OH SB324

Establishes mandatory minimum nurse-to-patient ratios in hospitals, ranging from 1:1 in operating rooms and critical care units to 1:5 in rehabilitation and skilled nursing units, with ratios determined by unit type and patient acuity.

Requires hospitals to create nursing care committees with at least 50% direct-care registered nurse membership to develop evidence-based staffing plans and address nurse-to-patient ratios.

Prohibits hospitals from retaliating against nurses who refuse assignments they are not competent to perform, imposing mandatory overtime to meet ratios, or filing complaints with the nursing board based on assignment refusal.

Grants registered nurses the right to act as patient advocates, object to unsafe practices, and assess whether medical orders are in patients' best interest before implementation.

Establishes fines of up to $25,000 plus $10,000 per unit shift for non-compliance, and allows nurses to sue for damages including reinstatement, lost wages, attorney fees, and court costs for violations.