- Email: [email protected]
Nursing Education
L E T T E R S
Nursing Education I read with interest your editorial,
“Women’s Health: Nurses Pave the Way” (March/April 1995 JOCNN). I agree with your statements about the need for women’s health to take a lifelong perspective and move from being tied to only reproductive heath issues. I , too, feel w e are making progress in getting restrictions lifted on tlie research situations that exclude women from studies. O n e area, however, I am concerned about is nursing education. You challenge those of us in academia to rethink curricular issues regarding women’s health, but you also suggest that this is less crucial for nursing education than medicine. I think it may b e a less crucial but still significant issue in nursing education. Given the push to move students, undergraduate a n d graduate, quickly though the educational process, their studies focus o n meeting acute needs o f clients in hospitals, while tlie needs of the communityIxisecl clients who are less acutely ill are often p~isliedaside. This means that content about women’s health issues outside tlie childbearing process o r tlie intensive care setting may be excluded from the curriculum. Altliougli there is a l o t of discussion about the need for more emphasis on breast cancer, cervical cancer, HIV, and gynecologic problenis such as urin:iry incontinence and perimenop~iusal management, the reality is these are still the first content areas to be cut t o make r o o m for critical care, adult medical-surgical nursing, or some community content. Even traditional topics of women and depression :ind other psychiatric mental health issues often are not included i n clepth i n most nursing educational programs. Certainly topics of stress management, self-esteem, rape, spousal abuse, battered women, fibromyalgia, o r chronic fatigue are not consistently examined i n nursing curricula.
Sepfemher 1995
My concern lies in two areas. We are shortchanging our students’ education and certainly the clients they serve by excluding these critical elements of nursing care. It is ironic that in nursing, still a predominantly woman’s profession, we are very aware of the toll of maladies of women on our friends, colleagues, students, and ourselves, yet we continue to perpetuate the problem. Yes, we are making progress as women and as nurses in our awareness of women’s health issues. I feel, though, that now is the time to make sure women’s health becomes essential content in undergraduate and graduate curricula across the country. We would not think of having a graduate come out of any nursing program without exposure to critical care or adult medical-surgical content. Then why would we feel any less passionate about women and their health needs? Let’s change the direction of nursing education to keep u p with the increasing numbers of women’s health issues and the trends in women’s health research. Only then can we provide leadership for medicine in our training of nurses in women’s health. Carole Kenner, RNC,DNS, FAAN Professor/Departm en t Chair Paretit Child Health Nursiiig College of Nzrrsirig atid Health Utiiiwrsitj! of Ciiiciniiati Citicinnati. OH
Advertising of Bottle-feeding Products I take exception to the advertising in o u r professional journal o f products that promote artificial infant feeding.
The JOCNN editor welcomes readers’ comments. Address letters to the editor, J O C N 4 700 14th St., NW, Suite 600, Washington, DC 20005-2019. All letters should be typed double-space and signed by the author. Letters will be published at the editor’s discretion, and JOCNN reserves the right to edit all letters.
I believe that w e have an obligation to women and infants to reject adver-
tising by manufacturers of products that claim to “simulate breastfeeding” (May 1995 JOGNN, p. 297). Dr. Haller encourages us, in her editorial on page 293 of the May issue, to base o u r practice on research. She identifies nurses as “research consumers.” Research in the area of infant feeding has demonstrated the importance of breastmilk and of the breastfeeding experience for mother and infant. Manufacturers of artificial infant feeding formula and products are in part responsible for our bottle feeding culture. As proponents of women’s and infant’s health, we should reject the notion that breastfeeding and breastmilk can b e replaced. Kathleen O’Hara D u f y , RNC, BSN, IBCL C White Kiiwr.]iriiction, VT
Researcb-based Practice 1 commend tlie editors for tlie excellent Volume 24, Number 4. I n the e d itorial, you again raised the important issue that “our goal is research-based practice . . . contrasted with practice based o n tradition, authority, or trial and error.” Doris Coward’s report o n selftranscendence in women with AIDS is an inspirini example of the complex human issues we can observe with objectivity and clarity as w e create a science of nursing. The articles o n cultural concepts in clinical care were excellent. The medical systems w e have developed to provide obstetric and neonatal care have in themselves become a complex cultural framework. Childbirth workers in hospital and medical systems constitute an important subculture, with shared beliefs and values, rituals, and traditions, most of which ;ire untested and unquestioned. What effects do our simplest routines have o n individuals entering the medical culture?
J O C N N 593
Nursing Education I read with interest your editorial,
“Women’s Health: Nurses Pave the Way” (March/April 1995 JOCNN). I agree with your statements about the need for women’s health to take a lifelong perspective and move from being tied to only reproductive heath issues. I , too, feel w e are making progress in getting restrictions lifted on tlie research situations that exclude women from studies. O n e area, however, I am concerned about is nursing education. You challenge those of us in academia to rethink curricular issues regarding women’s health, but you also suggest that this is less crucial for nursing education than medicine. I think it may b e a less crucial but still significant issue in nursing education. Given the push to move students, undergraduate a n d graduate, quickly though the educational process, their studies focus o n meeting acute needs o f clients in hospitals, while tlie needs of the communityIxisecl clients who are less acutely ill are often p~isliedaside. This means that content about women’s health issues outside tlie childbearing process o r tlie intensive care setting may be excluded from the curriculum. Altliougli there is a l o t of discussion about the need for more emphasis on breast cancer, cervical cancer, HIV, and gynecologic problenis such as urin:iry incontinence and perimenop~iusal management, the reality is these are still the first content areas to be cut t o make r o o m for critical care, adult medical-surgical nursing, or some community content. Even traditional topics of women and depression :ind other psychiatric mental health issues often are not included i n clepth i n most nursing educational programs. Certainly topics of stress management, self-esteem, rape, spousal abuse, battered women, fibromyalgia, o r chronic fatigue are not consistently examined i n nursing curricula.
Sepfemher 1995
My concern lies in two areas. We are shortchanging our students’ education and certainly the clients they serve by excluding these critical elements of nursing care. It is ironic that in nursing, still a predominantly woman’s profession, we are very aware of the toll of maladies of women on our friends, colleagues, students, and ourselves, yet we continue to perpetuate the problem. Yes, we are making progress as women and as nurses in our awareness of women’s health issues. I feel, though, that now is the time to make sure women’s health becomes essential content in undergraduate and graduate curricula across the country. We would not think of having a graduate come out of any nursing program without exposure to critical care or adult medical-surgical content. Then why would we feel any less passionate about women and their health needs? Let’s change the direction of nursing education to keep u p with the increasing numbers of women’s health issues and the trends in women’s health research. Only then can we provide leadership for medicine in our training of nurses in women’s health. Carole Kenner, RNC,DNS, FAAN Professor/Departm en t Chair Paretit Child Health Nursiiig College of Nzrrsirig atid Health Utiiiwrsitj! of Ciiiciniiati Citicinnati. OH
Advertising of Bottle-feeding Products I take exception to the advertising in o u r professional journal o f products that promote artificial infant feeding.
The JOCNN editor welcomes readers’ comments. Address letters to the editor, J O C N 4 700 14th St., NW, Suite 600, Washington, DC 20005-2019. All letters should be typed double-space and signed by the author. Letters will be published at the editor’s discretion, and JOCNN reserves the right to edit all letters.
I believe that w e have an obligation to women and infants to reject adver-
tising by manufacturers of products that claim to “simulate breastfeeding” (May 1995 JOGNN, p. 297). Dr. Haller encourages us, in her editorial on page 293 of the May issue, to base o u r practice on research. She identifies nurses as “research consumers.” Research in the area of infant feeding has demonstrated the importance of breastmilk and of the breastfeeding experience for mother and infant. Manufacturers of artificial infant feeding formula and products are in part responsible for our bottle feeding culture. As proponents of women’s and infant’s health, we should reject the notion that breastfeeding and breastmilk can b e replaced. Kathleen O’Hara D u f y , RNC, BSN, IBCL C White Kiiwr.]iriiction, VT
Researcb-based Practice 1 commend tlie editors for tlie excellent Volume 24, Number 4. I n the e d itorial, you again raised the important issue that “our goal is research-based practice . . . contrasted with practice based o n tradition, authority, or trial and error.” Doris Coward’s report o n selftranscendence in women with AIDS is an inspirini example of the complex human issues we can observe with objectivity and clarity as w e create a science of nursing. The articles o n cultural concepts in clinical care were excellent. The medical systems w e have developed to provide obstetric and neonatal care have in themselves become a complex cultural framework. Childbirth workers in hospital and medical systems constitute an important subculture, with shared beliefs and values, rituals, and traditions, most of which ;ire untested and unquestioned. What effects do our simplest routines have o n individuals entering the medical culture?
J O C N N 593