cancers, the benefits of mammography clearly outweigh the risks. I suggest that if we discourage women from utilizing mammography we will have an even greater problem in the future. Many older women were socialized in an era that dictated unquestioning acceptance of medical authority. This is not acceptable. Women should request mammography if their physician does not suggest it and should be aware of diagnostic options such as biopsy and fineneedle aspiration. Women should question all treatment recommended if cancer is diagnosed and obtain second opinions. There are numerous medical centers across the country that specialize in breast disease and treatment. There are breast cancer advocacy groups that can assist women and families in determining their options. We, as nurses and health care professionals, have the responsibility to know not only the scope of the problem of breast cancer and older women, but also the means by which we may alter its progression. Clear, objective, and rational information is crucial. My article was intended to be a step in that direction. MARGE DRUGAY
When a Coworker Dies
The year 1991 was a difficult year at the health care facility where I work in Tucson. In the summer, a long-term nursing assistant in her mid-forties died suddenly at a local fitness center. She had been a strong, resourceful woman, who managed her job and family as a single parent. The staff reeled from her death and sought solace in each other and in prayer. A memorial service at the nursing home helped, but the loss was great and difficult to accept for the staff. The fall brought two more tragedies to our family. One of the staff, who had worked and lived in Tucson about 4 years, had a grand mal seizure after her shift one night. Fast-growing lung cancer was discovered with metastasis to the brain. Through her radiation treatments we rallied to help with her daily activities so she could stay in her beloved home. The day after her 59th birthday, she died. Another loss, and on the same unit where the first person had died in the summer. The staff was in a state of shock. During this period, a long-term staff person had a
Agree or disagree with a n a r t i c l e or e d i t o r i a l ? H a v e a n u r s i n g tip o r i n s i g h t to s h a r e ?
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stroke. She was only 49 years old. The last week of her life was spent with us where we could care for her and visit each day. We knew the damage was irreversible and that death was near. How did we cope with these three losses in I year? One way was sharing our grief with our coworkers and talking about our lost friends. In-service sessions on "Death and Dying" were made available to all staff. Memorial services at our facility that staff and family could attend helped m a n y people in their grieving process. Even though we all have dealt with death in our roles as caregivers, these deaths were of close friends, people our age or younger. Our own mortality and views on life were brought sharply into focus. Faith and trust in our God was a solace and salvation for many during that difficult year, 1991. When you work in long-term care, dying and grief are always present. Our residents, like the populations of other long-term care facilities, have multiple medical problems, personal and financial losses, and often welcome death as an end of their loneliness and suffering. People outside of the long-term care facility may think that staff members become immune to death, that they don't care or grieve for the residents. This, of course, is not true. We have a wonderfully caring staff who consistently demonstrate this in their dealing with each resident. With the death of a resident, many staff talk about their loss and some, even find it hard to let go and allow the person their right to die. We forget sometimes that grieving and death does not respect age, gender, rhyme or r e a s o n - - t h a t it touches each of us. Our feelings about these losses reflect our ethnic and environmental backgrounds. The New Year dawned with renewed hope and optimism for a more tranquil year. We held a tree-planting ceremony outside the main entrance in honor of our three departed friends. As the flowering plum tree grows and blossoms, it will give each of us renewed strength as we carry on in our mission of caring for the elderly residents that each of the departed loved so dearly. J O A N PFAFF, MSN, R N
Director Staff Development and Quality Assurance Handmaker Jewish Geriatric Center Tucson, Arizona
Write to P r i s c i l l a E b e r s o l e ,
GERIATRIC NURSING, 2790 Rollingwood Dr., San Bruno, CA 94066.