As a manager now involved in the hiring of new nurses, I was very surprised to read about the dramatic safety impact of nurses with a bachelor of science in nursing (BSN) degree ("Two Steps Toward Improving Patient Care and Safety," In the News, June).

I've worked in Magnet institutions that wouldn't hire nurses with associate's degrees unless they had experience, but as a nurse with a baccalaureate and a seven-year career-during which I worked with many excellent and competent nurses with associate's degrees-I sometimes wonder if this practice is for the best. I would be interested if the differences in outcomes are still as great after nurses with associate's degrees have been practicing for several years.

The real question facing nursing is how do hospitals promote and reward not only the formal advancement of nurses' education but also lifelong learning, which is needed to respond to the stronger push toward evidence-based practice.

Gina Montefusco, BSN, RN, CPEN

Seattle