Nursing Practice

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Nurses wearing masks in hospital

The Nursing Practice & Patient Advocacy Program is involved in five broad categories of activities:

  1. Nursing practice issue research, analysis, and resolution.
  2. Patient advocacy
  3. Continuing education
  4. Competency
  5. Safe patient care

Purpose and Objectives

To advocate for direct-care nurses and patients on all public policy matters related to safe care and nursing practice, including safe nurse-to-patient ratios and patient advocacy rights and duties. (For more information re the program please access our Nursing Practice Program Brochure)

Major nursing practice issues

  • Promotion of the registered nurse as the direct-care provider in all healthcare settings.
  • Patient advocacy and the nursing process.
  • Empowerment of the PPCs (Professional Performance Committees).
  • Encroachment into nursing practice by other licensed and unlicensed health caregivers.
  • External forces promoting reallocation of nursing functions.
  • Technology and the deskilling of the profession.
  • Deregulation through movement of services from inpatient to outpatient and home settings.
  • Development and monitoring of staffing ratio language.
  • Fragmentation of RN title and work.
  • Occupational health hazards for nurses and violence in the workplace.

Assignment Despite Objection

A Nurses’ Guide to Filling Out an Assignment Despite Objection (ADO) Form.

The purpose of this form is to notify hospital supervision that you have been given an assignment which you believe is potentially unsafe for the patients and/or staff. This form will document the situation.


Nurses wearing masks in hospital

Nurse to Patient Ratios

Bedside Nurses across the country know mandated nurse to patient ratios are necessary to ensure safe patient care, yet California is still the only state to mandate ratios on all units in acute care hospitals.

Lawfully mandated minimum nurse staffing levels at hospitals in California have been proven to save lives and enhance patient care.

For more on this issue please access our Ratios white paper here.


Ratios legislation supported by NNU

The Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (S.1113/H.R. 2530)

There are no federal mandates regulating the number of patients a registered nurse can care for at one time in U.S. hospitals. As a result, registered nurses (RNs) are consistently required to care for more patients than is safe, compromising patient care and negatively impacting patient outcomes. These dangerous conditions are causing thousands of RNs to leave the hospital bedside. This legislation would improve patient care and increase nurse retention, by setting mandated, minimum, registered nurse-to-patient staffing ratios.

RNs nationwide are actively working with NNU to win their own mandated direct-care RN-to-patient staffing ratios. RNs in other nations have also been fighting to improve conditions for their patients. Studies show that staffing ratios save lives, yet understaffing is a major issue RNs struggle with every day.  Together, we can change that.

Join our ratios coalition here!