Too few nurses taking care of too many patients.
It's a chronic problem at hospitals across the country.
The nursing shortage is having a critical impact, according to author Suzanne Gordon.
"We have 60 studies that show the impact of not having enough nurses on pneumonias, falls, bedsores," said Gordon.
98,000 preventable deaths occur in hospitals each year, according to the Institute of Medicine.
24% of those are caused by understaffing.
"What we're finding is that nurses are either quitting or new nurses are leaving after two years because the workloads are too high," Gordon said.
Intensive care units are required to meet strict nurse to patient ratios.
But on the regular floors nurses are often outnumbered.
Registered nurse Betsy Morville said, "When I worked in Philadelphia years ago I had 22 patients on the weekend. I had 14. I worked the night shift. It was too much."
Hospitals in the Baptist Health System have been trying all kinds of recruiting incentives, including $10,000 bonuses for employees who bring in new E.R. nurses.
California tried a totally different tactic, setting mandatory nurse to patient ratios in all hospital units.
Gordon said, "Nurses from outside the state are going there. It has increased retention and recruitment."
Bi-partisan Florida legislators have also tried to push a similar law, but have met with resistance.
Florida State Representative Julio Robaina said, "The hospitals put up an enormous fight because of the money they would have to pay out in additional nurses to cover the ratio."