I recently read "Nurses at the Bedside-Who Will Be Left to Care?" (Editorial, February). This topic is of great concern to me and some of my fellow nurses. As a nurse for more than 30 years on various ICU and step-down units, I have precepted many younger nurses. On average, they stay in the ICU setting for about two years, then move on to an advanced practice career. Although your article suggests that it's the schools that are pushing these younger RNs toward advanced practice, I believe it's the stress of the hospital environment.

Hospitals must change. The nurse-to-patient ratio is often too high to deliver optimal care. Our ICU has a ratio of 1:3, the step-down unit is 1:5, and the med-surg unit 1:6. How can nurses deliver optimal care under these circumstances? Our younger RNs feel abused, exhausted, and overworked. They are looking for any role that is not associated with bedside nursing. This should worry us all.

It would be nice for AJN to outline a practical change for hospital administrators to follow to prevent this worrisome outcome. The message is clear to any nurse who works in a hospital setting: hospitals must stop killing their nurses!

Jean Branthover, BSN, RN

Dayton, MD