The research on fatigue caused by the lack of sleep and by stress is incredibly strong. The airline industry made significant changes to its policies and won't schedule pilots or flight attendants if they've not had sufficient rest and sleep. Sleep-deprived pilots can be dangerous, and health care workers can be equally so. As Ms. Semelsberger points out, the health care industry has not taken the airline industry's proactive steps, but that doesn't mean it shouldn't.

While the nursing shortage places a huge burden on staff nurses, it by no means precludes ensuring patient safety. Nurses must find ways to change schedules instead of saying they can't. The bottom line is that health care managers and administrators must improve the working conditions of nurses-including scheduling shifts so that nurses get sufficient rest and sleep.