Background Nurses are employed in large numbers throughout health care. When their salary cost is considered as a percentage of total salary cost, they are arguably the most costly group of employees. Healthcare facilities have the potential to achieve large financial savings by reducing the number of nurses they employ. However, this may have negative consequences for staff, patients and the organisation as a whole.

Conclusion Research has shown that by reducing the number of nurses, patient outcomes deteriorate and length of stay increases. Curtailing nurse staffing levels can also lead to poor staff morale, nurse retention and recruitment problems and malpractice suits, which can raise costs far above the expense of employing more nurses. By reducing nurse to patient ratios, that is, by reducing the number of patients (see nurse to patient ratio box opposite), it is probable that patient care will improve along with patient satisfaction, poor morale will dissipate, fewer lawsuits will be filed and agency nurse use will decrease, all of which will help to reduce hospital costs in the long term.