Nurses are special people who provide extraordinary care to Maine people in every community, in hospitals, clinics, schools, long-term care settings and all kinds of health care settings.

These worthy accomplishments have been sustained even while Maine’s nursing shortages challenged the recruitment and retention efforts needed to continue providing quality patient care. Our nurses earned the pride and respect of every citizen as they responded to the COVID-19 pandemic by caring for the most acutely ill in our hospitals and supporting public health initiatives to help us all to stay healthy. As we transition to a post-pandemic period, it is understandable that nurses continue facing unprecedented challenges.

Complicating this dynamic is a bill in the Maine Legislature to require health care facilities to enforce a nurse-to-patient staffing ratio bill that will put even more stress on how patients will access care when they need it.

If passed by the Legislature, the patient ratio bill will impose inflexible staffing mandates and require another layer of regulatory oversight to monitor compliance for nurse staffing assignments in health care facilities, including every hospital and ambulatory surgical facility. In other words, if this bill passes, Maine’s health care facilities will be required to comply with at least 13 more pages of regulations as described in the proposal, without evidence that the policies will improve Maine’s already high standards for providing quality nursing care.

In fact, the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality ranks Maine in the first quartile (best quality) in overall quality of care.

Many of Maine’s nurses and nursing leaders oppose the inflexible mandates described in the ratio bill because there is no meaningful data to support how state-imposed staffing mandates in hospitals will improve patient care or create more nurses. Furthermore, to comply with the additional burdensome mandates proposed will cost hospitals millions of dollars.


Maine’s nursing shortage is largely the result of nurses who have retired at a rate faster than nursing education programs can replace them. Today’s nursing shortage is expected to remain constant through 2025. Mandated staffing ratios will not increase the numbers of nurses to care for our patients.

Nurses continue to receive the highest ethics rating from Americans among a diverse list of professions, a distinction we have held for more than two decades. This deserved public support is the result of the dedication nurses hold for our profession. We are focused on providing quality evidence based care. There are already multiple staffing regulations in the evaluations required for licensing by conditions of participation in Medicare and Medicaid, in the Joint Commission Accreditation and from the DHHS division of licensing. Therefore, another layer of compliance is not necessary.

Imposing by law even more regulations on professional practice to create ratio mandates is not a proven method for educating and recruiting more nurses into the profession. When nurses have expressed strong opposition to three previous nurse staffing bills in the Legislature, legislators agreed and rejected the mandate proposals.

Staffing ratios will have the negative impact of limiting access to care when health care facilities are unable to comply with the mandates. Hospitals will close beds and ambulances will be diverted when the law limits nursing care assignments.

In May, nurses will honor the visionary Florence Nightingale who elevated nursing to a prestigious and independent profession. Quality patient care requires nurses who aspire to our profession. We would rather see the Legislature focus efforts on increasing the pool of qualified nurses rather than forcing arbitrary ratios that will raise health care costs and decrease access to care.

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