Good for Ms. Lasater, for staying with the dying patient. I fully understand the kind of day she had. Ours used to be a transitional care unit, essentially a skilled unit that cared for medically complex patients. It was a difficult but manageable job. We knew when we would be receiving patients because they had to be approved by our care coordinator for entry onto the unit. We had five or six patients per nurse, and four technicians working with us. The system worked well.

Now we never know when new admissions will be arriving. Our staffing has changed from four nurses and four technicians to five nurses and 1.5 technicians (one technician works half a shift) if we're full. The staffing pattern changes depending on the patient census and the shift. Some of us work 12-hour shifts. Our competent staff now feels very incompetent. The hospital provides 10-minute classes that supposedly teach us all we need to know about techniques like initiating insulin drips and patient-controlled analgesia pumps. And, yes, we too are "talked to" if we stay late. We need more technicians, who are less expensive to employ than nurses and can greatly help us manage our patient load.

I've been a nurse for 42 years. I've always worked. I love the profession. However, something needs to change. Patients are not receiving the care they deserve. But I'm glad to hear that at least one did. I'm placing a copy of her article in our break room-maybe I'll even give it to our supervisor.

Charlotta Toth-Fisher, RN

Cedar Rapids, IA