Book excerpt: At 6:30 A.M. a head nurse reviews room assignments and the day''s challenges ahead: twenty-nine patients, most of them seriously ill, and four nurses to care for them. That means a barely manageable and potentially risky patient-nurse ratio of seven to one, with one nurse taking eight patients. Unfortunately, this dismal scenario is played out again and again in hospitals across the country.This in-depth, behind-the-scene''s account of a healthcare system under stress and the declining quality of medical treatment in America should serve as a wakeup call to the public. Faye Satterly, a Registered Nurse with over two decades of experience, spells out the alarming statistics: The average nurse today is forty-five years old and anticipating retirement. Only 12 percent of nurses are under age thirty. At the same time, nursing schools report decreasing enrollments and fewer graduates. The result is that the nurses who are on the front lines of healthcare are feeling overwhelmed and leaving the field for less stressful opportunities outside hospital settings.Compounding the looming crisis is the fact that just as nurses are becoming scarce, the need for them is becoming ever greater. Over the next decade, aging baby boomers will swell the ranks of the over-fifty-five population, a group that experiences higher healthcare needs than those in their thirties and forties.There are answers, the author insists, but they will require an honest public debate about our choices and expectations. What are we willing to do and how much are we willing to pay for safe, effective delivery of healthcare?This fascinating and disturbing account by a veteran nurse with extensive experience is a compelling call for action to counter the nursing shortage and ensure that "caring" regains its premium status in healthcare.