This is in response to a letter from Mildred Cannon of Bradley (BDN, Dec. 10) who had a suggestion to address the nursing shortage with alternative licensing, i.e. a “certificate.”

Currently, nurses go to college for four years. During that time, nurses are educated in anatomy, physiology, pharmacology and other sciences. Upon graduation, nurses take an exam to obtain a license to practice. Because of the rapidly changing environment of healthcare, nurses are required to take update courses in their specialties.

This is the minimum training for a nurse. Anything less can effect the quality of care that our patients deserve. You want the most educated and skilled healthcare worker caring for your loved one.

The idea of a certificate, with no college education, already exists. These people are called nurse’s aides. Nurse’s aides work under the direction of a licensed registered nurse. You cannot replace RNs with nurse’s aides. The health care industry has tried to do that very thing for years.

The current acronym for RN replacement worker is UAP (unlicensed assistive personnel). UAPs have been used to replace RNs across the country with disastrous results. These people work outside of the jurisdiction of the Board of Nursing. Therefore, controlling what a UAP is allowed to do or not do becomes complicated.

According to an article in the September Reader’s Digest, UAPs have been found illegally assisting in surgeries in more than 20 hospitals in California. Some medical advice lines are staffed by UAPs.

The health care industry is profit-minded. Maine needs to lead the way to demand quality care for all. As a patient, you must insist that you get the care you deserve. Ask which procedures are best performed by RNs or try to make sure that a family member or friend is on hand as your advocate if you are unable to monitor your care.

According to the HRSA (a federal agency), Maine has the highest percentage of nurses working in non-nursing jobs in New England. Nurses are leaving the bedside because of the stresses of working with increasing numbers of UAPs, increasing paperwork, and having higher numbers of patients per nurse.

If we allow nurses to do what they were trained to do – take care of patients – we will see nurses return to the bedside. How do I know this? I have proof.

In the state of Victoria, Australia, more than 2,000 nurses returned to the bedside when they were assured of safe staffing by law. The state of Victoria passed a patient/nurse staffing ratio law earlier this year. Nurses who had left now had a law to back them up.

The same thing can happen right here in America. Maine can take the lead on this issue and attract nurses to the state if patient/nurse staffing ratios are instituted.

Certainly, this is not the only answer. Money needs to be dedicated to nursing education. Nurses need to be included in decision making that effect their practice at their place of work.

Quality patient care combined with scientific training, knowledge and experience is what makes a good nurse. You can’t get that combination using a shortcut.

Judith Brown RN, CCRN, lives in Bangor.