635 SPREAD TOO THIN: THE CASE FOR FEDERALLY MANDATED MINIMUM NURSE-TO-PATIENT RATIOS IN HOSPITALS Katelyn Kuwata I. I NTRODUCTION Nurses are crucial to high quality health care. 1 They provide surveillance of patients, early detection of complications, and timely interventions that save lives. 2 In his autobiography, Dr. Lewis Thomas 3 wrote: My discovery . . . is that the institution is held together, glued together, enabled to function as an organism, by the nurses and by nobody else. They spot errors before errors can be launched. They know everything written on the chart. Most important of all, they know their patients as unique human beings [and] [b]ecause of this knowledge, they are quick to sense apprehensions and act on them. 4 In hospitals, however, this glue is often spread too thin. When nurses are overloaded with patients, they do not have time to know each one as a unique human being. The ability to “ spot errors before they can be launched ” and “ sense apprehensions and act on them ” is not an inherent nursing quality that holds constant under all circumstances. Rather, it is a skill that nurses exercise when their J.D. Candidate, May 2017, Loyola Law School, Los Angeles; B.S.N., May 2008, University of Pennsylvania. I would like to thank Dean Brietta Clark for her guidance on this Note, the members of the Loyola of Los Angeles Law Review for their hard work, and my family for their tremendous support. 1. Robert L. Kane et al., The Association of Registered Nurse Staffing Levels and Patient Outcomes , 45 M ED . C ARE 1195, 1195 (2007). 2. Linda H. Aiken et al., Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction , 288 J. A M . M ED . A SS ’ N 1987, 1993 (2002). 3. Dr. Thomas (1913 – 1993) was an American physician, researcher, author, and teacher. He graduated from Harvard Medical School, and served as Dean of New York University Medical School and Yale Medical School. Ann Woodlief, Lewis Thomas , D ICTIONARY OF L ITERARY B IOGRAPHY (2003), . 4. L EWIS T HOMAS , T HE Y OUNGEST S CIENCE : N OTES OF A M EDICINE W ATCHER 67 (1983) (emphasis in original); see Jack Needleman et al., Nurse Staffing Levels and the Quality of Care in Hospitals , 346 N EW E NG . J. M ED . 1715, 1715 (2002).