Cheers for cheek

LETTERS DELAYED EFFECTS FROM CORONARY BYPASS? I find the articles in GN pertinent to us the nurses who are the "front line" in geriatric care. However, I would like to see a discussion about the possible long-term psychological ieffects of coronary bypass in the older adult. I am researching the subject for my own information, and I !wonder whether other nurses are coming across similar findings. I work in a prevention and health maintenance program for senior citizens that has over 3,000 patients, some of whom have undergone corionary bypass surgery. All are clinically stable. Their elapsed postoperI . . at~ve,tsme varies from three weeks to t two years. One of my findings is a t delayed emotional response, apparntly due to a change patients perceive in their internal body image. [~atients have told me of feeling suiCidal or mutilated long after their rei ~overy, and one patient laughingly :lescribed "all my psychosomatic ~ches and pains during my first year [ ,, ~ostop. Some say they are afraid that "all those hookups inside" will :ome apart. I [ Patients have made most of these :omments spontaneously during my !ngmal history taking or updating of heir charts. It seems to me that the coping proless is going on with these patients :ven though it may be at a different Jace and perhaps more privately hari with patients who have experinced alterations in external body mage. Postmastectomy, colostomy, nd amputee patients have the benet of nurses teaching, explaining, nd answering questions as dressings re changed and irrigations are one. Is the bypass patient at that arly postoperative stage simply so lad to be alive that the emotional 3ping process only begins later, in ~eir homes? If any GN readers have findings ke mine or know where I can locate lore information on the subject, !ease write me in care of the edi-

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PATRICIA LANE, R.N., N . J .

C,reatview Manor resident Mary Wempe and Jennifer Bergman admire their photos, taken when they were 100 and 3, respectively, on GN's March/April cover.

FROM A PROUD GERONTOLOGICAL NURSE Congratulations on the article "Crestview Manor: A Caring Community" ( M a y / J u n e 1981, p. 202). As a proud gerontological nurse for 15 years, I appreciate any evidence of positive attitudes, concerns, and good quality of life for all residents in long-term care. I would like to commend you for CHEERS FOR CHEEK Congratulations on publishing an article of the caliber of "A Change of Life" by Mary Vida Cheek ( M a y / June, p. 192). It is not only wellwritten but is an honest, perceptive appraisal of her new life-style. It was worth the price of a year's subscription to GN. I shared the article with a younger friend and her comment was "this should help many people." To me, her statement sums up the value of Mary Cheek's excellent account of her adjustment struggle. JUNE D. WATSON, R.N., N.C.

I hope to use "A Change of Life" in my work in two day-care centers in Long Beach. However, our goal goes the other way--keep people at home when possible. That's far more real-

Geriatric Nursing, American Journal o f Care for the Aging. Even the covers, especially the March/April 1981 cover, reflect the positive images o f and for gerontology. If only the address labels could be placed elsewhere--what an inspiring collection of "living art." DONNA TARBUTTON, R.N.,C.,Kans.

istic in California than many other places. JANIS DAVID, Calif. REQUIRED READING I thoroughly enjoyed Jan Bergman's article, "Recruitment, Selection, Retention" ( M a y / J u n e , p. 199). I always feel that perhaps there are going to be some changes in the care of the elderly when I hear of people like Jan and Paul Bergman . . . it just isn't happening in our area. Every owner and administrator of a nursing home should be required to read her article and have to defend their own operations without the usual whining excuses. We need more people like Jan Bergman speaking out on issues such as this. DEANE G H O L S O N . R . N . . / ( a n