For years the American Nurses Association has backed bills based on staffing committees that just don't work. In fact some of the states that have adopted these laws have the worst working conditions for nurses leading to unsafe practices when caring for patients. It is time for the American Nurses Association to start standing up for bedside nurses and stop bowing to the hospital industry. In signing this petition if you are a nurse you pledge not to pay dues to the American Nurses Association until they back laws that set nurse to patient ratios. In signing this petition, if you are a patient advocate, a patient, or a family member of the patient you pledge to educate yourself on the role that understaffing plays in your safety as a patient. The following are research findings related to understaffing and patient care; -The difference between 4:1 and 8:1 patient-to-nurse staffing ratios is approximately 1000 patient deaths (Aiken, Clarke, Sloan et al., 2002). - Patients on understaffed nursing units have a 6% higher mortality rate (Needleman et al., 2011). This risk is higher within the first 5 days of admission (Needleman et al.). - An increase of one RN full time nurse per 1000 patient days has been associated with a statistically significant 4.3% reduction in patient mortality (Harless & Mark, 2010). - Adding one patient to a nurse’s workload increases the odds for readmission for heart attack by 9%, for heart failure by 7%, and for pneumonia by 6% (McHugh, 2013). - Lower patient-to-nurse staffing ratios have been significantly associated with lower rates of: a. Hospital mortality; b. Failure to rescue; c. Cardiac arrest; d. Hospital-acquired pneumonia; e. Respiratory failure; f. Patient falls (with and without injury); and g. Pressure ulcers. (Aiken, Sloane, et al., 2011; Cho et al., 2015; Kane et al., 2007; Needleman, Buerhaus, Stewart, Zelevinsky, & Mattke, 2006; Rafferty et al., 2007; Stalpers et al., 2015) - Higher numbers of patients per nurse was strongly associated with administration of the wrong medication or dose, pressure ulcers, and patient falls with injury (Cho, Chin, Kim, & Hong, 2016) The choice is clear, we demand that the ANA protect our patients, and protect bedside nurses, by supporting nurse to patient ratio laws!