Label Patients With Care

Mr. Jepson (Reflections on Caring, January 2008) is on the right track with his point about avoiding medical jargon in our communication with or about our patients. I'd like to point out that the example he used regarding patients who may be diagnosed with schizophrenia might not be quite accurate. Suggesting that a patient "exhibits schizophrenia" would be as inaccurate as saying the patient "exhibits diabetes" or "exhibits hypertension."

Schizophrenia is a criteria-defined DSM-IV TR diagnosis of a serious mental illness, the effects of which can be devastating to individuals and their families. With evidence-based treatment—which includes individual and group psychotherapy, management of medication and cases, psychiatric rehabilitation, and vocational training—many individuals do recover and can lead happy and productive lives.

With such options available, it may be wrong to suggest that "no one wants to be told that he is a schizophrenic." Individuals diagnosed with such an illness and their loved ones should be fully informed of their diagnosis within the context of a psychoeducation model, where emphasis on instilling hope for the future occurs with a clear care plan for treatment.

Teaching our patients, whatever their diagnosis, using clear nonjudgmental terminology that allows time for questions and clarification, is an essential nursing practice responsibility in promoting wellness and preventing relapse. Thanks to Mr. Jepson for his great effort in bringing this important issue to your readers.

Robert J. Abel RN, BSN
New York, NY

'Lost Nurse' Still Wants To Help

I have worked in the healthcare field for 35 years, the first 10 years as a CNA, and the last 25 years as an RN. During all those years, there was much lifting, almost always manual, almost always with inadequate assistance. I weigh 90 lb., I am 4 feet and 11 inches tall, and moving, turning, bending, lifting, pulling up in bed, and—on one memorable occasion—even flinging myself under a patient who was falling out of bed in an attempt to protect the patient from injury, have naturally caused long-term damage.

Rods and screws hold my lumbar spine together. Because I am still in litigation, five years after the incident, I can't really give any details, but suffice it to say that I have virtually lost the use of my right arm and shoulder.The patient involved was not diagnosed with posttraumatic stress disorder, as he should have been, and I sustained an injury that brought my nursing career, and my plans to attend graduate school, to a screeching halt.

I am a lost nurse. I have a BSN, I am certified in rehab, I have worked in many environments, such as the hospital, doctors' offices, nursing homes, home health, nationwide triage, and public and private schools. I love being a nurse. I've maintained my active license, I subscribe to all the nursing journals, I have an up-to-date library of nursing and drug books. I am not the only lost nurse in this country. When will someone in our nursing leadership wake up and figure out how to use us? There are a lot of us, and we still want to help people, even though we need extra help ourselves.

Personally, being allowed to go to local schools and talking up nursing as a career sounds like a wonderful option. So many other nurses are more creative than I, and to waste all the knowledge and expertise, the enthusiasm and caring of so many people, would be a sin. Please reach out to us, because we are out here.

Name and address withheld on request

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