In April's Editorial, "Do the Right Thing," Diana Mason advises nurses to "prioritize the basics of nursing care," such as spending time with patients, bathing them, and ambulating them.

I agree, but in my years working in hospitals I've seen the focus shift from caregiving to paperwork. There are three to four flow sheets per patient. Other bedside paperwork must be filled out because of recommendations from the Joint Commission on Accreditation of Healthcare Organizations and the state. Too much responsibility is now placed on nurses to help make physicians' jobs easier. Even when patient information is computerized, you may have to print it out and place it on the chart because the physician prefers it that way.

Mason also argues against extended work hours. My coworkers and I prefer 12-hour shifts-we don't work overtime often, except when necessary, and we consider ourselves "old school" nurses. I don't agree with the studies asserting that working more than eight hours a day "can lead to fatigue and errors." The skill level and moral character of the nurse are the most important factors affecting the care given.

I've come to realize that nurses are here to please the facility and the physicians; the patients fall somewhere in between. Health care is constantly changing, and nurses must always stay on top of it.

Renee Sealy, RN

Richmond, TX