The "Readers Respond" column is designed to gix>e you, our readers, a chance to respond to a particular article, ask a question of an author or Editorial Board member, or speak out about the Journal and care of the elderly in general. We will offer authors the opportunity to respond to criticism and or questions that may be generated by their articles. Both the response and the original letter will be published in the same issue. If you wish to share your comments with our readers, please send your letter to the JOURNAL OF GERONTOLOGICAL NURSING, Charles B. Slack, Inc., 6900 Grove Road, Thorofare, New Jersey 08086.
Dear Ms. Gress:
The use of the controversial issue regarding the ANA resolution on requirements for entry into professional nursing practice as an attention getter topic for your editorial (J Gerontol Nurs 1980; 6(10):583-4) was indeed effective. I read your editorial and I share your concerns for the lack of adequately prepared and dedicated nurses to provide the nurse manpower needs for the elderly.
However, I was disappointed in your article. Your implication seems to be that resolution of the ANA controversial issue on entry into practice would also resolve the concerns you have for nursing care for the elderly. If this is your belief I challenge you to support it with factual evidence. If this is a misinterpretation of the intent of your editorial message I kindly ask that you give clarification that does not continue to leave the impression with your readers which promotes the idea that closing all diploma and practical nurse programs will alleviate concerns for nursing care of the elderly. It is my strong belief that the well prepared diploma and practical nurse graduate not only has been, but will continue to be among the best geriatric nurses that you shall find. We need more of the diploma and practical nurse programs to help in meeting the nurse manpower needs - not the closing of all of them as the ANA resolution would mandate if implemented.
At the age of fifty-eight, having had the BSN as my basic level of preparation and eleven years of experience as nurse educator in a diploma program, I feel qualified to make the above statements. When I am among those who in the near future join those who need geriatric nursing care, I shall welcome care from the graduate of the diploma and/or practical nurse programs.
Ruth B. Jones. RN. MS Director of Nursing Education Saint Mary's School of Nursing Huntington, West Virginia
Lucille Gress replies:
I appreciated the letter from Ruth B. Jones, in which she raised questions about the intent of the editorial and expressed concern about nursing care of the elderly.
The intent of the editorial was to call attention to the need for the nursing profession and individual nurses to come to a resolution of the issue of entry into practice and to get on with the process of carrying out the mission of the nursing profession.
Fifteen years is far too long to spend on a single issue, i.e., entry into practice. There are multiple issues and challenges that merit attention of and action from the nursing profession and individual nurses. The indecision and concomitant discord that has arisen over a single issue has dissipated energies which should be directed toward other vital issues and concerns affecting the profession and its ability to meet the needs of people for nursing care.
The crucial point is that vital issues other than the entry into practice need to be addressed, if the nursing profession is to effectively discharge its responsibility to society which has mandated its existence. Perspective on the situation may be gained through perusal of such books as Action and Affirmation: Toward an Unambiguous Profession of Nursing (Lysaught, 1981 ) and Current Perspectix'es in Nursing Education (Williamson, 1978).
Currently, the problem of *maldistribution" of nurses within the divisions of nursing practice and the episodic and distributive areas of care needs to be examined. The baby boom is over, but the babies have grown older with the likelihood of increasing health care needs characteristic of many oldey persons. The contribution of nurses presently caring for the elderly is not to be discounted, but their ranks are too slim to effectively meet the challenge imposed by this increasing population of older individuals. Moreover, additional knowledge of human development and aging and the behavioral sciences is essential for those providing rare. The issue of care of the elderly should be confronted as one of the many issues that nursing must grapple with in the process of achieving its mission of providing health care for all segments of the population, including the elderly.
My plea is for an objertive approach to the assessment of the health care needs of society and for action in keeping with this assessment and established priorities.
Also, I would emphasize the need for the pursuit of excellence in nursing as an important part of the developmental process of the nursing profession which is charged with the responsibility of providing nursing services to the various societal populations.
Lucille D. Gress, RN, MA Associate Professor School of Nursing University of Kansas College of Health Sciences Kansas City, Kansas
To the Editor:
Re: Nan Wan Home for the Respected Aged
On April 6, 1980 I had the pleasure and privilege to visit one of the most famous homes in China, The Nan Wan Home for the Respected Aged. It is operated by Nan Wan Commune and located in the suburbs of Beijing (Peking) city.
The home was established in 1958. It serves 80 aged women and men. The residents are no longer able to work in the commune in agricultural activities, and they do not have offspring*.
The home offers food, shelter, clothes, medical care, pocket money, and burial. The staffs include the administrator, one barefoot doctor for preventive medicine, one nurse aide, three attendants and three cooks.
The residents' ages range from 57 to 106 years, and the average age is 75.
The accompanying pictures were taken at the home during the visitation.
Margaret L. Tso. MEd. OTR U.S. Soldiers' ir Airmen's Home Washington, DC 20317
Figure 1 : At the Entrance of Nan Wan Home for the Respected Aged are the commune leader (left) and the administrator (right).
Figure 2: The barefoot doctor with visitor at the clinic.
Figure 3: The women's dormitory (two persons to one room).
Figure 4: The men's dormitory (three persons to one room). A married couple may stay together in one room.
Figure 5: The library at the Nan Wan Home.
Figure 6: Some recreation (gardening).
Figure 7: The attendants prepare winter clothing for the residents.