Pros and cons of mandating nurses

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But Jan Emerson, spokeswoman for the California Hospital Association, which fought implementation of the ratios with an unsuccessful court challenge, says they are tough for hospitals to enforce.

"The most onerous aspect to the ratios is the requirement that hospitals be in 'continuous compliance'—that means in compliance every minute of every shift on every unit every day," Emerson says.

The other problem Emerson points to is with ratios in the emergency room, where the ratio is one nurse to four patients.

"The only time a hospital can go above this ratio is when there is a local or state declared emergency.

"We've been fighting for a similar bill in Massachusetts," says David Schildmeier, director of communications for the Massachusetts Nurses Association.

He says similar legislative proposals are working their way through 13 other states as well.

One-to-four patient ratio is required in antepartum, postpartum, pediatric care, and in the emergency room, telemetry, and other specialty care units.

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