Nurses say NO to ratios

The Legislature's Labor Committee is considering LD 1639, which would implement rigid patient to nurse ratios in hospitals.  This legislation would increase the cost of healthcare in Maine, limit access to hospital care, and decrease hospital quality. 

What this legislation would do:
  • Cost well over $100 million. When nearly half of Maine hospitals were operating on negative margins before the pandemic, hospitals simply cannot absorb the substantial, increased costs from mandated ratios;
  • Limit access to hospital care.  Hospitals that can't meet the rigid ratios will have to close beds units or even whole facilities..This means ill and injured Mainers may have to travel farther for care causing unnecessary and potentially dangerous delays; and
  • Strip nurses of autonomy and flexibility.  Nurses staff units based on the condition of the patients, the skill and experience of the nurses on duty and even the layout of the care environment. 
What this legislation won't do:
  • This legislation won't create a single nurse.  Hospitals know we need more nurses, we have job postings for more than 1,000 of them.  Only 2.3% of nurses are unemployed in Maine, so hospitals are focusing their efforts on training new nurses and encouraging young people to choose careers in healthcare;
  • It won't improve healthcare quality.  Only one other state, California, has rigid ratios like envisioned in this bill. Maine's hospital quality routinely is ranked among the best in the country.  California's is mediocre at best;
  • It won't help recruitment and retention.  Nursing homes are governed by mandatory staffing ratios and they have been forced to close beds and whole facilities because of staffing shortages.




Maine hospitals and others are working to increase the nursing workforce in the state.  A recent report showed that those efforts are paying off.  Despite the nationwide nursing shortage, Maine's shortfall of nurses has actually declined and the average age of nurses has dropped. The number of working RNs younger than 35 grew by over 1,000.



Letter from the Board of Nursing refuting testimony that there are 12,000 unemployed active nurses.  In fact, there are only about 860, with many giving the reason that they are taking care of home and family.


Mandated staffing ratios may not solve the complex issues facing hospitals and nurses (Bangor Daily News, May 15, 2023) " At a time when Maine already has a nursing shortage, we are concerned this bill would make the situation worse without addressing the underlying causes of worsening conditions in hospitals in Maine, and across the country. This could mean that hospitals would have to close units and deny care if they couldn’t hire enough nurses to meet the mandates in LD 1639."

Margaret McRae: LD 1639 is a bad move for patients and nurses (Sun Journal, May 24,2023) "LD 1639 removes nurse autonomy to make the necessary decisions to provide safe, effective, quality care. It essentially reduces every patient and every nurse to just a number by mandating nurse-to-patient ratios. These ratios are not evidenced-based and do not take into account the patient as an individual."

Steve Jorgensen, Patricia Scherle, Steve Littleson and Kris Chaisson: Nurse staffing bill threatens access to health care (Sun Journal, June 8, 2023) : "Despite our aggressive efforts to hire more nurses — including offering free education and recruiting nurses from across the globe — Maine, like the rest of the nation, does not have enough nurses to meet our needs."



The Maine Nursing Coalition opposes inflexible mandates

LD 1639 won't create one more nurse, but LD 1797 will train more nurses.  Read more about what hospitals and others are doing to train more nurses.