Safe staffing (ratios) in the Safe Patient Care Act
Watch Rep. Jon Hoadley's testimony to the Michigan House Health Policy Committee about legislation to set safe limits on patient assignments here.
Under this legislation (House Bill 4279 and Senate Bill 159 of 2019-2020):
- A committee of at least 50 percent direct-care RNs plans and monitors staffing levels.
- Minimum safe RN staffing, based on national evidence-based standards, by unit
- Hospital must post information about the law and inform patients about how to report violations.
- State runs a toll-free hotline to receive complaints.
- Whistleblower protection for those who report violations.
- Additional time for rural hospitals to comply.
- Fines for non-compliance, to create true accountability
Number of Patients per RN in the Safe Patient Care Act
Emergency Room 1:3 plus one ER nurse for triage
Medical-Surgical 1:4
Pediatrics 1:4
Behavioral Health 1:4
Rehabilitation Care 1:5
Operating Room 1:1 plus one scrub assistant
Post-anesthesia 1:2
All intensive care units, including ER, neonatal and pediatric 1:1
Stepdown 1:3
Telemetry 1:3
Labor and Delivery
First stages of labor 1:2
2nd and 3rd stages of labor 1:1
Intermediate newborn nursery 1:3
Noncritical antepartum patients 1:4
Postpartum mother-baby couplet 1:3
Postpartum mother or well-baby care 1:6
Emergency Room 1:3 plus one ER nurse for triage
Medical-Surgical 1:4
Pediatrics 1:4
Behavioral Health 1:4
Rehabilitation Care 1:5
Operating Room 1:1 plus one scrub assistant
Post-anesthesia 1:2
All intensive care units, including ER, neonatal and pediatric 1:1
Stepdown 1:3
Telemetry 1:3
Labor and Delivery
First stages of labor 1:2
2nd and 3rd stages of labor 1:1
Intermediate newborn nursery 1:3
Noncritical antepartum patients 1:4
Postpartum mother-baby couplet 1:3
Postpartum mother or well-baby care 1:6
Limiting forced RN overtime in the Safe Patient Care Act
Watch Rep. Stephanie Chang's testimony to the House Health Policy Committee about her 2017 bill to limit forced RN overtime here.
In the 2019-2020 session, these bills are House Bill 4280 and Senate Bill 161. Under this legislation:
- Nurses can’t be ordered to work more 12 hours (a standard, expected shift in many hospitals).
- RNs can still volunteer for overtime, if any is needed, if they know they can provide safe care.
- RNs must have 8 continuous hours off after a shift of 12 hours or more, to rest.
- Nurses are protected from discipline, firing or losing their license if they refuse unplanned extended shifts.
- 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
Watch Rep. Aaron Miller's testimony to the House Health Policy Committee about his bill to require hospitals to disclose their RN-to-patient ratios here.
In the 2019-2020 session, this legislation is House Bill 4281 and Senate bill 160. 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 Dawn Kettinger at the Michigan Nurses Association.
If you have any questions or want to get involved, please contact Dawn Kettinger at the Michigan Nurses Association.