allnurses Guide Meriwhen, ASN, BSN, MSN, RN 4 Articles; 7,907 Posts Specializes in Psych ICU, addictions. May 25, 2017 It is possible to get to the staffing ratios you posted, many hospitals do for select units, but it is generally at the cost of ancillary staff, increased patient costs, etc. What will happen--besides all the good things--is that nursing salaries will drop and/or LVNs and CNAs/techs will go away. Probably both. So then the RN will have only 4 med-surg patients, but it will be total care nursing for those 4 patients. No staff to help with passing meds, taking vitals, feeding, bathing, toileting, answering call bells, etc....the RN is going to have to do it all.California seems to be working out pretty well with some of the highest salaries in the country.And some California hospitals have done just what I said they would, and gone total care nursing.