1
........ ililililililiiiiiiiiiiiiiiii!i!i!i!i!i!ilililililiiiiii!i!i!iil I TRIC ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: N iNc ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: iliii SN IST :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:+:+:.:.:.:.:-:.:.:.:.:.:.:+:-:. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .:.:+:,:.:.:.:.:+:.:.:.:.:.:+:.:.:.:.:.:.:+:.:.:.:.:.:.:.:,:. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ililili ,i',i',i',i ot Sic..Ts ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::i:i:i:i:i::::::"::'' "::i :.:: ..... :::!:#:!:!:!:::~0i:!~R IENC E TO. Participate as a geriatric team member collaborating on geriatric patients' nursing needs. Support nursing units with consultation, education, direct patient assessment and special care pla]ming. Serve as a geriatric care advisor for patients and families. .....,....................,........,.................................. [~i!!i!!i!!~!!~i!!~i~i!!i!!i!!i~i!!i!!i!!~i!!~i!!i[N~ Lug E: • Master's Degree in Gerontological Nursing. 3-5 yrs. experience as a Clinical Specialist. • Registered Nurse in Connecticut. We offer excellent fringe benefits and one of the highest Salaries. For further informa- tion or to arrange an interview, please call Elizabeth Waters, Nurse Recruiter, 203-863-3156. Outside of CT 1-800-332-NURSE. GREENWICH H O S P I T A L Perryridge Road, Greenwich, Connecticut 06830 EqualOpportunity Employer 1¢7F LETTERS Restraint Myths? Or Facts? The "Restraints in the '90s" portion of the Nov./Dec. issue contains some useful information and good ideas. Un- fortunately, the "Debunking the Myths" article doesn't come ~lose to debunking any of the four supposed myths. First, to disprove that restraints re- duce falls, the authors compare Sun- shine Village, where 83% of falls in one year occurred among restrained residents, with Chandler Hall, where falls dropped 30% when restraints were discontinued. I have no reason to believe that there's a fair resemblance between the two homes. The decrease in falls at Chandler Hall may have had to do with increased staffmg, staff education, or a change in the type of residents. Further, the statement about Sunshine Village can be seen as providing evi- dence that Sunshine Village is restrain- ing the people most likely to fall. Second, the statement, attempts to restrain a frightened personleads to increased fear and possible belliger- ence, ignores that the restra!nt may provide a resident with security. I currently care for three residents who show genuine appreciation for being restrained, and one of them be- comes visibly agitated when her re- straints are untied or too loose. The assertion that "restraints have a dehumanizing effect on the caregiver as well as the resident" may be true some of the lime; it~ certainly not true all the time. As for the evidence that "restraints restrict creativity and individualized treatment," I've seen very creative use of restraints. They are among many tools that can be used to prevent in- jury to residents and can certainly be part of an individualized care plan. Finally, the authors claim that "deaths directly attributed to restraints are not uncommon," and then fail to provide even one example. Wouldn't it Agree or disagree with an article or editorial? Have a nursing tip or hz- sight to share? Write to its at Geri- atric Nursing, 555 West 57th Street, New York, NY10019. be better to say that improper use of restraints and improper supervision of restrained residents have been in- volved in resident deaths? The topic of restraints is certainly a worthy item for further coverage. However, I'd like to see both sides of the issue covered fairly. EVAN HOAGLAND Madison, WI Let's Talk Some More In her excellent article, "Let's Talk" (Jan./Feb.), Harriet Berliner covered well the concept of improving commu- nications with and among residents. We thought you would be interested in knowing about Pat Ruble's book titled Memories & Moonbeanzs which offers a program very similar to Berliner's. THOMAS H. KELLY Care Communications Paola, KS GERONTOLOGICAL NURSEPRACTITIONER Medcenter One, a fully accredited 256- bed acute care hospital, is seeking a full- time Gerontological Nurse Practitioner to help develop diversified geriatric outpatient services including geriatric assessment. Pri- mary duties include: working with our Medi- cal Director (a fellowship trained geriatri- cian), and the Geriatric Assessment Team in providing direct patient care; teaching and consulting in the hospital with other staff; providing community education; and evaluating inpatients for discharge planning. Qualifications include: Nurse Practitioner Certificate with clinical emphasis in geriatric practice; demonstrated leadership, commu- nication, decisior] making and organization- al skills in history taking; conducting physi- cal exams and nursing assessments relating to Geriatrics. Comprehensive benefit package; salary commensurate with exl:~rience. Enjoy four seasons of recreational and cultural activi- ties in a family oriented capital city. Contact: Human Resources Department MEDCEN'~RONE 300 NorthSeventhStreet Bismarck, North Dakota 58501 (701) 224-6126 medcenter one,. Equal Opportunity Employer Circle No. 15 on Reader Inquiry Card Circle No. 14 on Reader Inquiry Card

Let's talk some more

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........ ililililililiiiiiiiiiiiiiiii!i!i!i!i!i!ilililililiiiiii!i!i!iil

I TRIC :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

N iNc :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

iliii SN IST :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: . : . : . : . : . : . : . : . : . : . : . : . : . : . : . : . :+ :+ : . : . : . : . : - : . : . : . : . : . : . :+ : - : . :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

.:.:+:,:.:.:.:.:+:.:.:.:.:.:+:.:.:.:.:.:.:+:.:.:.:.:.:.:.:,:. :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

ililili ,i',i',i',i ot Sic..Ts ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::i:i:i:i:i::::::":: ' ' " : : i : . : : ..... • :::!:#:!:!:!:::~0i:!~R IENC E TO.

• Participate as a geriatric team member collaborating on geriatric patients' nursing needs.

• Support nursing units with consultation, education, direct patient assessment and special care pla]ming.

• Serve as a geriatric care advisor for patients and families.

.....,....................,........,..................................

[~i!!i!!i!!~!!~iiii!!~i~ii!!i!!i!!ii~i!!i!!i!!~i!!~i!!iiiiii[N~ L u g E:

• Master's Degree in Gerontological Nursing.

• 3-5 yrs. experience as a Clinical Specialist.

• Registered Nurse in Connecticut.

W e o f f e r excellent fringe benefits and one of the highest Salaries. For further informa- tion or to arrange an interview, please call Elizabeth Waters, Nurse Recruiter, 203-863-3156. Outside of CT 1-800-332-NURSE.

GREENWICH H O S P I T A L

Perryridge Road, Greenwich, Connecticut 06830

Equal Opportunity Employer 1¢7F

L E T T E R S

R e s t r a i n t M y t h s ? O r F a c t s ?

The "Restraints in the '90s" portion of the Nov./Dec. issue contains some useful information and good ideas. Un- fortunately, the "Debunking the Myths" article doesn't come ~lose to debunking any of the four supposed myths.

First, to disprove that restraints re- duce falls, the authors compare Sun- shine Village, where 83% of falls in one year occurred among restrained residents, with Chandler Hall, where falls dropped 30% when restraints were discontinued.

I have no reason to believe that there's a fair resemblance between the two homes. The decrease in falls at Chandler Hall may have had to do with increased staffmg, staff education, or a change in the type of residents. Further, the statement about Sunshine Village can be seen as providing evi- dence that Sunshine Village is restrain- ing the people most likely to fall.

Second, the statement, attempts to restrain a frightened personleads to increased fear and possible belliger- ence, ignores that the restra!nt may provide a resident with security.

I currently care for three residents who show genuine appreciation for being restrained, and one of them be- comes visibly agitated when her re- straints are untied or too loose.

The assertion that "restraints have a dehumanizing effect on the caregiver as well as the resident" may be true some of the lime; it~ certainly not true all the time.

As for the evidence that "restraints restrict creativity and individualized treatment," I've seen very creative use of restraints. They are among many tools that can be used to prevent in- jury to residents and can certainly be part of an individualized care plan.

Finally, the authors claim that "deaths directly attributed to restraints are not uncommon," and then fail to provide even one example. Wouldn't it

Agree or disagree with an article or editorial? Have a nursing tip or hz- sight to share? Write to its at Geri- atric Nursing, 555 West 57th Street, New York, NY10019.

be better to say that improper use of restraints and improper supervision of restrained residents have been in- volved in resident deaths?

The topic of restraints is certainly a worthy item for further coverage. However, I'd like to see both sides of the issue covered fairly.

EVAN HOAGLAND Madison, WI

Let's Talk Some More

In her excellent article, "Let's Talk" (Jan./Feb.), Harriet Berliner covered well the concept of improving commu- nications with and among residents. We thought you would be interested in knowing about Pat Ruble's book titled Memories & Moonbeanzs which offers a program very similar to Berliner's.

THOMAS H. KELLY Care Communications

Paola, KS

GERONTOLOGICAL NURSE PRACTITIONER

Medcenter One, a fully accredited 256- bed acute care hospital, is seeking a full- time Gerontological Nurse Practitioner to help develop diversified geriatric outpatient services including geriatric assessment. Pri- mary duties include: working with our Medi- cal Director (a fellowship trained geriatri- cian), and the Geriatric Assessment Team in providing direct patient care; teaching and consulting in the hospital with other staff; providing community education; and evaluating inpatients for discharge planning.

Qualifications include: Nurse Practitioner Certificate with clinical emphasis in geriatric practice; demonstrated leadership, commu- nication, decisior] making and organization- al skills in history taking; conducting physi- cal exams and nursing assessments relating to Geriatrics.

Comprehensive benefit package; salary commensurate with exl:~rience. Enjoy four seasons of recreational and cultural activi- ties in a family oriented capital city.

Contact:

Human Resources Department MEDCEN'~R ONE 300 North Seventh Street Bismarck, North Dakota 58501 (701) 224-6126

medcenter one,. Equal Opportunity Employer

Circle No. 15 o n R e a d e r Inquiry Card

Circle No. 14 on Reader Inquiry Card