Dear Editor, We read the reply by Bambi and colleagues  to our article  with interest and pleasure. The authors draw our attention to some important factors which fuel conflicts between nurses and physicians: disparity of power between the professional groups, undue workload resulting from a high nurse-to-patient ratio, and the low social recognition and pay which are disproportionate to the role nurses play in the healthcare system. All these points are valid. In Germany, a national survey among nurse directors in the ICU reported an increase of ICU services over recent years with growing numbers of beds, patients, and need for mechanical ventilation but at the same time lack of qualified nursing staff, resulting in unduly high nurseto-patient ratios and overtime working hours . Job satisfaction is low in nurses although the work of nursing rates high in the public opinion  (Table 1). A European survey included nurses working in 623 hospitals, nursing homes, and home care institutions and was composed of two measurements with a 1-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. Among those who left their profession, the majority (86.8 %) left voluntarily. Nurses indicated that the reasons for leaving were (a) working conditions (e.g., relationship problems, emotional difficulties, time pressure and quality of care, dissatisfaction with use of one’s competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) and (b) family reasons (e.g., caring for relatives) . What must be done to increase the work-place value and professional power of nurses? One suggestion is to learn from other national systems which may do better, for instance in regard to education, qualifications, and professional responsibilities of nurses. Obviously, this is an internal affair of the nursing profession but, in a workplace that is so highly interdependent as the ICU, doctors must be interested in a healthy future for nurses, too.