Pa nursing laws mandating

Medical and surgical nurses would have a maximum of four patients while psychiatric nurses would be limited to five.

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The news upset advocates who argued that overburdened nurses provide lower quality care and are more likely to leave the organization.

They pointed to research that showed that fears related to safety-net California hospital closures or a less-skilled nursing staff never materialized.

The latter required that the hospital couldn't change other hospital staffing levels to offset the nurse-staffing requirements.

Massachusetts providers would have also had much less time to comply with the new ratios compared with California's incremental implementation.

"We have shown that indeed 15 years after the passage of California ratios, California has experienced a more rapid decline in mortality than other states," said Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania.