Nevada legislation to establish nurse, patient ratios goes to governor
Two sides are warring over the passage of a bill mandating nurse-to-patient ratios and increasing transparency in work protections.
Senate Bill 182, sponsored by Sen. Rochelle Nguyen, D-Las Vegas, passed through the Assembly on Monday and is awaiting a signature from Gov. Joe Lombardo. The bill is aimed at reducing nurse burnout and increasing patient safety by establishing maximum limits on the number of patients nurses can be assigned to in various hospital units, policies for additional compensation and keep records of any refusals, objections and requests to be relieved.
Nurses are thrilled, hospitals are wary — both are because of the nursing shortage in Nevada.
Currently, Nevada is over 14,000 nurses short of meeting national employment rates or averages, according to a 2025 Nursing Workforce in Nevada report from the Nevada Health Workforce Research Center. Also, the study calls the nursing workforce in Nevada “underdeveloped by regional and national standards.”
The shortage has led to higher nurse-to-patient ratios in hospitals, leading to decreased safety for patients and workers, according to nurses who have lobbied in support of the bill. During the bill hearing on March 6, one nurse recalled one certified nursing assistant taking care of 36 patients in the intermediate care unit.
“This is a day that will change nursing in Nevada for the better, forever,” said Karen Pels-Jimenez, a RN from Las Vegas, in a statement from National Nurses United. “Having legal limits to the amount of patients nurses can be assigned at one time is more than just commonsense regulation — it is the key to making our hospitals safer places to get care and better places to work.”
The two largest nursing unions in Nevada are National Nurses Organizing Committee/National Nurses United and SEIU Local 1107, both heavily lobbying in support of the bill.
California enacted similar legislation 20 years ago, which National Nurses United said “revolutionized” nursing for workers in the state, having “a dramatic impact on their working conditions.”
Hospitals say it’s ‘impossible’
Hospitals are against the bill, saying it would be “impossible” to sustain current levels of care, potentially leading to the shuttering of beds or services, relying on travel nurses, diverting ambulances to other emergency departments or reducing critical capital investments to support Nevada’s growing population, according to nonprofit Nevada Hospital Association.
“We are deeply disappointed by the passage of SB182, which would impose the strictest mandatory nurse-to-patient staffing ratios in the country. Nevada is already experiencing one of the most critical nursing shortages nationwide,” said Nevada Hospital Association President and CEO Patrick Kelly. “We strongly urge Gov. Lombardo to veto SB182 to avoid further straining our already overburdened healthcare system.”
Dignity Health President Katherine Vergos said the health system has a “productive relationship” with union partners and has developed their own staffing structures, but overall believes it will lead to a reduction in services and the bill would override their “collaborative model” with the union.
“Imposing mandated ratios without addressing the underlying workforce capacity will only exacerbate this crisis,” said Vergos. “Hospitals will face the painful choice of reducing services or limiting patient admissions due to insufficient staffing, which will directly impact access to care in communities across the state.”
In a statement to the Las Vegas Review-Journal, Intermountain Health said “mandated ratios create a scenario that takes personalized care out of the equation. We believe there are better solutions than mandated nursing ratios, solutions that allow for the greater flexibility of the care team.”
The legislation would be imposed on hospitals in counties whose population is 100,000 or more, which is only Washoe and Clark County, and hospitals that are licensed to have 70 or more beds.
Some of the ratios proposed are one direct care nurse to a patient in the operating room, critical or intensive care unit, is in active or any stage of labor and one for each newborn; one-to-three for nurses in the pediatric, cardiac, intermediate care or observational unit; one-to-four for ambulatory care, oncology, acute rehabilitation, medical-surgical, psychiatric or pre-surgical; among many others, including some which are governed by time and guidelines for a state of emergency.
Additionally, it would require health care facilities to provide additional compensation for licensed nurses who are: assigned to float between units, perform duties that involve unusual hazarsd or serve as preceptors.
Hospitals would also be required to keep records for two years of each nurses refusals, objections and requests to be relieved, the frequency at which is happened and how the hospital adressed them.
Contact Emerson Drewes at edrewes@reviewjournal.com. Follow @EmersonDrewes on X.
