With increasing demands on medical care services, one of the trends is the mixed patient room arrangement of single/double-bed and multi-bed rooms in a nursing unit on the same floor. This influences nurse-to-patient assignment and often causes an unbalanced workload and longer travel distances for nurses. The objective of this study was to investigate how floor configuration and room density influence nurse travel in the hospital’s medical surgical units in Korea. This study presented a novel approach to measure nurse travel distances in eight existing nursing units. The agent-based simulation was conducted to model nurses’ walking trails, and the distance of one nurse travel to assigned patient rooms was measured for each nurse. With revisions in the spatial arrangement of patient rooms, locating multibed rooms near the nurse station, symmetric room layout centering the nurse station, and planning both single/double-bed and multi-bed rooms on one side of corridors, nurse travel distance decreased more than 15%. This study contributed to the knowledge of agent-based simulation as an evaluation framework for spatial analysis. Apart from application to Korea, these results are particularly of interest in countries where private patient rooms are not commonly economically feasible.