I am writing in response to the article in the June issue “Clinical Units With the Healthiest Work Environments” (2008:65–77). Although the study undertaken by the 2 nurse researchers provides valuable and needed evidence into the work environments of nurses, I am concerned about the groupings of units. The coupling of postanesthesia units (PACUs) and the operating room (OR) is particularly troubling to me as a perianesthesia nurse.

In the article, Schmalenberg and Kramer state that only staff nurses can effectively confirm if their environment is healthy. As such the pairing of OR and PACU skews the reality of these staff nurses. Although the nursing staff of the PACU and OR coordinate and collaborate very closely, their work environments are very different. The OR nurses work in close proximity with physicians, while for the most part advocating and caring for sedated or anesthetized patients....

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