Pa. nurses celebrate passage of Patient Safety Act in state House

Long-awaited legislation that would limit the number of patients that hospitals can assign to an individual nurse passed in the Pennsylvania House on Wednesday with bipartisan support. 

The Patient Safety Act, which specifies the number of patients per-nurse required in different hospital settings, passed with a 119-84 vote. Two Democrats voted against the bill, while 19 Republicans voted in favor of House Bill 106, which now goes to the state Senate for consideration.

Nurses and their unions have said high staff-to-patient ratios have contributed to high turnover and difficulty recruiting replacements, especially following the COVID-19 pandemic, when many experienced burnout from the harrowing nature of their work with gravely ill patients.

“This bill is not easy, but today we’re going to make a choice, and to me this is an easy choice. This is a choice to not only help nurses, but help hospitals,” state Rep. Thomas Mehaffie, R-Dauphin, said. 

Mehaffie is co-prime sponsor of the bill with Rep. Kathleen Tomlinson, R-Bucks.

Mehaffie said lawmakers have heard the concerns of nurses for nearly two decades and the bill has evolved drastically in that time. 

“We don’t have a nurse shortage, we have a nurse retention problem. We are not keeping nurses in the hospitals. The turnover is nearly 30% and we need to change that environment,” Mehaffie said.

The healthcare industry has opposed the legislation, saying that rigid nursing requirements are not the solution, and will eliminate the flexibility that hospitals need to provide appropriate nursing care.

Several lawmakers shared their experiences in which they and loved ones were affected by a shortage of nursing staff.

Rep. Tarik Khan, D-Philadelphia, who is a nurse, said his colleagues go to work every day with the fear of harming a patient because of unmanageable workloads. Khan gave an example, telling a story he said he had never told before, about administering the wrong medication to a patient, who suffered an acutely elevated heart rate as a result.

“Fortunately, that patient was unharmed, but in our commonwealth, unfortunately, due to the fact that there is no safe minimum nursing standards, overburdened nurses all over are making avoidable errors like I did on the floor,” Khan said. 

Nicole Stallings, president of the Hospital and Healthsystem Association of Pennsylvania, said her organization and its members are willing to work with lawmakers and Gov. Josh Shapiro’s administration to find solutions to the nursing shortage.

Hospitals are working aggressively to recruit and retain nurses with pay raises, bonuses, loan repayment, work flexibility and other incentives, but remain unable to fill three out of every ten bedside nursing positions, Stallings said. 

“It is unrealistic to assume that a rigid mandate will bring to the bedside the tens of thousands of nurses who will be needed, in the specialties and geographic areas where they will be needed,” Stallings said in a statement. “Hospitals would be forced to make an impossible choice: Break state law at the risk of losing their license, or close beds and reduce services to meet ratios.”

During a rally in the Capitol Rotunda that followed the vote, Republican and Democratic co-sponsors of the bill spoke of the effort needed to move the legislation through the Senate, where it has stalled in past sessions.

Sen. Maria Collett, D-Montgomery, is the prime sponsor of companion legislation in the upper chamber and noted that GOP leaders refused to move the bill last session even with 21 co-sponsors.

“We need you to keep the fight up,” Collett said. “Just keep calling your state senators and encouraging your friends, colleagues and patients to call their state senators to make sure they signed on to the Patient Safety Act.”