Dear Hospital Administrators, Hello, from one of your high or low performing hospital's staff nurses. Who? Oh right...the nurses who keep my hospital running but I don't even see what's in front of my face, that's who. The abused, the yelled at, the under compensated, the stressed out, and over worked nurses. Yes, all of the above is true. Nursing shortage? Your outer excuse for not allowing your nurse managers to post and fill staff nurse positions which they ask for weekly. Nurses don't bill for services. Too bad for us, because if we did, we would be treated better. We are lumped together with the dietary aids, housekeeping, and those who stock the storeroom. Easy to fire and replace at will. Healthcare is a business, people. Hospital administrators don't care about you; they care about your money. Doctors and nurses do care about you, but they are just caught up in the system. So what do we want from you, our boss' bosses? We want reasonable expectations from hospital management and we want someone to be on our side. We don't want another lunchbag or pen for nurses week; we want our voices to be heard. We want to feel like we own the hospital and not just work there. Patient satisfaction is huge, but it's not because hospital administrators care about their patients. They care about the reimbursement tied to patient satisfaction. They will make the job of their nurses harder to please their customers or patients. This makes the nurses unhappy because they can't do their job as well and their satisfaction with their job lessens. Add this on to other on the job stresses and your nurse retention rate suffers. Which probably doesn't bother you that much, since nurses are replaceable, right? If you want to improve customer satisfaction you must make sure your nurses are happy. Ask any nurse and this is what he or she will tell you. Happy nurses equal happy patients. The majority of you are in violation of labor laws which allow your hospital's nurses to get an uninterrupted break each shift. From my personal experience, which you lack, the only way this will happen is if you staff for a relief nurse on each unit on each shift who is there solely to cover other nurses when they take their well deserved breaks. Staffing is another issue which is in your control. Hire more nurses and lower your ratios! No nurse should be taking care of seven plus acutely ill patients. It is not safe. I'm an ER nurse. I have seen the abuse against nurses from patients. Screaming, yelling, hitting, biting, spitting, profanity, sexual comments/groping, twisting arms, throwing objects, and punching are just some of the experiences nurses go through daily. This has to stop. This should not be tolerated. There should be zero tolerance for this type of violence and assault. If this were to happen outside of the hospital, charges could be pressed. Every hospital should take this type of abuse seriously. All cases of rude, inappropriate, and dangerous behavior should be reported immediately and a police officer should be available at all times to file a report about the occurrence and see if charges can be filed. There are laws in place protecting healthcare workers. Many hospitals have police officers staffed in the emergency department and following up on such cases can be an extension of their role. I hope you take these points into consideration and make nursing better for us. Sincerely, An anonymous nurse on her way to burn out and orthopedic surgery who will NOT give up on this profession.