AUGUSTA, Maine — The Maine Senate passed Wednesday a bill that would see the state join California as the only ones with minimum nurse-to-patient staffing ratios.
The measure from Sen. Stacy Brenner, D-Scarborough, who worked as a nurse-midwife earlier in her career, has pitted the state’s nurses union against the Maine Hospital Association, and it took a long time to receive a vote after getting tabled last year.
The Senate voted 22-13 along mostly party lines to pass it Wednesday. Sen. Joe Baldacci of Bangor was the lone Democrat opposing it and Sen. Jim Libby of Standish was the lone Republican to support it. It faces further votes in both chambers.
The amended bill would require various ratios at critical access hospitals starting July 1, 2025, such as assigning a nurse to no more than two patients receiving neonatal intensive care, four patients receiving telemetry services and five patients receiving surgical or speciality care.
Those maximum numbers of patients per nurse would drop by one starting July 1, 2026, under the bill, which exempts the state-run Riverview and Dorothea Dix psychiatric centers and allows critical care hospitals to request flexibility regarding the ratios.
The amendment to the proposal also allows hospitals to avoid penalties for “unpredictable and uncontrollable” rapid increases in patients during emergencies causing multiple casualties and severe injuries, such as disasters and acts of violence.
Hospitals who violate the staffing requirements would face maximum fines of either $5,000 or $12,500 starting July 1, 2026, and those top penalties would rise to $10,000 and $25,000 one year later, under the bill.
Nurses showed up to the State House last year to testify in support of Brenner’s bill and share tales of exhaustion, guilt and burnout while working in hospitals with severe staffing shortages.
“This is the most significant legislation for patient safety that has ever been proposed or passed in our state,” Maine State Nurses Association President Cokie Giles said after Wednesday’s vote.
Maine hospitals acknowledged the staffing crises they face but argued the mandated ratios would force them to close beds in order to comply. Sharon Baughman, MaineHealth’s chief nursing officer, said last year “training more nurses and building cultures of inclusion and feedback” are solutions, rather than ratios.
Sen. Marianne Moore, R-Calais, and other Republican senators argued nursing unemployment is already low, with Moore saying the bill could bring an already strained health care system in Maine “crashing down and further limit access to care, especially in rural areas.”
Supporters pointed to California, which implemented in 2004 the nation’s first and so far only minimum nurse-to-patient staffing requirements, and research finding lower patient mortality, lower nurse burnout and other positive outcomes. Numerous other states, such as Massachusetts and Vermont, have varying staffing regulations.
Brenner grew emotional Wednesday while recalling her experiences with working 14-hour shifts, not having time to use the bathroom and leaving a hospital with a sense of “dread” over whether she forgot a task while scrambling between duties.
“Being in the Legislature feels like a relaxing hobby in comparison to working as a bedside nurse,” she said.
