Nurse Leaders Urge Workforce Solutions over Ratio Mandates

June 14, 2023

Pennsylvania nurse leaders are urging the General Assembly to make investments that would grow the commonwealth’s nursing workforce and bring more nurses to the bedside rather than mandate staffing ratios.

That ask came in a letter today signed by 428 nurses serving in executive, managerial, and bedside care roles in communities across the commonwealth.

“We need your help. We need more nurses,” the letter said. “But, we implore you to take meaningful steps that will actually develop more nurses for the bedside, not tie our hands with ineffective legal mandates as we strive to provide the highest quality care for our patients.”

House Bill 106, which, among other measures, would impose government-mandated nurse staffing ratios in Pennsylvania hospitals, advanced out of the House Health Committee last week and may soon be considered by the full chamber.

Nurse leaders described significant challenges filling open positions in hospitals despite efforts such as major pay increases and bonuses, flexible scheduling, investments in staff safety, support for education and career advancement, and renewed focus on wellness initiatives, employee assistance programs, peer supports, and emphasis on work/life balance. They noted they have brought on travel nurses, increased staff that support nurses, and piloted approaches like team-based care and virtual nursing to support their nursing staff and ensure high-quality patient care despite nurse shortages.

The letter calls for promoting nursing careers, enabling nursing schools to educate more students, offering incentives for nurse educators and preceptors, and making nursing education more accessible through scholarships and loan forgiveness.

“Government-mandated ratios strip us of the ability to use our professional skills, experience, and judgment by removing the very flexibility we rely on to be effective leaders of nurses and providers of patient care,” the letter said. “If strict, government-mandated RN staffing ratios are required in Pennsylvania, we believe that there will be real and lasting damage to Pennsylvania’s entire health care system.”

Also today, HAP President and CEO Andy Carter sent a letter to lawmakers opposing House Bill 106, noting that Pennsylvanians will wait longer for or struggle to access care as hospitals are forced to adjust to the mandated ratios.

“Given the well-documented, nationwide shortage of bedside nurses, if passed, this bill will put Pennsylvania hospitals in the impossible position of having to choose between reducing their capacity to care for patients or breaking the law at the risk of losing their licenses,” Carter wrote.

For information about HAP’s advocacy, contact Heather Tyler, vice president, state legislative advocacy.