The Importance of Nurse-to-Patient Ratios

Registered nurses (RNs) have been named the nation’s most honest and ethical profession for the 19th year in a row. When there aren’t enough of them to adequately care for every patient , everyone suffers—patients, nurses, physicians, and the facility itself.


As a result, nurse-to-patient ratios are important in terms of patient safety and quality care. We look at the complexities of establishing minimum nurse staffing levels for safety.


Medicare-certified facilities are required by law to “have an adequate number of licensed registered nurses, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed.”

The benefits of matching nurses’ skills and competencies to the needs of patients are becoming more widely recognized. The benefits of an appropriate nurse-to-patient ratio are clear. 

Patient Quality Care

The quality of patient care decreases as the number of patients in a nurse’s care increases. A study published in the New England Journal of Medicine found that unsafe staffing levels were “associated with increased mortality” for patients (Needleman et al., 2011).

Better nurse staffing ratios increases quality of care for all patients. According to one study, only 14 percent of patients that said there were never or rarely enough nurses on the hospital ward rated their care as excellent. In comparison, 57 percent of patients that believed there were sufficient nurses and that their treatment was outstanding.

Nurses who are struggling to care for too many patients may not only neglect mission-critical tasks, but they may also be unable to undertake other “soft” nursing duties such as proper patient communication and bedside manner. As a result, adequate staffing is critical for nurses to have more time to educate their patients about their medical condition (s). Nurses can also provide patients with resources to help them live better lives and manage their conditions. It can also improve teamwork and care coordination.


Nurse Safety and Satisfaction

Nurses report greater job satisfaction when they have fewer patients to care for at once. The pandemic has exacerbated the long-standing issue of nurse burnout. On top of that, having improper nurse patient ratios leads to increased feelings of fatigue, stress, feelings of helplessness, and retention. Job dissatisfaction, higher turnover, and even feelings of resentment toward their employer have all been linked to high nurse-to-patient ratios. Nurses working in these environments are more likely to make a medical error or mistake.

There is proof that appropriate staffing and nurse-to-patient ratios can also keep nurses physically safe. According to one study, the California nurse staffing law was associated with 55.6 fewer occupational injuries and illnesses per 10,000 RNs per year, which was approximately 31.6 percent lower than the expected percentage if the law had not been enacted. This translates into shorter lengths of stay, lower readmissions, and lower nurse turnover for that state’s hospitals, among other benefits.

Reducing Medical Errors

Many patients who are admitted to hospitals face significant risks during their stay. Nurses can improve the quality of care they provide to patients while still meeting their needs. Nurse-to-patient ratios can help to prevent errors that could lead to patient harm or death. Each of the five rights for medication administration (the right patient, the right drug, the right dose, the right route, and the right time.) is predicated on the nurse’s ability to focus on the task at hand. Nurses can create hospitable conditions that make patients feel safe and comfortable in their hospital room by creating a positive work environment and using good communication skills.

As previously stated, inadequate nurse-to-patient ratios are associated with negative outcomes other than those caused by missed nursing care. A systematic review and meta-analysis of 35 articles, discovered a significant link between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units, particularly in-hospital mortality.

Medical Facility Benefits

Employing more nurses may not appear to be cost effective for healthcare facilities, but it is. According to a study published in Medical Care, hiring more nurses and having a lower nurse-to-patient ratio reduced hospital stays for patients and helped save money on medical costs.

As previously noted, quality nursing care improves the overall perception of a hospital facility as well as patient outcomes. The higher the quality of nursing care provided, the higher the perception of the facility.


Take it from us: safe nurse-patient staffing ratios are a really big deal.


The number of medical professionals on staff at a given time makes a huge difference to patient care. The right number of nurses, doctors, and other certified caregivers can help patients feel more comfortable and satisfied with their care. They can also ensure that all patients get the attention they need, when they need it—and not when it is too late..


If you’re working at a facility that isn’t meeting their staffing requirements, don’t be afraid to speak up! Patient care is too important to ignore these issues.