The nurse-to-patient ratio should be no different than that proposed in the ASPAN standards. Observation care could consist of one nurse for three to five patients, depending on the acuity and type of patients. Critical care patient ratios should be no different from the ratio used in the intensive care unit (ICU), namely, one nurse to two patients, unless the patient’s acuity dictates otherwise. The standards reflect that there needs to be two competent personnel, one of whom is an RN possessing competence appropriate to the patient population and in the same room/unit where the patient is receiving extended observation level of care. The need for additional nurses and support staff is dependent on the patient acuity, patient census, and the physical facility (ASPAN, 2014).