LETTERS
AJN’s
to the Editor
RETIREMENT
“Preparing for Retirement in Uncertain Times” (January) was instructive and helpful. Nursing jobs are plentiful, and many nurses switch jobs multiple times, leaving pensions depleted or nonexistent. I suggest setting up a portable pension system, so that each nurse’s pension could grow as long as the nurse stayed in the profession. This system would also give nurses more bargaining power regarding wages and working conditions. Charles Kaiman, MSN, RN, NP, CS Albuquerque, NM
ETHICAL ISSUES
The decisions nurses make on a day-to-day basis are not as simple as people may believe, as illustrated in “Ethical Issues for Nurses in Force-Feeding Guantánamo Bay Detainees” (Ethical Issues, November 2014). It’s a scary feeling knowing you must choose between two bad choices. Physicians and nurses don’t just make clinical decisions. We often make life-changing decisions. Thank you for reminding us. Jennifer Gore, RN Whiteville, NC
CNAs IN NURSING HOMES
I write from the perspective of having worked for the World Health Organization (WHO) in a developing country in the early 1980s (“Our Ebola Wake-Up Call,” Editorial, December 2014). Two things frustrate me about the Ebola crisis. One is the reluctance of governments and, especially, the WHO to acknowledge the severity of the problem. The second is how relatively inexpensively Ebola can be managed (using antipyretic medications and oral or iv rehydration). As the Editorial states, protection from this disease is not complicated. It is a matter of investing in basic resources to protect frontline caregivers.
I’ve worked in a nursing home as both a certified nursing assistant (CNA) and an RN supervisor (“The Impact of Turnover in Nursing Homes,” Journal Watch, September 2014). In addition to my leadership responsibilities, I cared for as many as 30 patients during an average shift. Many were recently discharged from the hospital and needed intensive care. It was impossible to grow as a leader when you did not have time to lead. Administrators need to adjust the nurse-to-patient ratio and train more CNAs. They should also use tuition reimbursement to encourage CNAs to obtain a nursing license. From these nurses will come your next generation of leaders.
Nancy Sharts-Hopko, PhD, RN, FAAN Villanova, PA
Richard Wolfe, RN Louisville, KY ▼
EBOLA
Practice Update Since the article “Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring” (Diabetes Under Control, February) went to press, the American Diabetes Association (ADA) updated its standards of care. The ADA now recommends a premeal blood glucose target of 80–130 mg/dL, rather than 70–130 mg/dL, to better reflect new data comparing actual average glucose levels with glycated hemoglobin targets.
REFERENCE American Diabetes Association. Glycemic targets. Sec. 6. Standards of medical care in diabetes—2015. Diabetes Care 2015;38 Suppl 1:S33-S40.
[email protected]
AJN’s
to the Editor
RETIREMENT
“Preparing for Retirement in Uncertain Times” (January) was instructive and helpful. Nursing jobs are plentiful, and many nurses switch jobs multiple times, leaving pensions depleted or nonexistent. I suggest setting up a portable pension system, so that each nurse’s pension could grow as long as the nurse stayed in the profession. This system would also give nurses more bargaining power regarding wages and working conditions. Charles Kaiman, MSN, RN, NP, CS Albuquerque, NM
ETHICAL ISSUES
The decisions nurses make on a day-to-day basis are not as simple as people may believe, as illustrated in “Ethical Issues for Nurses in Force-Feeding Guantánamo Bay Detainees” (Ethical Issues, November 2014). It’s a scary feeling knowing you must choose between two bad choices. Physicians and nurses don’t just make clinical decisions. We often make life-changing decisions. Thank you for reminding us. Jennifer Gore, RN Whiteville, NC
CNAs IN NURSING HOMES
I write from the perspective of having worked for the World Health Organization (WHO) in a developing country in the early 1980s (“Our Ebola Wake-Up Call,” Editorial, December 2014). Two things frustrate me about the Ebola crisis. One is the reluctance of governments and, especially, the WHO to acknowledge the severity of the problem. The second is how relatively inexpensively Ebola can be managed (using antipyretic medications and oral or iv rehydration). As the Editorial states, protection from this disease is not complicated. It is a matter of investing in basic resources to protect frontline caregivers.
I’ve worked in a nursing home as both a certified nursing assistant (CNA) and an RN supervisor (“The Impact of Turnover in Nursing Homes,” Journal Watch, September 2014). In addition to my leadership responsibilities, I cared for as many as 30 patients during an average shift. Many were recently discharged from the hospital and needed intensive care. It was impossible to grow as a leader when you did not have time to lead. Administrators need to adjust the nurse-to-patient ratio and train more CNAs. They should also use tuition reimbursement to encourage CNAs to obtain a nursing license. From these nurses will come your next generation of leaders.
Nancy Sharts-Hopko, PhD, RN, FAAN Villanova, PA
Richard Wolfe, RN Louisville, KY ▼
EBOLA
Practice Update Since the article “Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring” (Diabetes Under Control, February) went to press, the American Diabetes Association (ADA) updated its standards of care. The ADA now recommends a premeal blood glucose target of 80–130 mg/dL, rather than 70–130 mg/dL, to better reflect new data comparing actual average glucose levels with glycated hemoglobin targets.
REFERENCE American Diabetes Association. Glycemic targets. Sec. 6. Standards of medical care in diabetes—2015. Diabetes Care 2015;38 Suppl 1:S33-S40.
[email protected]
