As a trauma nurse, I'm faced with many obstacles that have the potential to affect patient outcomes. Studies on quality care address factors such as availability of supplies, updated equipment, modern facilities, and education or training. Although these are important, the bigger concern is the nurse-to-patient ratio ("Data Again Show Nurse Staffing Improves Outcomes in a Variety of Settings," In the News, March). I could have the best education and access to the most modern equipment and facilities, but if I have too many patients to care for at the same time, none of that matters.

In 2015, the Registered Nurse Safe Staffing Act was introduced in Congress; it aims to bring bedside nurses and the administration together to establish nurse staffing plans for all units. Nurses, administrators, and politicians need to continue to work together to implement the changes needed to allow nurses to uphold their professional, ethical, and moral obligations to their patients.

Unregulated staffing is still a significant barrier to nurses' abilities to provide optimal patient care. Minimum nurse-patient ratios are a necessity for nurses to provide the standard of care that's expected.

Marcia Alligood, RN

Shelby, NC