SPRINGFIELD, Ill. — It's National Nurses Week, and advocates for the profession are continuing their fight for safer working conditions.

There is no limit in Illinois as to how many patients an RN can treat at one time. According to Alice Johnson, executive director of the Illinois Nurses Association, this can lead to understaffing and compromised patient care. However, she noted, minimum nurse-staffing levels for hospitals could be created through the Safe Patient Limits Act, HB 2604.

"First and foremost, nurses are patient advocates, and the Safe Patient Limits Act is really about protecting and caring for patents,” Johnson said. “I think we're going to see real change this year because nurses are energized and ready to step up and make sure that this law gets passed."

According to state records, there are more than 182,000 registered nurses in Illinois. Half of them work in hospital or acute-care settings. And notes Johnson, on a medical-surgical unit, the likelihood of patient death rises by 7% for each patient past four who is assigned to an RN.

Opponents to the bill counter there is no solid evidence that mandatory staffing ratios improve the quality of care.

Danny Chun, speaking on behalf of the Illinois Health and Hospital Association, says a 'one size fits all' approach limits hospitals flexibility. "We strongly believe that mandating nurse staffing ratios in hospitals would be unworkable and would not improve quality or patient outcomes, but could actually undermine patient's access to needed healthcare."

His organization is promoting an alternative approach for each hospital to come up with its own guidelines for nurse staffing, developed with the guidance of direct care nurses.

Johnson said she questions other claims by opponents that the limits would be too costly for hospitals to implement, leading to closures or reduced services.

"More nurses is going to mean better patient care, it's going to mean more safety for the nurses and that is going to save money,” she argued. “There was a study that showed that implementing the Safe Patient limits would save over $1 billion for Illinois hospitals."

Chun strongly disputes the methodology of the study, released by the Illinois Economic Policy Institute.

Johnson said improved nurse-to-patient ratios also would reduce costs by reducing workplace burnout and staff turnover. California is the only state that has a law mandating required minimum nurse-to-patient ratios, which a 2015 study associated with more than 50% fewer occupational injuries and illnesses per 10,000 RNs per year.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.

The California State Assembly is considering a bill to require schools to have a cardiac arrest response plan. Assembly Bill 2887 would make sure schools update their safety plans to include CPR training and an automatic external defibrillator or AED onsite.

Dr. Stephen Sanko, a professor of clinical emergency medicine at USC, and a founding member of the Cardiac Arrest Survivor Alliance, is a volunteer expert for the American Heart Association. He said having a plan in place is critical.

"The American Heart Association is promoting that schools have a cardiac arrest response plan. A written protocol for what to do in order to decrease the likelihood that if somebody collapses, that they die," he said.

Two years ago, 15-year-old Cash Hennessy collapsed on the football field due to a previously unknown heart defect. Two off-duty medics in the stands gave him CPR. The school brought out its AED - but it was useless, because the batteries were dead.

Hennessy said the experience was traumatic.

"I feel blessed that I had people there for me, that could give me C-P-R. But I think about if those people weren't there and that was another kid, who knows what would have happened? Because there wouldn't have been an AED to save them," he explained.

An AED walks people through the steps to deliver a life-saving shock to a person's heart until an ambulance arrives. Studies show that 70% of kids who suffer sudden cardiac arrest at school recover if an AED is deployed correctly - whereas the survival rate for kids and adults not in the hospital is less than 12%.