for nurse-to-patient ratios that put patient safety first.

Take Action on this Bill