April 9th, 2025

Ron DeSantis

Governor of Florida

400 S. Monroe Street

Tallahassee, FL 32399

Dear Governor DeSantis,

     I am writing to urge you to support legislation that mandates safe nurse-to-patient ratios in hospitals and skilled nursing facilities across the state of Florida—modeled after the successful law implemented in California.

     Numerous studies and real-world data show that safe staffing ratios reduce mortality rates, decrease hospital-acquired infections, prevent medication errors, and significantly lower nurse burnout. In turn, these improvements lead to higher nurse retention, increased patient satisfaction, and better overall healthcare outcomes.

     Unfortunately, many of our healthcare institutions—particularly for-profit hospitals and skilled nursing facilities—continue to prioritize profits over patient safety. Nurses who raise concerns about unsafe conditions often face retaliation. This dangerous and unsustainable culture puts both nurses and patients at risk.

     Let me be clear, as a nursing instructor I can say, we do not have a nursing shortage. We have a shortage of nurses who are willing to sacrifice their licenses and their well-being by working under unsafe, exploitative conditions. To protect both our nurses and our citizens, Florida must take bold action.

     I urge you to champion legislation that includes:

 Mandatory, nurse-to-patient ratios that are based on patient acuity, ensuring nurses are assigned fewer patients when caring for individuals with more complex and high-risk medical needs.

Financial penalties for facilities that fail to meet safe staffing standards.

Whistleblower protections for nurses who report unsafe or unethical practices.

Safe Staffing Saves Lives.

      Currently, skilled nursing and rehab facilities can give one nurse up to 40 patients. That is so unsafe, it should be a ratio of 1 nurse to 13 patients in a skilled nursing and rehabilitation for top of the line care. 

     The state of California has led the way with enforceable nurse-to-patient ratios in the hospital setting that are adjusted by unit. These include:

ICU – 1 nurse for every 2 patients

Emergency Room – 1:4 (with triage sometimes requiring 1:2)

Step-down / Telemetry – 1:3

Medical-Surgical Units – 1:5

Psychiatric Units – 1:6

Labor & Delivery – 1:2 for active labor

Postpartum – 1:4

Pediatrics – 1:4

Operating Room – 1:1 per patient under anesthesia

     These laws have not only improved patient outcomes but they have also decreased nurse turnover and reduced burnout.

     In addition to staffing reform, I respectfully urge the state to incentivize hospitals and skilled nursing facilities that prioritize both patient-centered care and nurse well-being. Incentives could include:

     Tax credits or grants for facilities offering nurse wellness programs, safe staffing models, or integrative care initiatives.

     Medicaid/Medicare reimbursement bonuses based on patient satisfaction, nurse retention, and reduced adverse outcomes.
     Public recognition or accreditation for nurse-friendly institutions.

     Some leading healthcare systems are already taking meaningful steps:

North Well Health in New York provides wellness retreats and mindfulness programs through its Nurse Resilience Program.

Cleveland Clinic offers retreat-style workshops for stress relief, mindfulness, and emotional support.

Stanford Health Care funds multi-day wellness retreats to address nurse burnout and promote mental well-being.

     By investing in nurse wellness and safe staffing, Florida can become a national model for ethical, sustainable, and compassionate healthcare.

     One day, each of us will be a patient. Let us act now to fix the broken system to build the kind of system we would want for ourselves and our loved ones. Let us build the bridge we will one day walk across—a bridge to a safer, healthier future for every Floridian and eventually every American.

     Thank you for your time, service, and leadership.

Sincerely,

Dannin Grosso, RN

Nursing Instructor and Founder of Integrative Home Health Services 

Danninbrae@yahoo.com

Bradenton, Florida