Nursing and Health Care Needs in the Wake Shortage (Ginzberg, 1948; Brown, of the Current AIDS Crisis and 1948)
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~o,ve,• e~ NOVEMBER 1992 VOLUME 13, NUMBER 9 ~ 0 0"-0 00~ ~0· 0~ <?00\> e~0c? ~# '('.0(0 6~¢o <;)o<'~"" 00 /\0 ~o"-0 ~ "\O .;,'& 0'"'7 "\'00 yfP .,,,rt:' Nursing (;'"'•><\V .,0 ~\V "' in Society ~(0 ('i 0 ~ Violence Against Women Substance Abuse During Pregnancy Shortage as Shorthand A Nursing Center in Brooklyn Official Publication of the National League for Nursing Decision '92 Don't Forget to Vote! November 1992 Volume 13 FEATURES Number 9 Editorial: Remembrance of Things DEPARTMENTS Past-Present 451 Calendar 453 1993 NLN Biennial Convention Information 459 Washington Focus 454 Ways of Teaching, Learning, and Knowing AIDS: about Violence Against Women 464 Advocacy & Jacquelyn C. Campbell Activism 456 Studies indicate that 20-30 percent of women have lived or are living with an abusive partner-yet only five percent are identified as victims of NLN abuse in health care settings. Why are the other 15-25 percent overlooked? Perspective 494 Substance Abuse During Pregnancy: Announcements 498 Legal and Health Policy Issues 472 Bookends 499 Jerelyn Weiss and Mary Jo Hansell Prosecuting drug-abusing pregnant women is questionable on both legal Classifieds 500 and ethical grounds. A better course, argue the authors, is to institute nurse managed primary prevention programs to promote prenatal health in such women. NURSING & HEALTH CARE offers diverse views on subjects of interest to readers. Articles rep Shortage as Shorthand for the resent the opinions of individual Crisis in Caring 480 contributing authors and are not necessarily those of the National Barbara L. Brush League for Nursing. The term II nursing shortage, 11 asserts the author, may itself obscure solutions to this persistent problem. Second class postage paid at New York, NY and additional offices. A Nursing Center in Brooklyn 488 Cover art: Poster for Community Sandra B. Fielo and Rae Lord Crowe for Creative Non-Violence designed How a college of nursing and a community agency teamed up to by Terry Devone Wilson, photo provide elderly residents of two urban neighborhoods with continuous, graph by Peter Garfield. case-managed health care. NURSING & HEAL TH CARE 13:9 Nove111ber 1992 449 NURSING & HEALTH CARE NATIONAL LEAGUE FOR NURSING, BOARD OF GOVERNORS Published by the National League for Nursing PRESIDENT M. Louise Fitzpatrick, EdD, RN , 350 Hudson Street Claire M. Fagin, PhD, RN, FAAN FAAN New York, N.Y. 10014 Dean and Professor, College of Outside New York City: 800-669-1656 Professor, University of Pennsylva In New York City: 212-989-9393 nia School of Nursing, Philadel Nursing, Villanova University, phia, PA Villanova, PA Chief Executive Officer Pamela J. Maraldo, PhD, RN, FAAN Maureen Sullivan Foley, PhD, RN PRESIDENT-ELECT Chief Executive Officer, Bayonne Vice President, Communications Visiting Nurse Association, Bay Lisa Moss Carol Lindeman, PhD, RN, FAAN onne, NJ Dean and Professor, School of Editor Ellen T . Fahy, EdD, RN Nursing, Oregon Health Sciences Shirlene R. Harris, PhD, RN University, Portland, OR Director, Schools of Nursing, Managing Editor Baptist Medical System, Little Thomas C. Goss TREASURER Rock, AR Associate Editor Marci Tlusty Patricia R. Forni, PhD, RN, FAAN Elizabeth Holman, MS, RN Dean and Professor, University of Director, Community Health Advertising and Sales Oklahoma, College of Nursing, Services Nursing Center, Scotts NEX, Inc. 800/ 541-9129 Oklahoma City, OK dale, AZ Subscriptions Manager Joyce Johnson, DNSc, RN Marek Fedor SECRETARY Vice President of the Division of Special Assistant, NLN Communications Pamela J. Maraldo, PhD, RN, FAAN Nursing, Washington Hospital Chief Executive Officer, National Center, Washington, DC League for Nursing, New York, NY ADVISORY BOARD Carolyn Kay Marvin, MPH, RN Director of Nursing, Midland Gloria Bruno, MA, RN GOVERNORS County Department of Public Vice president/ director of nursing, Health, Midland, MI Greenwich Hospital Association, CT Karen Beaver, EdD, RN Sheila P. Burke, MPA, RN , FAAN Professor and Nursing Coordinator Lucie S. Kelly, PhD, RN, FAAN Chief of staff, Office of the Minority and Professor, Practical Nursing Professor Emeritus, Columbia Leader, U.S. Senate, Washington, DC Program, Weber State College, University, New York, NY Ogden , UT Colleen Conway-Welch, PhD, RN, FAAN Dean, School of Nursing, Vanderbilt Nancy F. Langston, PhD, RN University, Nashville, TN Beverly H. Bonaparte, PhD, RN , Dean and Professor, School of FAAN Nursing, Virginia Commonwealth Kathleen M. Dirschel, PhD, RN President, The Gladstone Group, University, Richmond, VA Vice chancellor/ dean, Graduate School of Inc. New York, NY Nursing, University of Massachusetts Clair E. Martin, PhD, RN, FAAN Medical Center, Worcester, MA Marilyn Campbell, MS, RN Dean, Nell Hodgson Woodruff Mary E. Duffy, PhD, RN Chairperson, Division of Nursing, School of Nursing, Emory Univer Associate professor, The University of Mesa Community College, Mesa, AZ sity, Atlanta, GA Texas Health Care Center at Houston, TX Gloria M. Clayton, EdD, RN Judith Shockley, MSN , RN Helen K. Grace, PhD, RN, FAAN Coordinator of health programming and Professor, School of Nursing, Associate Professor, University of program director, W.K. Kellogg Founda Medical College of Georgia, Texas Health Science Center, School tion, Battle Creek, MI Athens, GA of Nursing, San Antonio, TX Robert V. Piemonte, EdD, RN , FAAN, CAE Frances J. Dunston, MD, MPH Mary K. Wakefield, PhD, RN, FAAN Executive director, National Student Administrative Assistant to Senator Nurses' Association, New York, NY Commissioner, New Jersey Depart ment of Health, Trenton, NJ Quentin N. Burdick, Washington, DC Marianne Roncoll, PhD, RN Clinical director, Obstetrics and Neonatal Nursing, Hospital of the University of Pennsylvania, Philadelphia, PA Nursing & Health Core(ISSN 0276-5284) is published monthly (except July and August) by the National League for Nurs ing, Inc., 350 H udson Street , New York, N.Y. 10014. Members of the National League for Nursing receive Nursing &: Health Care as a Christine Tanner, PhD, RN, FAAN membership benefit. Subscription rates for nonmember individuals: $30 one year , $50 two years; libraries and institutions: $50 Professor, Office of Research, School of one year, $85 two years; outside U.S. add SI O per year for postage. Second-class postage paid at New York, N. Y ., and additional Nursing, The Oregon Health Sciences mailing offices. POSTMASTER: Send address changes to Nursing & Health Care , National League for Nursing, 350 Hudson Street, New York NY 10014. Copyright 1992 by National League for Nursing, Inc. except where otherwise noted. Printed in U.S.A. University, Portland, OR All rights reserved. Reproduction in whole o r in part without written permission is prohibited. 450 NURSING & HEALT H CARE 13:9 November 1992 Remembrance of Things Past - Present Ellen T Fahy, EdD, RN hinking back to my tion to begin preparing for a beginning days in more competitive role in pri T academic administra mary care provision. tion in the early sev- The articles in this issue of enties, they were a time of up Nursing & Health Care might heaval ("What do you think we very well serve as some sort of have now? " I hear you ask), a measuring rod relative to the and change within American distance nursing has come since society. We had just come off the early seventies in confront the most tumultuous decade of ing crucial health problems and the century in terms of social, providing primary care. Two political and economic unrest. are addressed specifically to When I hear The Weavers sing women: abuse, the abused and "Wasn't That A Time," although melange of social change to the abuser. Another speaks to I am fully aware they are cel better meet health needs in education for primary care to ebrating another era in our communities. Preparation in those who continue to fall country, I am always reminded medicine had become so highly through the cracks in our health of the decade of the sixties. specialized there appeared to care system. Continuing chal Societally, the disenfranchised be a gaping hole in the area of lenges to nursing education can among us seemed to have found primary care. Some of us be be found. Those of us who have a new voice; within academe, lieved (and still do) nursing struggled with curriculum is students achieved some hith could not only fill the bill, but sues should resonate to the po erto unattainable rights; in different and better ways. sition. These articles are pre faculty's voice was broadened; Basic to our thinking was the sented along with another di protesting became a way of life. premise that nursing and the mension but no less important With the passage of Medicare/ social order were inextricably social policy question, the per Medicaid in 1965, health care bound and should, through our petual question of the nursing was declared a right not a privi· education programs and subse shortage. Can it be defined lege; feminism was emerging quent practice, participate in along less traditional lines than from underground. Anything the broadened definition of purely economic? Could there seemed possible. health under way in society to be some feminist issues lurk Beginning in the sixties with include poverty-racism-sex ing? The contents take a swipe Loretta Ford's program at the ism---classism. Such a premise at a broad canvas of unresolved University of Colorado and would necessitate significant national health issues and try reaching new dimensions in the changes in our curriculum ef to chart a place for them in seventies, in nursing education forts beyond the traditional ap both nursing education and there was much excitation proach of learning to care for practice settings. I@ about the preparation of nurse the acutely ill, institutionalized practitioners to step up to the individual, albeit in an excel plate and be counted in the lent fashion. This was in addi- f NURSING & HEALTH CARE JH Novembec 1992 451 NLN ANNOUNCES NURSING'S FIRST COMPUTER ADAPTIVE TES1 CAT PHARMAC'1 TEST NLN, the quality leaders in nursing assessment, now offers you a cutting-edge assessment tool that prepares your students for the future NCLEX.