To the Editor:
In the October 1991 issue of Pediatrie Annals, Figure 2 was included in the article, "Obstetrical Issues in Substance Abuse," to dramatize the complex healthcare network required for the care of chemically dependent pregnant women. What your readers may not appreciate, however, is that this figure graphically illustrates the nursing model for the care of chemically dependent pregnant women developed by Patricia Alien, RN, CMS; Thérèse Caffery, RN, CMS; Laurie Ernest, RN, CMS; and Charlotte Torres, RN, CMS. This model is currently used at the University of Rochester in New York.
It is widely accepted that this group of high-risk patients requires the attention of many types of health-care providers. What is more relevant is that while physician management of these patients receives the most visible attention, both in media coverage and in journal articles, the network of nurses and other health-care professionals who create and employ this type of model are, in feet, often the most essential groups involved in caring for these patients. In short, the medical role of the physician caring for these patients is often far less difficult than that of other care providers meeting the psychosocial and community needs of these patients. Institutions that commit themselves to identifying and caring for patients who are chemically dependent will fail unless they recognize the need to construct an integrated program for health care that is based on coordinating the efforts of both institutional health-care providers and community workers.