Let us instill in nurses the need to advocate for safe working environments as well as grit ("Helping Students to Be Gritty," Teaching for Practice, January). Bedside nursing has changed. Patients' acuity levels are higher, the demand to "serve the customer" is a higher priority, and charting processes are more complex and less forgiving. Add in the decrease in support staff across hospital organizations and you find nurses manning the desk, the bedside, and the multidisciplinary team. Factor in charting, med passes, wound care, chart reviews, toileting, and countless other tasks, and what you have isn't a recipe for developing grit, but a recipe for poor patient outcomes.

Racheal H., via ajnoffthecharts.com