Nurses March on Washington

One reason is that many hospital associations oppose mandatory staffing ratios, arguing that such rules are inflexible and prohibitively expensive. The American Hospital Association calls nurse staffing mandates “ineffective” and warns that such laws “cannot guarantee a safe health care environment or quality level.”

While some studies suggest that increasing nurse staffing ultimately saves money by reducing costly turnover, finding enough permanent staff to comply with a state staffing mandate can be challenging, particularly in medically underserved rural areas. That can leave hospitals more reliant on travel nurses, which is costly and may force cuts in other areas.

Federal Staffing Bills

Demonstrators are calling on Congress to enact federal limits on nurse-patient ratios. Rep. Janice D. Schakowsky (D-Ill.-9) introduced such a bill last year: H.R.3165, which would establish federal limits of one to six patients per registered nurse, depending on unit and acuity, and require covered facilities to submit staffing plans to the Department of Health and Human Services (HHS).

HHS would be responsible for establishing the details of the staffing requirements through regulation, but the bill establishes basic standards, including prohibitions on mandatory overtime and on substituting technology like video monitors for direct care nurses.

The bill would allow individual states to set more stringent requirements without risking federal preemption, and would permit exceptions to the rules in the event of a public health emergency.

At present, H.R.3165 has 84 cosponsors, but it has yet to come to a vote in the House. However, the day before the nurses’ demonstrations, Sen. Sherrod Brown (D-Ohio) introduced a Senate version of the bill, S.1567, which currently has five cosponsors, including Sen. Alex Padilla (D-Calif.)

Workplace Violence Bills

Marchers are also advocating for federal rules on workplace violence. Last year, the House of Representatives passed H.R.1195, the Workplace Violence Prevention for Health Care and Social Service Workers Act, which would require most hospitals to create detailed plans for protecting healthcare workers from workplace violence or risk losing their Medicare funding.

Although H.R.1195 passed by a 254–166 margin, it has not yet been approved by the Senate, although Sen. Tammy Baldwin (D-Wis.) introduced a Senate version, S.4182, on May 11, 2021. At present, it has 26 cosponsors, including California Sens. Alex Padilla and Dianne Feinstein.

You can find out more about both bills and track their progress at congress.gov.

In this Article: Legislation and Public Policy, Workplace Safety