Journal of Gerontological Nursing

LETTERS TO THE EDITOR 

To the Editor

Emily Clements

Abstract

As a 51 -year-old LPN, I am having a hard time surviving in the nursing profession. Three years ago I dropped out of nursing (in nursing homes) because I could not live with the chore of tube feeding people restrained from pulling out those tubes. On Medicaid and judged incompetent, no one listened to their pleas of "let me go." Lawsuit fear ruled.

After 2 years of college classes for social work, I tried working as an LPN in group homes for mentaUy retarded/ developmentally delayed clients. Here, "quality of life" ruled many joint decisions made in behalf of the clients. Hoping progress had been made, I applied for work in several local nursing homes.

In one nursing home, discharge planning meant "no discharge planned." Fact sheets listed the name of the funeral home and city (no phone or address). Three of 27 had family involvement/visits; 24 had no family listed.

At another nursing home, in the first half hour of orientation, I heard the raw truth: they no longer accept clients with "do not resuscitate" orders. In other words, no one will die there - all are sent to the hospital at first sign of critical crisis.

At a third nursing home, cost documentation ruled the orientation. Few charts listed the funeral home of choice; discharge planning listed the hospital of choice and "private pay" insurance information. Six of my 12 clients (on my first day) had tube feedings. Again, they were too confused to be considered competent, but the pleading eyes and grabbing hands called out to me. There really are humans behind all the costeffective mechanical care.

Then, the October issue of the Journal of Gerontological Nursing arrived with an editorial from an instructor who is shocked over the lack of LPN training for the "charge nurse" duties I have lived with for 30 years. Her two terms, "dysfunctional organization" and "planning by crisis" aptly describe why I am having trouble surviving in nursing.

I fell in love with geriatric clients/ patients 30 years ago. Their wisdom, patience, and dignity fed my soul. Back then, they could say "no more" and the hospital where I trained followed their individual wishes. Now, no one asks, no one listens; each fights a lonely battle quite ignored.

Your articles are well-documented surveys of documentation; a state-ofthe-art example of our information economy. They offer me no relief, no reason to continue in the nursing profession. Please cancel my subscription.…

As a 51 -year-old LPN, I am having a hard time surviving in the nursing profession. Three years ago I dropped out of nursing (in nursing homes) because I could not live with the chore of tube feeding people restrained from pulling out those tubes. On Medicaid and judged incompetent, no one listened to their pleas of "let me go." Lawsuit fear ruled.

After 2 years of college classes for social work, I tried working as an LPN in group homes for mentaUy retarded/ developmentally delayed clients. Here, "quality of life" ruled many joint decisions made in behalf of the clients. Hoping progress had been made, I applied for work in several local nursing homes.

In one nursing home, discharge planning meant "no discharge planned." Fact sheets listed the name of the funeral home and city (no phone or address). Three of 27 had family involvement/visits; 24 had no family listed.

At another nursing home, in the first half hour of orientation, I heard the raw truth: they no longer accept clients with "do not resuscitate" orders. In other words, no one will die there - all are sent to the hospital at first sign of critical crisis.

At a third nursing home, cost documentation ruled the orientation. Few charts listed the funeral home of choice; discharge planning listed the hospital of choice and "private pay" insurance information. Six of my 12 clients (on my first day) had tube feedings. Again, they were too confused to be considered competent, but the pleading eyes and grabbing hands called out to me. There really are humans behind all the costeffective mechanical care.

Then, the October issue of the Journal of Gerontological Nursing arrived with an editorial from an instructor who is shocked over the lack of LPN training for the "charge nurse" duties I have lived with for 30 years. Her two terms, "dysfunctional organization" and "planning by crisis" aptly describe why I am having trouble surviving in nursing.

I fell in love with geriatric clients/ patients 30 years ago. Their wisdom, patience, and dignity fed my soul. Back then, they could say "no more" and the hospital where I trained followed their individual wishes. Now, no one asks, no one listens; each fights a lonely battle quite ignored.

Your articles are well-documented surveys of documentation; a state-ofthe-art example of our information economy. They offer me no relief, no reason to continue in the nursing profession. Please cancel my subscription.

10.3928/0098-9134-19900101-10

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