New Oregon law establishes safe staffing ratios

The new law makes Oregon the second state in the nation to adopt mandatory nurse staffing ratios and the first state to put ratios into statute.

This story was published in the Fall 2023 issue of The Washington Nurse.

27 illustration large ONA HB 2697
Oregon Gov. Tina Kotek signed House Bill 2697, Oregon's Safe Staffing bill, into law on Aug. 11, 2023.

On Aug. 11, 2023, Oregon Gov. Tina Kotek signed House Bill 2697 into law. The new law makes Oregon the second state in the nation to adopt mandatory nurse staffing ratios and the first state to put ratios into statute.

In addition to establishing minimum nurse-to-patient ratios, the law provides for wall-to-wall staffing committees, investigations, and enforcement when hospitals fail to follow the law. It also ends the “buddy break system” in which nurses end up with double the patient load when another nurse takes a break.

The bill provides for RN staffing ratios across several different patient care units. Ratios in medical-surgical units are 1:5, moving to 1:4 in June 2026. Certified Nursing Assistants will be assigned to a maximum of seven patients on the day shift and 11 patients on the night shift.

Oregon law has provided for RN staffing committees since 2001. The new law adds two new staffing committees: one for service workers (such as environmental and food services) and one for technical providers (such as radiology and ultrasound techs) and professional providers (such as physical therapists and occupational therapists).

The bill was championed by the Oregon Nurses Association (ONA). Among the bill’s chief sponsors was Oregon Rep. Travis Nelson, RN. The final language of the bill reflected agreement among ONA and other unions — the Oregon Federation of Nurses and Health Professionals (OFNHP), Service Employees International Union 49, and Oregon American Federation of State, County and Municipal Employees — with the Oregon Association of Hospitals and Health Systems, representatives of Oregon Health and Sciences University, Providence, and Salem Health.

Jennifer Mensik-Kennedy, PhD, MBA, RN, NEA-BC, FAAN, president of the American Nurses Association — and an ONA member — had testified in support of the bill when it was heard in committee earlier in the year. In her testimony, she noted that ANA “supports enforceable, minimum nurse staffing ratios as a valuable approach to reduce patient harm, improve quality outcomes, and ensure the creation of a healthy work environment.”

Randi Weingarten, president of the American Federation of Teachers — the national labor partner of ONA, OFNHP, and WSNA — praised the new law.

“This is a groundbreaking day for a groundbreaking bill that will make hospitals and healthcare settings safer for Oregon’s patients and staff alike,” she said.

“ONA’s fight for safe staffing doesn’t end with the passage of this law,” said ONA Executive Director Anne Tan Piazza. “Our nurses and caregivers know what patients need at our hospital and care settings. We will continue to fight for improvements in our collective bargaining agreements and in Oregon law.”

WSNA Executive Director David Keepnews, PhD, JD, RN, FAAN, offered WSNA’s congratulations.

“As we work to implement Washington’s new safe staffing law, we are thrilled at this important victory for nurses and patients in Oregon,” he said. “We are so proud of our friends and colleagues in ONA, and their labor partners, for achieving this historic success.”