Maureen Shawn Kennedy's Editorial, "Straight Talk About Nursing" (December 2013) made me want to cry-and then laugh out of hurt and anger. For years, bedside nurses have been screaming and shouting that care is suffering because of inadequate staffing and higher acuity patients.

I aim to provide the best evidence-based care I can, and I do so at the expense of other patients and myself. I am exhausted. I am also guilty-I've been the nurse who tells the discharged patient to call his primary care physician with any questions about medications. This is because, by the time I'd finished the discharge instructions, it was 2 pm, the patient was anxious to leave (even though I still had 20 things left to do that should have been done two hours before), and I hadn't yet used the bathroom during my shift (I'd made sure all my patients had, though). I didn't turn an unresponsive patient every two hours because I had other patients making requests for pain medications or for other needs to be fulfilled. I hadn't eaten since 4:30 am, when I had a quick breakfast. I was hungry, tired, and under pressure to get that discharged patient out the door ASAP so the room could be ready for a new patient.

I agree, wholeheartedly, that something must be done. But telling us we aren't thinking? All we do is think-about how much more we should be doing for our patients. We blame ourselves, and we're frustrated and angry because we are well aware of all the things we aren't able to accomplish during the course of an exhausting, 13.5-hour shift. I never go home thinking, "Wow, I was a really good nurse today."

Jamie Kuhlman, BS, RN

Kettering, OH