On International Nurses Day, the D.C. Council was targeted by protesters seeking approval for a bill to force mandatory staffing ratios for nurses and patients at D.C. hospitals. (Aaron D. Davis/The Washington Post)

A decade after the first and only strict law on nursing ratios went into effect in California, the nation’s largest nurses union on Monday again targeted D.C., hoping it can convince the 13-member D.C. Council to break a national stalemate over the issue.

National Nurses United, which represents 185,000 registered nurses nationwide, organized a rally on Pennsylvania Avenue of about 50 RNs on International Nurses Day. The group delivered to council members a list of alleged incidents of unsafe care in D.C. hospitals due to nurses being stretched thin in recent months in caring for patients.

A bill to require D.C. to institute strict rules — limiting to four the number of patients per nurse in many situations — has been stymied in the council’s health committee and shows no signs of being resuscitated anytime soon.

Like with other national goals for labor groups, such as increasing the minimum wage and demanding more compensation of big-box retailers, the D.C. Council remains an attractive target for the nurses union. It would have to convince just a handful of Council members, rather than an entire state legislature, to make the ratio law.

In D.C., a majority of Council members actually signed on in support of the measure last year, but one of those signatories — Yvette M. Alexander (D-Ward 7), chair of the health committee, has delayed the bill. Alexander said in March that she had grown sympathetic to the hospital industry’s arguments against the bill: that its effects on patient safety is unproven and that increasing nurse staffing will lead to decreases in other key hospital personnel.

But nurses who spoke outside the Wilson Building on Monday morning said they believe they eventually will win over the council with the help of constituents who face poor service in D.C. hospitals.

Potential benefits of strict nursing ratios remains a point of contention, with few large-scale independent reviews of patient outcomes of the law in California, where nurses unions have great leverage with hospitals and some have won significantly higher pay and other benefits compared to those on the East Coast.

Council member Tommy Wells (D-Ward 6) and Vincent B. Orange (D-At Large), who both ran for the Democratic nomination for mayor, spoke at Monday’s rally. In the run-up to the April 1 primaries, Orange attempted to circumvent Alexander’s committee, introducing emergency legislation to pass the bill directly to the council. Orange withdrew the bill after Alexander accused him of election-year politics.