The postsurgery unit at Midland Memorial Hospital in Midland, Texas, tried a similar approach to the one described in "The Sterile Cockpit: An Effective Approach to Reducing Medication Errors?" (Cultivating Quality, February), and it was also not very effective.

In my opinion, nurses must, by necessity of their job description, be the most interruptible people on the unit. They are responsible for intake and, essentially, for receiving input from everybody else on the floor. The nurse can't say, "Oh, I'm sorry. I can't help you now because I'm passing meds."

Most importantly, if the nurse appears unavailable to provide personal attention to a patient's family, this can cause the family's perception that their loved one is receiving poor care. The undeniable truth is that customer perception is the real driver of patient care.

William Goble, RN

Odessa, TX