As a retired Navy nurse and current educator, I agree with Susan Puterbaugh, whose perspective reflects the experience of many educators in an increasingly complex health care system. ("A New Reflex," Viewpoint, August.)

The knee-jerk referral to eduction is inadequate. We should take a systems approach to solving problems rather than accuse nurses of lacking the ability to use prevailing practice standards to maintain patient safety. We should require further education only when it's needed.

Patrick Wrencher, MS, RN

Cincinnati, OH