To the Editors:

I take exception to the anti-union position of your editorial titled “Professionalism” (September 2003: 394–396). You state that unions destroy the ideals of professionalism because trade unions can’t be patient centered. You don’t mention nurse managers who cut staffing to the bone so they can receive bonuses for meeting their budgets. They’re not really patient centered, either. Most nurse managers today are merely yes-men for profit-centered hospital administrators.

If staffing and resources are in short supply and working conditions have deteriorated, doing the best we can with what we have indicates a conservative, if not reactionary, approach. Yet, you call this professionalism. It seems that a patient-centered approach can only evolve from a united group of bedside nurses who are seeking to improve working conditions. Better environments for nurses would impact patient care in a positive...

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