I am an RN on a surgical floor in a large, acute care facility. I never felt I was ignoring any aspect of my patients' and caregivers' needs until I read Susan Reinhard's Viewpoint (August) on the need for nurses to support caregivers.

Unfortunately, it's not always possible to assess the needs of the patients and their caregivers before discharge. Time is limited, and nurses may pass on this task to the next shift. But soliciting other professionals may help; psychosocial matters can be delegated to social workers, physical therapists may be able to teach ways to nav igate into a vehicle or home, and respiratory therapists may instruct patients in the use of devices that even experienced nurses may not know about. In the meantime, I will do what I can to ensure that my colleagues remember these practical aspects of care.

Diane Achatz, RN

Brighton, MI

I was disappointed by Reinhard's Viewpoint. I am a travel nurse working in a well-staffed hospital; given the time constraints, I find it a challenge to give families all the information they require at discharge. Reinhard points out how nurses are failing their patients and their families but offers few suggestions. For example, couldn't rehabilitation nurses and case managers assist in instructions before discharge? The majority of nurses who work hard to bridge patients' and families' transition to home deserve more credit.

Garry Johnson, RN

Palo Alto, CA

As a nurse, I haven't found the Health Insurance Portability and Accountability Act (HIPAA) to be an "easy excuse to avoid difficult conversations." But after reading "HIPAA and Talking with Family Caregivers" (August 2006), I felt relieved knowing that the "HIPAA scare" is being named and examined. It gives patients privacy and confidentiality and protects health care workers. It shouldn't cause us fear. I will be sharing this article with coworkers to ease the confusion that many have about divulging the right information, at the right time, to the right people.

Caresa E. Laird, BSN, RN

Miami, FL