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“Can’t eat lunch, have to chart more, scan more, educate more. This patient deserves better care, but there is not enough time.” None of it is in the staffing matrix — and all of it reaches the patient.
From the department
One bathroom break during the entire shift.
“At home yet worried about my patients. Family is worried about me.”
Fewer long-term Nurses training the incoming generations. Much less experience in the field.
What we stand for
Patients first
Limits by unit. Enforceable limits for every unit — no more than four patients per Nurse on med-surg, one or two in the ICU.
Real ratios, posted. The actual numbers, where everyone can see them.
Enough techs. Safe tech-to-RN ratios so Nurses can nurse.
A charge Nurse who can lead. The charge Nurse carries no patient assignment and is staffed above the unit’s core numbers.
Competent before floated. No Nurse is assigned to a unit without orientation and proven competence there.
Families heard. When a family says something is wrong, someone answers.
Social work that shows up. Timely, accountable, with follow-through.
Time that is ours
No forced overtime. Only in true emergencies — never to cover routine short staffing. End-of-shift holdovers capped at one hour.
Days off are off. No mandatory call-ins.
On-call is paid. Waiting by the phone is work.
Eight hours off after a twelve. Rest before the next shift, guaranteed, and no more than seven days in a row.
Real breaks. An uninterrupted 30-minute meal break, paid if you work through it — and a quiet place to take it. No “buddy breaks” that leave one Nurse covering two assignments.
Training we can attend. Not straight after a shift. Night shift are people too.
Work/life balance. Your leave is your time. No mandatory meetings on vacation. No calls or texts when you’ve finally managed to relax.
Safe on every shift
Violence protection. Nurses named in KRS, and protection in practice on every unit.
Know who is calling. Every P25 radio with a unique and accurate ID and name at the console, and an emergency button someone answers.
Safe skies. Crew rest and safety for Flight Nurses, Flight Paramedics, Flight EMTs and Pilots.
Rules with teeth. Repeated staffing misses go to binding arbitration, with payment to every Nurse working short. Overtime above set limits brings fines that go back to the unit. Protection for Nurses who speak up.
Speak up safely
A safe coworker. No one should share a unit, a transport or a flight with someone who makes unwanted advances, crosses lines or makes the shift feel unsafe. Concerns are documented, investigated and acted on — not waved off as “he said, she said.”
Report without retaliation. Harassment and safety reports go to someone outside the chain of command, and the person who reports is protected. Nobody gets told to keep quiet.
Handled the right way. Complaints are investigated promptly and impartially by someone outside the chain of command. Two people in every meeting, the option to ask for an interviewer of a particular gender, a written record, and no contact between the parties while it’s open.
Safe to step away. Anyone who reports harassment or violence can leave the area with pay, take up to two paid shifts away, and is never transferred just for reporting. No discipline for reporting violence, and no one discourages a police report.
Someone in your corner. Trained Persons of Confidence support anyone who reports harassment, from the first conversation to the outcome.
Nothing hidden
Transparency. Planned versus actual staffing, overtime and patient volume for every unit, in the open.
Reports that get answers. Every safety report gets a response and a fix.
Nurses at the table. Staffing committees at least half direct-care Nurses. Every unit has written staffing guidelines, and the unit’s Nurses vote on changes to them.
Human in charge. Any AI used in patient care is tested, explainable and never replaces a Nurse’s judgment.
Pay in the open. Published pay ranges by region — staff, travel, transport and flight.
Leaders who lead
Human and strong. Leaders who lead by example, know the floor, communicate with compassion and support their Nurses.
A voice where decisions are made. When staffing, budgets and policy are decided, the people doing the work have a say — through representatives they choose, not only through management.
Keep good Nurses. Retention, not churn — a full-time core and a career path worth staying for. Know your worth.
A real core team. Fewer travelers, more full-time Nurses who know the unit.
A seat at the table. Nurses in Kentucky bargaining law.
Every Nurse counts. Covered by the role, not the employer — public, private, hospital, transport or air.
What safe looks like.
These aren’t wish-list numbers. They are the staffing guidelines in the University of Michigan nurses’ 2026–2029 contract — negotiated by their union, written into the agreement, and backed by binding arbitration with $200 per shift owed to each Nurse directly affected when a unit is staffed below them. Kentucky Nurses deserve the same.
General care (adult)
3–4 patients per Nurse
the old “up to 4 on nights” exception was removed in 2026
Telemetry / step-down
3 patients per Nurse
same for combined general care + hard-wired telemetry
2 on a secure unit · psych ED 3 per 2 Nurses on the secure core
Bone marrow transplant
2–3 patients per Nurse
3–4 on nights
Pediatrics (general care)
3–4 patients per Nurse
the night-shift exception was removed in 2026
Pediatric, cardiac and newborn ICUs
1 patient per Nurse
PICU, PCTU and the Brandon NICU · 2 for other ICU or step-down-status patients · ECMO adds a second trained RN or specialist at the bedside
Operating room
A Nurse in every room
2026 AORN guidelines
Recovery (PACU)
1–2 patients per Nurse
phase 1: 1 · phase 2: 2 · pre-op: 3 (2026 ASPAN)
Women’s hospital / L&D
Per guidelines
2026 AWHONN guidelines
Source: Agreement between The Regents of the University of Michigan and The Michigan Nurses Association and The University of Michigan Professional Nurse Council, 2026–2029 — the tentative agreements signed in the 2026 negotiations and ratified by members on July 24, 2026, in effect through March 31, 2029. Article 13, Staffing and Scheduling, Paragraph 90B.1, “Current staffing level guidelines (RN only)”; dispute remedies at the Tripartite Arbitration Panel provisions in the same article. Figures shown as patients per RN; the agreement calls them guidelines and allows staffing to flex for patient acuity (Paragraph 90B.2). Specialty areas not listed (ECMO, procedural areas, hematology-oncology, children’s ED) have their own guidelines. Negotiated by MNA–UMPNC nurses; ratification announced by the Michigan Nurses Association; the prior 2022–2026 agreement is published by Michigan Medicine Nursing at med.umich.edu. Credit: Michigan Nurses Association and the University of Michigan Professional Nurse Council. Neither MNA nor the University of Michigan endorses this site.
Mark the wires.
Flight Nurses, Flight Paramedics, Flight EMTs and Pilots land at night beside power lines and towers they can’t see. Orange marker balls are cheap. Wire strikes are not.
Owenton, Kentucky · October 7, 2024
Air Evac 133
A Pilot, a Flight Nurse and a Flight Paramedic were killed when their helicopter struck a guy wire on a 601-foot tower beside the high school landing zone. A clear afternoon, a low sun. The NTSB’s final cause is still pending — but marked guy wires near landing zones could prevent strikes like this one.