Patient safety time for federally mandated registered nurse to patient ratios.

COVID-19 highlighted the role registered nurses (RNs) have in our healthcare system. The shortage of equipment plus an overwhelming demand for nursing care placed significant stress on nurses. The physical and emotional toll of caring for COVID patients and not having an adequate number of nurses in many cases placed many nurses in harm's way. Despite some healthcare systems reporting significant profits during COVID, few nurses benefited financially. ICU nurses found themselves assigned to three or more patients. Having a defined RN to patient ratio is an urgent need. Pass efforts to mandate via Federal legislation ratios have failed largely due to hospitals' opposition. California has had mandated RN to patient ratios since 2011. Their experience has proven that patient outcomes improve as well as nurse retention. Hospitals' decrease has largely offset the impacts of hospitals' net revenue by decreasing acquired infections, reducing the 30-readmission rate, and improving patient satisfaction scores. As documented in recent Harris polls, the consumer appears ready to support nurses, with nurses enjoying significant public support. The political climate for such change is favorable compared to the past. The Yoder-Wise Planned Policy Change illustrates how Federal legislation mandates RN to patient ratios is achievable.