To the Editors:

I have been a nurse for 30 years. Most of that time has been at the bedside in critical care. Much to my dismay, I have watched nurses, hospital administrators, and nursing models come and go. The saddest thing I have seen die is altruism as a component of professional nursing. The causes of this demise are many. First and foremost, an increase in technical knowledge, increased responsibilities and decision making, and increased performance expectations of the professional nurse have not been accompanied by a commensurate increase in pay or recognition.

I have seen nurses who are taking care of patients on left ventricular assist devices and also on continuous renal replacement therapy asked to provide coffee cups for the waiting room. The public has yet to realize that nurses provide the steel infrastructure that enables a hospital and critical care patients to survive.

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