Despite failure of patient ratio bill, Maine nurses union celebrates progress in staffing fight
Nurses rallied in Portland on April 2024 calling on the Maine Legislature and Gov. Janet Mills to support a safe staffing bill. (Provided by National Nurses United)
The Maine Legislature adjourned last week without taking action on a bill that would have created mandated nurse-to-patient ratios in certain health care settings — a move advocates argue is needed to enhance patient safety.
LD 1639 would have established minimum staffing requirements based on various circumstances, such as the level of care patients are receiving. It would also have protected nurse whistleblowers who speak out about unsafe assignments and authorized the Maine Department of Health and Human Services to enforce nurse-to-patient limits.
Although LD 1639 passed the Senate in an initial March vote by a 22-13 margin, the Maine House never voted on the bill, tabling the measure last month and never taking it back up again before adjournment.
Mary Kate O’Sullivan, a bedside nurse and member of the Maine State Nurses Association — which pushed for the bill — said the proposal simply didn’t have the votes needed to pass the House.
However, O’Sullivan said given the strong opposition to the measure from hospitals, she’s proud of the work advocates did to advance the bill.
“It truly was like a David and Goliath situation when you look at the Maine Hospital Association and … how hard the hospital industry fought us on this bill. It is actually incredible how much we accomplished and how far we got,” she said.
Multiple hospitals did indeed come before the Legislature’s Labor and Housing Committee in opposition to the bill, citing a nursing shortage that they said would only be exacerbated by mandated ratios.
In her testimony last year on the bill, Sharon Baughman, chief nursing officer for MaineHealth, argued that because the measure would force hospitals to hire many additional nurses, it would be prohibitively expensive, leading to reductions in services.
“Staffing is not always perfect, and the nursing profession is hard. But mandated ratios are not the solution to this issue,” Baughman said. “Training more nurses and building cultures of inclusion and feedback are. I urge you — don’t strip nurses of their autonomy, don’t reduce nurses to a number, don’t further reduce access to care in our rural areas.”
Proponents countered some of those arguments by pointing to an amendment attached to the bill, which they said addressed many of the concerns raised. That amendment would have gradually phased in staffing requirements for critical access hospitals along with monetary penalties and would have required the Department of Health and Human Services to establish a process for critical access hospitals to request flexibility regarding direct-care nurse staffing requirements, among other provisions.
O’Sullivan also disputed the arguments against staffing ratios, saying that hospitals could further invest in nursing if they wanted to and that the industry will always “cry poor.”
Research has found that each additional patient the average nurse is responsible for raises the odds of patient mortality. That patient safety aspect is a key reason why nurses pushed for LD 1639, O’Sullivan said.
“It’s not a sustainable job to be a bedside nurse,” she said. “And it needs to be. Because patients need us.”
While O’Sullivan doesn’t know if nurses and advocates will push for a similar policy during next year’s legislative session, she said the overall fight for nurse to patient ratios is far from over.
“It’s not going away,” she said. “We’re not going to stop until we get safe staffing.”
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