AMSN Medical-Surgical Nurse Staffing Task Force Presents Recommendations for Safe, Effective Staffing to Ensure Patient Safety and Support Nurse Well-Being

The Academy of Medical-Surgical Nurses (AMSN) Medical-Surgical Nurse Staffing Task Force is pleased to present the Recommendations for Safe, Effective Medical-Surgical Nurse Staffing. Developed in the spring of 2025, these guidelines are a result of a comprehensive, year-long review of current literature, evidence-based practices, benchmarking data, and national best practices. These staffing standards also incorporate valuable insights from frontline clinicians, nurse leaders, and educators and reflect AMSN’s vision for the future of medical-surgical nursing. 

The aim of these recommendations is to: 

1. Offer evidence-based guidance and a framework to shape hospital medical-surgical practice environments.
2. Ensure patient safety and quality of care through safer nurse staffing.
3. Support nurse well-being and retention through improved workloads and work environments.
4. Advocate for the medical-surgical nursing specialty.

The Staffing Task Force guidelines contain four key components to be considered when preparing patient care assignments for a hospital medical-surgical unit. These include: 

1. Direct patient care registered nurses shall not be assigned more than five patients, as a guideline. 
2. Acuity-based adjustments should be made as needed to reflect patient complexity, unit-specific demands, and nurse experience.  
3. Hospitals and care teams should integrate validated acuity-based staffing tools (such as EMR-based acuity tracking) to adjust staffing based on real-time patient complexity and staff experience. 
4. Hospitals and care teams should invest in ancillary staff to support nurses, reduce nurses’ technical workload, and allow nurses to maximize their scope of practice.   

As part of this work, AMSN urges all medical-surgical nurses to collaborate closely with healthcare leaders and policymakers, uniting their voices in advocacy at both state and federal levels. Together, we can drive the development of patient-centered, nurse-supportive, and sustainable staffing that upholds the integrity of care and the well-being of the nursing workforce. The Nurse Staffing Task Force welcomes your feedback on these guidelines at the upcoming AMSN Convention, taking place Sept. 11–13, 2025, in Austin, Texas.  

Together, we are advancing the future of medical-surgical nursing — one nurse, one assignment, and one patient at a time. 

AMSN Medical-Surgical Nurse Staffing Task Force Members 

Monica van der Zee, BSN, RN, CMSRN – Task Force Chairperson
MaryLou Booher, BSN, RN, CMSRN
Marie Mullins, BSN, RN, CMSRN
DeLaura Padovan, BSN, RN, CMSRN
Nora Ann Sangirardi, BSN, RN, CMSRN, MEDSURG-BC, GERO-BC
Dorothy Syrocki Haag, MS, RN
Sarah Varney, MSN, RN