Nursing as Metaphor

To the Editor: The thoughtful contribution by Fagin and Diers (July 14 issue)* on the role of nurses and the "psychological milieu in which nurses live and work" fails to take note of some recent subtle but important changes. The authors point out, truly enough, that nurses "work predominantly in settings that are dominated by physicians..." However, they do not address a change that is occurring. In the past 5 to 10 years nurses have slowly but firmly moved into positions of control over physicians. Examples abound: hospital utilization review is done by nurses, and they control admissions and discharges. . . . No extract is available for articles shorter than 400 words.