I enjoyed reading the September 2021 editorial, "The Nursing Crisis in Acute Care." I am retired now, but I used to tell my patients, "Medical insurance companies are not in the business of insuring your health; they are in the business of making a lot of money for their executives and shareholders."

I believe that hospitals have gone the same route. At one hospital where I worked, management would purposely staff the ED short one nurse for all shifts, although there were sufficient nurses to fully staff the unit. And when another hospital I worked for was bought by a for-profit corporation, I immediately saw additional, unnecessary testing and admissions. The ED physicians would tell me that was what they were told to do by the corporation. At that point, at age 65, I retired from nursing.

It is obvious that so many hospitals-at least the big ones-are operating to generate revenue instead of delivering health care. And you know as well as I that over the years nurses have had to acquire and use greater amounts of knowledge and complex skills, and there are more and more rules and regulations, but nursing staffing levels and salaries have not increased accordingly.

The hospital system seems on the verge of collapse for the above reasons. The COVID-19 crisis has brought it to the edge of the abyss.

Perhaps it is time for the Joint Commission to stop assessing and writing rules for bedside care and instead start writing them for hospital organization and operation.

Joseph Treimel, BSN

Pleasant Valley, NY