Safe staffing (ratios) in the Safe Patient Care Act
Under this legislation:​
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Minimum safe RN staffing, based on national evidence-based standards, by unit
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Hospital must post information about the law and inform patients about how to report violations.​
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​Additional time for rural hospitals to comply.
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Fines for non-compliance, to create true accountability
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The ratios in the legislation are as follows (registered nurse: maximum patients):
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Emergency department 1:3 plus one RN for triage
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Medical-surgical 1:4
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Pediatrics 1:3
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Behavioral health 1:4
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Acute rehabilitation 1:4
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Intensive care (all units) 1:1
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Post-anesthesia 1:1
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Stepdown 1:3
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Telemetry 1:3
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Operating room 1:1 plus one scrub assistant
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Labor and delivery
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1:3 Antepartum
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1:1 Active labor; during birth (1 RN for birthing patient, 1 RN for baby); Immediate postpartum couplet; unstable newborn; medical/obstetric complications (epidural, c-section); patient receiving conscious sedation
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1:2 Antepartum if continuous fetal monitoring is required; intermediate care newborn; postpartum/ postsurgical patient-baby couplet
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1:4 Postpartum birthing patient or well-baby care
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Limiting forced RN overtime in the Safe Patient Care Act
Under this legislation:
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Nurses can’t be ordered to work longer than scheduled.
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RNs can still volunteer for overtime, if any is needed, if they know they can provide safe care.
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RNs must have 8 continuous hours off after a shift of 12 hours or more, to rest.
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Nurses are protected from discipline, firing or losing their license if they refuse unplanned extended shifts.
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The limits will be suspended during emergency situations or when a nurse is in the middle of a critical patient procedure.
Hospital transparency in the Safe Patient Care Act
Under this legislation hospitals must disclose to the public their actual RN-to-patient ratios, which are closely tied to patient outcomes, so consumers can make informed choices and everyone has real data to evaluate. There is currently no law requiring this transparency.
Contact Us
If you have any questions or want to get involved, ​please contact Yousef Rabhi at the Michigan Nurses Association.