I felt compelled to comment about the nurse who was trying to make a difference with dying patients and their families ("Family Dynamics: Trying to Make a Difference," Ethical Problems, June 2006). The dynamics were complicated and her good intentions weren't appreciated.

My friend is just completing her chaplain training, and this sounds like the type of situation she's been learning to address with patients and families. Perhaps the hospital chaplain could help this nurse support troubled families while removing her from the complicated dynamics of the situation.

MARYBETH ROSE, RRT, RETIRED

Canton, Ohio

A hospital staff nurse who wants to support a dying patient and his family should discuss the option of a hospice referral with the patient's discharge planner. In hospice, the entire family becomes the patient and receives support from the hospice team, including the nurses, social workers, and chaplains. Hospice services don't stop when the patient dies; they remain available to family members for at least a year following the death.

MICHELE GARGES, RN, CHPN, MSN

Statesboro, Ga.