When I started as a nurse here in the U.S. I was young and naive and didn’t know any better. I started as a nurse in a sub acute unit which was a Skilled Nursing Facility. During that time I was blessed to work with an LVN or a License Vocational Nurse who was so knowledgeable and experienced. We each had 12 patients a piece and since I am an RN, I was always in charge and would be responsible for all intravenous drips or medications and admissions.

It was hard and involved labor intensive duties because even though patients were not acutely ill, they still have a lot of needs. These were patients that came from the acute settings who had strokes, hip surgeries, knee surgeries, heart surgeries etc., so they would require intravenous antibiotics, dressing changes, feeding tube management, tracheostomy care, Foley catheter care, wound care, transfer assists, assistance with their activities of daily living, physical, occupational and speech therapy etc.

I didn’t know any better then so I diligently performed those responsibilities for 8 years without any complaints until I got burned out and so I left.


Moved To An Acute Setting


I moved to an acute setting which was a hospital. It was an Acute Rehab Unit which sounded so promising at first because when I was hired, they promised a nurse patient ratio of 1 nurse to 5-6 patients. Sounds good right, since I came from a unit with 12 patients in which I had to supervise an LVN with her 12 patients and plus being in charge all the time in which I had to be responsible for the organization of the unit for the whole shift.

It was great at first despite having to work with difficult coworkers, until after my month of orientation. It was often short-staffed so I would end up with 7-9 patients. The realization sets in, that that particular set up was much harder compared to my previous work as the type of patients that we had, although stable, still needs a lot of care. Most still requires intravenous drips, blood works, blood transfusions etc. aside from therapies.

Not to mention, when other floor or unit becomes short-staffed, the tendency of one nurse to be floated was high. I remember being floated to a Neuromuscular floor to take care of 6 patients. Being a newer nurse to that hospital who just finished  orientation to an Acute Rehab, made me lost. I struggled and was very upset as it was so unsafe for my patients and me as I was not so familiar with those kinds of patient population and most of their medications then.

I got more furious ‘though when the manager told me that after my 8 hours on that floor, I would go back to my home floor which was the Acute Rehab Unit to complete my 4 hours there as they didn’t need me anymore and that my home floor needs me for that 4 hour.

I had to stand my ground and so I talked to the Director of Nursing and made her realized the consequences of what they were asking of me. I was floated to a floor that I was new to with 6 high acuity patients (heavy and has a lot of needs) . Then after 8 hours I was being asked to float back to my home floor even though I was not yet done documenting on those 6 patients I had for 8 hours. They expected me to take care of brand new patients for another four hours. Patients that I would have to familiarize myself all over again and familiarize myself to their plan of care and medications  which usually takes a while and would only mean that for  4 hours I will be very stressed and  those patients may not get the attention that they needed because I still need to finish charting on those 6 patients that I previously had.

The unsafe decision-making of these leaders are placing nurses of becoming stressed which can result to making mistakes that may harm patient’s and nurses health and well-being.

policy for nurse patient ratio

Proposed Federal RN Ratios


So for years now, nurses has been in despair regarding this nurse patient ratio. Across the nation the safer staffing ratios has been an issue. Due to tighter budgets and substantial increase in number of patients, nurses has been placed in a very unsafe situation of caring for an amount of patients that is impossible for one to provide a good quality of care which in turn can endanger himself/herself and the patient.

Nurse.org has written that “mandated staffing ratio is the key solution in addressing this issue” which I also believe . According to them as of 2017, California is still the only state to have a safe patient ratio law. The California Nurses Association worked diligently to advocate and lobby for the law despite resistance from the powerful hospital industry in which hopefully other states will follow suit to protect nurses and patients which in the long run will be beneficial for everybody.


What Are The Importance Of Safe Nurse Patient Ratio


  1. Nurses will be able to take care of their patients adequately.
  2. They will have enough time to handle issues as they arise regarding patient care and their specific conditions.
  3. Medicine errors will be avoided.
  4. Infection control will be given a higher focus.
  5. Patient’s fall will be lessened.
  6. Patient’s skin care will be given focus that will lead to being free of acquiring pressure sores.
  7. Less stress for nurses and other healthcare professionals.
  8. Nurses and patient satisfactions are going to be higher.
  9. Nurses will have enough time to properly educate patients and their families.
  10. Less likelihood of patients getting sicker that can lead to death.
  11. Nurses will have enough time in undertaking of any procedures which eventually will give them time for breaks that will avoid other health problems and eliminate stress.
  12. Retention of nurses will increase.
  13. Nurses shortage may not be a case anymore.
  14. Health care cost will be lessened.



Unsafe nurse patient ratio and shortage of nurses does not correlate to the purpose of healthcare system which is to provide a safe place for patients to receive treatment, care and to heal. According to nurse.org, unsafe and stressful working conditions have caused 1 out of 5 new nurses to leave the profession completely within just 12 months of earning their license. 1 out of 3 nurses leave within two years of starting work due to burnout, being overworked and feeling pressured to take more patients and responsibilities.

The sad reality of unsafe nurse patient ratio which if not acted upon will cause more shortage in nurses which will not be beneficial to both hospitals, patients and nurses that chose to stay.

Let us make a discussion about this issue. Have you had any experience regarding nurse patient ratio? For any questions and comments, please leave them down below.