"RN Staffing Time and Outcomes of Long-Stay Nursing Home Residents" (Original Research: A New Look at the Old, November 2005) touts RNs as a salvation to nursing home residents and the quality of care. I have worked in long-term care for 20 years, and I watched the RN population disappear because of cost cutting. I worried at the time that our facility wouldn't survive.

But then I realized that the RNs didn't provide much direct care to patients. LVNs and certified nursing assistants are the lifeblood of nursing homes. It's extremely hard work, whether you have 38 or 58 patients-as I did-to whom you're accountable.

Cynthia McGrath, LVN

Riverside, CA