Safe RN Staffing Legislation Fact Sheet and Historical Timeline


  • Hospitals begin cutting nursing staff and replacing registered nurses with unlicensed personnel (no scientific data available to address questions raised by nurses on the safety implications to patients – industry assures no adverse impact to patient care).


  • MNA holds town meetings throughout the state open to nurses and consumers. All report health care changes as a result of managed care, deregulation and re-engineering causing patients to suffer.


  • MNA Statewide Safe Care Campaign is formed.
  • Hospitals merge to compete, leveraging higher reimbursement rates from insurers – further nursing staff is cut.
  • Blue Ribbon Commission with nursing and consumer input fashions a number of legislative health policy initiatives to rectify the rapidly deteriorating conditions in health care. (RN/Health professions ID requirement, Whistle blower legislation, moratorium on for-profits, hospital service closure oversight process, health data collection/disclosure requirements, RN-to-patient minimum staffing).


  • Hospital industry claims nurses are exaggerating claims of poor care, no need for legislation.
  • First State House rally for RN-to-patient minimum staffing.
  • MNA files minimum safe RN staffing legislation.



  • Boston Business Journal story: 495% increase in the number of patient complaints.
  • American Hospital Association survey: 35% of patients report substandard care.


  • Safe Staffing bill filed for 1999/2000 session.
  • Legislature passes “whistle blower protection” law to protect health care workers that speak out on patient safety and care.



  • New England Journal of Medicine report: ‘strong and consistent’ link between nurse staffing levels and patient outcomes.
  • Safe Staffing bill filed for 2002/03 session.
  • State House rally features delivery of more than 80,000 signatures of Massachusetts residents gathered in just 10 days in support of safe RN staffing legislation.
  • Independent survey of Massachusetts residents reveal 82% in favor of passing minimum RN-to-patient staffing – feel current situation critical.
  • With increasing data in support of bedside nurses claims of deteriorating patient care, hospitals cite an inability to recruit nurses as the reason to oppose minimum staffing.



  • Independent survey of part-time nurses in Massachusetts finds that among nurses who have left the bedside – a whopping pool of 22,000 in the state – over 65% say they would strongly consider returning to the beside if the minimum RN-to-patient staffing bill passed.
  • Over 1,000 registered nurses and patient advocates rally at the State House imploring lawmakers to bring relief to patients and families assuring safe nursing care in Massachusetts hospitals – pass Safe RN Staffing H. 1282.


  • Coalition to Protect Massachusetts Patients grows to 100 groups.
  • Negotiations with House leadership, MNA, MHA produce a compromise RN staffing bill.
  • Compromise Bill passes House 133-20. Senate fails to take up bill before end of session.


  • RN Safe Staffing bill passes House 120-34.
  • State Senate voted 23-13 in support of a drastically amended version of the Patient Safety Act (S. 2816).
  • Legislative session ends in stalemate on Safe Staffing bill.


  • RN Safe Staffing bill filed in new legislative session and released from Committee on Public Health and Committee on Health Care Financing.



  • A ban on mandatory overtime, originally a component of our safe staffing legislation, is passed into law by the legislature and goes into effect on November 5th, 2012
  • The MA Legislative session ends without a vote on the full Safe Staffing bill in either the House or Senate.


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