Nursing unions and their allies in the Washington State Legislature have introduced SB 5236, which enacts rigid staffing mandates. The bill is similar to legislation the unions and their allies attempted to pass in the 2022 legislative session (E2SHB 1868), which calls for nurse-to-patient ratios. One crucial difference in 2023 is that the bill does not establish what the ratios should be. Rather, the bill directs the Department of Labor & Industries to set ratios through rulemaking. The ratios would be developed by Jan. 1, 2027, and hospitals would be required to follow them by July 1, 2027. It also changes the mandatory prescheduled on-call cap from 24 hours per week to 60 hours per month.