I read with great interest "Wanted: Nurses Who Understand the ASC Mentality" (October, page 22) and agree that we should hire nurses with the appropriate attitude and the willingness to be flexible, team players. But I disagree that a new graduate most often fits that role best.

New grads are energetic and enthusiastic, but without at least a few years of nursing experience in a higher acuity nursing situation, they can't meet the clinical needs of the facility. And due to the types of procedures performed, the ASC is also limiting in the ability to develop a strong clinical background, to trouble shoot or problem solve - extremely important qualities in the ASC, where the nurse is forced to wear many hats.

The ideal ASC candidate is the RN who has been working for less than five years in an OR, ED or Critical Care Unit, loves what she is doing but doesn't want to take call or shift work anymore. That nurse will have had time to develop strong skills and not have too many ingrained bad habits, isn't burned out and can keep the pace, knows what nursing can require in the real world, will appreciate the hours and schedule of an ASC and tend to be a longer-term successful employee.

Joseph Hageman, BSN, RN
President, Association of Ambulatory Surgery Centers of North Carolina
Executive Director, Craven Surgery Center
New Bern, NC
jhageman@crmcnet.com

As the director of nursing at an ASC for six years and an RN with more than 27 years of experience in various clinical settings, I was disheartened by "Wanted: Nurses Who Understand the ASC Mentality." While I agree that the ASC is a different clinical environment than a hospital setting, the nursing process is not. New nurses molded to conform "to get the job done" who "will work for typically less money" and are trained as jacks-of-all-trades are not whom I would like to care for my loved ones or me. This is precisely the mentality that is demoralizing good nurses and contributing to our dwindling numbers. We should not have to "sell" our facilities to anyone - as the saying goes, "a good product sells itself."

Victor P. Krzesinski, RN
Director of Nursing
Wills Surgery Center of Plymouth Meeting, Pa.
willsplymouthmtg@aol.com

Anesthesiologist Shortage
Our hospital doesn't seem to fully appreciate the seriousness of the anesthesiologist shortage. Your September cover story will assist us in demonstrating that there is a serious shortage.

Jeff Wilner, MD
Chief, Department of Anesthesia
Oakwood Hospital