Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new knowledge and skills into practice for the first time. Your orientation lasted three days, which is the standard for in-home orientation for nurses compared to hospital orientation which lasts approximately six to eight weeks for new graduates. The change has just begun and you already have a new admission, a new detected pressure ulcer to evaluate, a possible drug reaction, several new takeoff orders, and eight patients to document for various reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a certified therapy technician (CMT) and three certified nursing assistants (CNAs) caring for 47 patients. The ideal nurse-patient ratio continues to be a national issue in both hospital and long-term care (LTC) settings. In the LTC context there is no official nurse-patient relationship; There is a suggested ratio between staff and patients. This problem not only affects new licensed nurses, but also experienced nurses. Recently, there have been controversial debates about whether heavy workloads are harmful to patients. Federal, state, and local governments regulate many aspects of health care. However, it is doctors, nurses and other healthcare professionals who provide care directly to patients. As a result, do insufficient staffing, heavy workloads, and unsupported work environments directly contribute to poor patient satisfaction, nurse burnout, high turnover, and job dissatisfaction? In nursing school, nurses are taught to apply the nursing process to administer care safely and effectively. However, this value does not always coincide with the employer. Instead, it is about the effort... of half a document... to help Congress. (2001). Adequacy of minimum nursing staff ratios in nursing homes. http://www.allhealth.org/briefingmaterials/Abt-NurseStaffingRatios.Gregory, L., A. An analysis of nursing home quality and staffing measures. (2010, December 21). Network. Retrieved from http://www.ncbi.nlm.gov/pmc/articles/PMC3006165/.Nelson, A., Powell-Cope, G., Palacios, P., Luther, L.S., Black, T., Hillman , T ., Christiansen, B., . . . . Nathenson, P., (2007). Network. Rehabilitation Nursing. Nursing staffing and patient outcomes in hospital and rehabilitation settings. Rehabilitation Nursing, Vol. 32, 179-200.Vahey, C.D., Aiken, H.L., Sloane, M.D., Clarke, P.S., & Vargas, D. (2010 Jan. 15).Web. US National Library of Medicine, National Institutes of Health. Nurse burnout and patient satisfaction. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904602/