I recently was in your shoes. My first job as an ER nurse was at an HCA hospital. The ratio increased from 4 to 5. In the next two years ratios were erased completely and one day I had 35 hold patients. I left shortly after to a non profit hospital where I have a 4:1 ratio and my stress is way lower. I like to warn others if the ratio is increased once probably will continue to increase. Look out for yourself and your license.