Increases in nurses' workloads, both in the emergency department and inpatient setting, were associated with more emergency department patients leaving against medical advice. When nurses care for more patients at a time, patients are attended to less frequently, which can result in more self-directed patient departures. Insufficient staffing in medical-surgical units contributes to longer length of stay and lower inpatient bed turnover. Hospital investments in safer staffing may reduce against medical advice departures.
Muir et al. (2026) studied this question.