Ohio Bill Tackles Staffing Standards, Incentivizes Nursing Students to Work In-State

Gayle Morris, MSN
Updated October 9, 2023
Edited by
    The Ohio Nurses Association worked with state lawmakers to develop a bill to protect nurses and patients by improving the nursing shortage.
    Ohio state capitol building in ColumbusCredit: Getty Images/iStockphoto
    • The Ohio nursing shortage has created a patient care crisis that state lawmakers seek to address.
    • The Nurse Workforce and Safe Patient Care Act will establish staffing ratios and student incentives.
    • However, some are not convinced better staffing and pay will improve the shortage but exacerbate it.

    In May 2023, the Ohio Nurses Association (ONA) declared a “Code Red” due to the state’s nursing shortage impacting patient care. Nationwide nursing shortages have influenced multiple nurse strikes to lower staff-to-patient ratios and increase pay.

    The Code Red campaign addresses the need for safe staffing to impact the “patient care crisis in Ohio,” said Rob Weitzel, RN, ONA president.

    As Ohio nurses coordinated efforts to appeal for better conditions, the Ohio legislature took notice and proposed the Nurse Workforce and Safe Patient Care Act. Let’s examine how lawmakers have responded and what the Act could mean for Ohio nurses.

    The State of Nursing in Ohio

    As part of the Code Red campaign, ONA conducted a survey to explore the state of nursing in Ohio and to measure support for a bill that includes minimum staffing standards. The survey results were compiled into the ONA’s Official Report: The State of Nursing in Ohio.

    The report revealed the following:

    • Roughly 40% of the nurses asked said their patient care units were “rarely” or “never” appropriately staffed.
    • Nearly 7 out of every 10 bedside nurses have considered quitting because of the shortage, and 58% who have already left the profession cited the same reason.
    • About 89% of respondents said improvements in nursing-patient ratios would increase their likelihood of staying in a direct care role, and 42.8% said they would consider returning if minimum staffing standards were passed.

    In May 2023, a local Ohio news station reported that roughly 100,000 RNs had left the workforce nationwide, citing the COVID-19 pandemic as the cause, and thousands more expected to leave their jobs within the next 5 years.

    Catherine Henderson, an RN at Ohio State University James Cancer Center, told a reporter from WHIO TV that staffing at the center had dropped from 80 full-time nurses to roughly 35. Kettering Health had 350 RN positions open in May 2023.

    “At the end of a shift, I am typically completely exhausted, mentally, physically,” said Henderson. “You’re burnt out, you’re overwhelmed, and to continue to go on like this, I don’t see it being sustainable.”

    State Lawmakers Respond to Staffing and Patient Safety Concerns

    On September 27, 2023, the Ohio Nurses Association was at the State House to introduce a bill alongside co-sponsors, Ohio Rep.Haraz Ghanbari, R-Perrysburg, and Rep. Elgin Rogers, Jr., D-Toledo.

    Ghanbari and Rogers believe introducing a minimum nurse-to-patient ratio can improve patient care and keep nurses working. Both are adamant that the state needs to do more to keep nurses from leaving the profession. This was the impetus behind the Nurse Workforce and Safe Patient Care Act.

    The Nurse Workforce and Safe Patient Care Act Explained

    The Nurse Workforce and Safety Patient Care Act establishes legally enforceable minimum staffing standards for nurses and creates a loan-to-grant program for nursing candidates. The $20 million loan-to-grant program makes nursing students eligible for a $12,000 loan-to-grant, equally distributed over four years.

    The caveat is that nurses must commit to serving in Ohio at the bedside or in nursing education for five years. The Act establishes staffing standards and preserves the role of nurse staffing commissions, ensuring they have representation in establishing safe staffing levels. It allows for a temporary deviation only under extraordinary circumstances. Finally, the legislation would create a reporting system for people to file against a hospital with inadequate staffing.

    Will These Efforts Lead to Better Nurse Retention in Ohio?

    According to 80% of healthcare executives, acquiring and retaining employees is one of the biggest risks to healthcare companies. Not all are convinced that minimum staffing ratios and better compensation could help improve the nursing shortage. Some, like the American Hospital Association, believe these laws could exacerbate the problem.

    In its “Code Red” press release, ONA addressed many objections often used when discussing staffing ratios and pay raises:

    “…raising compensation does absolutely help in retaining strong nurses, especially in rural areas where nurses are harder to find. Creating ratios also helps because working at the bedside becomes more manageable, allowing nurses to do what they do best…help patients heal.”

    As ONA found in its survey, the promise of better staffing ratios could entice more nurses who have left the profession to return.

    “We want to make sure that we are encouraging nurses to come here, stay here, make this home, and come do the job that you signed up to do and give those families the care that they need,” said Rep. Elgin Rogers, Jr., co-sponsor of the bill.