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National Campaign for Safe RN-to-Patient Staffing Ratios

Welcome to the National Campaign for Safe Patient Ratios!  


Welcome to our nationwide safe patient ratios campaign to ensure safe staffing for RNs and patients across the country.  We all deserve the best care possible. California’s historic first-in-the-nation safe staffing ratios, sponsored by the California Nurses Association, 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 RN ratios have been proven to improve the quality of care and nurse recruitment and retention in California hospitals.


We have two national safe patient ratio bills, one in the Senate S. 864 (Boxer) and the House HR 1602 (Schakowsky).

  • The National Nursing Shortage Reform and Patient Advocacy Act | S. 864 (Boxer) 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.

  • Safe Nurse Staffing for Patient Safety and Quality Care Act - HR 1602 (Schakowsky) 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.) re-introduced her Safe Nurse Staffing for 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.

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!

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TAKE ACTION, get involved, support legislation! Assess how California became the first state to win safe patient ratios. Diagnose good ratio bills from bad ones and why. Help plan safe staffing ratios in your state.

Let’s make safe ratios the law! Sen. Barbara Boxer (D-Calif.) introduced S. 739 to help reduce the nation's shortage of nurses and ensure patients get the care they need. Many states are also pushing their own bills for safe staffing.

After years of broken promises from hospitals to address patient safety issues resulting from inadequate RN staffing, we now know, nurses must lead the way to safe ratios.

Dozens of studies link safe RN staffing ratios to reduced rates of patient deaths and post-operative complications. Simply put, fewer patients provides more time for quality care.

RNs in Illinois, Florida, Michigan, Missouri, Massachusetts, Texas, DC, and elsewhere are actively organizing in support of Hospital Patient Protection Acts in their states.