How many nurses does it take to keep hospital patients safe and comfortable? It's a long-running source of tension between nurses and hospitals. It's also one that will intensify as hospitals head into a perhaps-unprecedented era of financial strain. Some argue the solution is government-mandated nurse-patient ratios. Others say the key is to give nurses the loudest voice regarding their staffing. Something approaching a worst-case scenario might have occurred recently at Carlisle Regional Medical Center, where the state painted a frightening picture of conditions that allegedly existed over several weeks in May and June. Insufficient nurse staffing was the root of the problems, according to the state Department of Health. For example, the investigation report cites times when as few as three nurses had to care for 30 medical-surgical patients. It said patients commonly were kept for hours in the emergency room -- even after they were officially admitted -- because there weren't enough nurses staffing inpatient units.