It's hard to adequately staff to that level when the systems/processes are largely unmanaged. By definition, an unmanaged process doesn't know how much nursing gets spent on each element, from patient care to admin work. So it becomes just a guess as to how many you need; when people work in unmanaged processes they tend to feel overwhelmed and the knee-jerk reaction is to hire more people. And often when you add more people to an unmanaged process, the inefficiency can compound, leading you to feel like you need more people to fill the continuing gaps.

Hiring more people can be part of the solution. But you need to understand and manage the process first to get to the right answer.