Beginning this month, the Massachusetts Nurses Association (“MNA”) initiated a signature drive to support legislation requiring hospitals to limit the number of patients cared for by individual nurses.  The initiative is titled the “Patient Safety Act” and strictly would limit nurses in a medical/surgical unit to caring for 4 patients, nurses in emergency departments to 1 to 3 patients, and nurses in critical care units to 1 to 2 patients.  The MNA claims that such requirements are necessary because “hospitals are forcing nurses to ration care, placing patient’s health in jeopardy.”  Lurking in the background of this issue are a recent nurses’ strike and use of staffing levels as a key bargaining point in negotiations between the nurses’ union and Massachusetts hospitals.  The proposed legislation would fine hospitals $25,000 per day for violations of staffing limits, require submission of annual staffing plans to the state health department, and affirmative efforts by the state health department to promote the nursing profession in order to swell ranks.  Similar efforts and legislation have been adopted in California and introduced in 10 other states.