Arthrotec

Something's out of focus when we have to worry about protecting our backs when we're extending our arms to a grieving family. As a case in point a former neonatal ICU nurse shares her thought about some very special snapshots in a letter below.

Treasured keepsake

As an experienced neonatal ICU nurse, I was upset that you'd raise legal concerns for nurses who help family members take pictures of their dying infant ("Sorrowful Snapshots," Ethical Problems, May 2000). This is probably the first time that the family has seen the infant outside the incubator without tubes and wires all over the place. A photograph of their baby makes a record of his birth; it's all they'll have to hold onto after he dies.

We shouldn't be so worried about litigation that we're afraid to respond to very real and simple human needs of a grieving family.

-JANE E. Owen, RN

Wheaton, Md.

Risking failure

I'd like to add the potential for liver failure to the adverse effects mentioned in the article "Heading off Adverse Reactions from NSAIDs" (Controlling Pain, March 2000).

Some pharmaceutical manufacturers recommend periodic liver enzyme testing for patients taking certain nonsteroidal anti-inflammatory drugs (NSAIDs) such as Arthrotec (diclofenac sodium and misoprostol) and Voltaren (diclofenac sodium).

When you have a patient taking NSAIDs, ask his practitioner whether periodic liver function studies are needed and document your discussion. Although liver failure is a rare reaction, too many patients are developing fulminating liver failure from using NSAIDs for pain management. Liver enzyme testing should at least be considered.

-DIANNE SNYDER, RN, CCRN, BSN

Brimfield Ohio

Sick of candy coating

I've been a nurse for 25 wonderful years. All the whining and candy-- coated solutions I read in our nursing journals offend me. I'd love to read about some not-so-ideal home health care situations similar to those I've run into that couldn't be fixed with safety railings in the bathroom.

I'm on our state's Board of Nursing Practice and Education Committee that makes recommendations to the board for review prior to its ruling. Recently, we successfully fought the Board of Pharmacy's ruling that prevented home health care nurses from carrying heparin to preserve central line accesses.

My advice to any nurse who doesn't like the way things are: Rally the support of your colleagues and find a solution-or try marrying a millionaire.

-ANN COTE RN

Plymouth, N.H.

Reporting back

Late last year, I wrote to you about understaffing and unhappy nurses at the hospital where I work ("Staffing Solutions, Anybody?" Letters, November '99). At that time, many of our nurses left for greener pastures, lured by better pay, choice of hours, and sign-on bonuses.

Well, I'm happy to report that half of them returned and are glad to be back. Apparently, the grass is not always greener somewhere else.

-ISABELLE L. COLOMY, LPN

Philadelphia, Pa.

Copyright Springhouse Corporation Aug 2000
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