The following study aims to determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention. Each additional patient per nurse was associated with a 23% increase in the odds of burnout and a 15% increase in the odds of job satsifaction. In hospitals with high patient-to-nurse ratios, surgical patients experience higher risk-adjusted 30-day mortality and failure-to-rescue rates.