Final answer:
The first action by the nurse in this situation is to document the situation in writing.
Step-by-step explanation:
The first action by the nurse in this situation is to document the situation in writing. This is important for several reasons. First, it ensures that there is a clear record of the nurse's concerns about the patient-to-nurse ratio and any potential risks it may pose to patient safety. Second, it provides documentation that can be used to advocate for appropriate staffing ratios and address any potential legal or regulatory issues. Finally, documenting the situation in writing allows the nurse to communicate effectively with other members of the healthcare team and the nursing supervisor.