I was shocked and saddened after reading this article. No one should be cared for in a nursing home under the deplorable conditions described by the authors. They attribute these conditions to multiple causes, but inadequate staffing is of primary concern. This, as well as inadequate training of staff, directly relates to inadequate reimbursement for care.

Nursing should not be silent on this issue. However, as was reported in another article in the issue, "The Top Nursing Story of 2008: Why Can't Nurses Just Get Along?" (In the News), nurses don't speak with one voice-our many professional organizations can't seem to agree.

We must speak with one voice and advocate for adequate staffing and realistic reimbursement. Otherwise, I fear there will be more patients like Louis Daly.

Patricia De Angelis Fife, MPA, RN

Merrick, NY