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[email protected] AJN t June 2008 t Vol. 108, No. 6 15

GERIATRIC DEPRESSION As a second-year nursing studentat San Francisco State University,I had several questions after read-ing the October 2007 How toTry This article on the GeriatricDepression Scale: Short Form(GDS: SF).1. When you are administering

the GDS: SF, is the patientaware that she or he is beingscreened for depression?

2. The Diagnostic and StatisticalManual of Mental Disorders,fourth edition, text revision(DSM-IV-TR), is used to diag-nose depression. Who makesthis diagnosis?

3. There are many Filipinos livingin the Bay area. Is the GDS: SFavailable in Tagalog?

Andrea BoltsSan Francisco

Author Sherry A. Greenbergresponds:1. Usually, yes. After obtaining a

full history and having anidea that the patient might bedepressed, I often say to thepatient, “I would like to askyou some questions about yourmood. Please answer ‘yes’ or‘no’ for each question.” If thepatient needs more direction,I’ll immediately start asking thequestions; this prevents thepatient from changing the sub-ject—especially if the patienthas dementia. I usually askfamily members to step out ofthe room for both depressionand dementia screening sothat they don’t answer for thepatient or influence the patient’sanswers.

After reading the How to Try This article, watch the accompanying video(http://links.lww.com/A101).

The clinician does a great jobof demonstrating how tointroduce the GDS: SF to thepatient (and the patient knowsthat she is being screened for depression). Also go to the How to Try This site(www.nursingcenter.com/AJNolderadults) for other arti-cles and videos on assessingmental status.

2. The DSM-IV-TR is the goldstandard for diagnosing psy-chiatric problems. It may beused as a guide for anyone atany level in any discipline, butthe diagnosis of depression—or any other medical condi-tion—is done by the physician,psychiatrist, or advancedpractice nurse. The GDS: SFis a tool for screening for, notdiagnosing, depression.

3. All approved translations of theGDS (both short and longversions) appear at www.stanford.edu/~yesavage/GDS.html. Tagalog is not one ofthem.

RESIDENCY PROGRAMS FOR NEW RNS?As a graduating student nurse, Irecognize the importance of aresidency program to help newgraduates make the transition toprofessional nursing (“KeepingNew RNs in Their Jobs,” In theNews, December 2007). I haveprior work experience in healthcare but I am still apprehensiveabout practicing nursing on myown. Preceptorship and addi-tional classroom instruction,which are included in a resi-dency program, might help to boost a new RN’s self-confidence.

Stephanie C. SchmittLittleton, MA

We’re aware of the impending“reality shock” of being new RNsas second-career baccalaureatestudents, and we strongly supportefforts to encourage professionaldevelopment and minimizenurses’ stress and job dissatisfac-tion. We agree that one-year nurs-ing residency programs may helptoward these goals.

Such programs can also aid inaddressing the issues that willarise as more experienced nursesretire and are replaced with newgraduates. Dracup and Morris,in an editorial titled “NurseResidency Programs: Preparingfor the Next Shift,” cite 2004statistics from the NationalSample Survey of RegisteredNurses and estimate that therewill be a “50% turnover in thenursing profession” by 2020.They correctly say, “We mustplan so that no patient perishesbecause of the influx of newnurse graduates.”1

In looking forward to our newcareers we find ourselves gravitat-ing toward institutions that will

AJN welcomes letters to the editor regarding recent-ly published articles, although critiques of originalresearch may be submitted at any time. Submissionsmust be typed, contain fewer than 300 words, and listthe correspondent’s name, address, and phone num-ber or e-mail address; include no more than three ref-erences for any statistics or studies cited. Letters will beedited for length, clarity, and accuracy. Submission ofa letter will constitute the author’s permission to publishit, although it doesn’t guarantee publication. Lettersbecome the property of AJN and may be published inall media. Send letters to AJNLippincott Williams & Wilkins 333 Seventh Avenue, 19th Floor New York, NY 10001 [email protected](212) 886-1206 (fax)

nize the need for keepsakes andburials for full-term stillbirths, butis it fitting for a nurse to prepare amemorial for a 12-week fetus? Itappears that many nurses andparents who have experiencedfetal loss say yes.

For example, Marie Gill,RN,C, a staff nurse at theBirthing Center at BrattleboroMemorial Hospital in Brattle-boro, Vermont, has been pursu-ing bereavement training for herwork with families who experi-ence early fetal loss.1 She says ofthe loss of a fetus before 20weeks’ gestation that “parentsmay choose to have the hospitaldispose of the products of con-ception, but many of them regretthat decision. . . . When I interactwith them later on during home-health visits, I hear statementslike, ‘I wish I knew where mybaby’s remains are.’” Gill’s workincludes providing arrangements

for cremation and a final restingplace for the cremated remains.

Our feelings of trepidationchanged to admiration for Perry.She and Gill are examples ofnurses who understand thepatient’s possibly deep feelings ofloss. Perry admits that she took achance when she made those tinyfootprints, but she could sensewhat the grieving parents needed.In the end, they had only theirmemories to take home. Nursescan ensure that those memoriesinclude sensitivity, compassion,and understanding.

Melissa DoyleHannah Moran

Marie ShadduckKaren WalshMilton, MA

REFERENCE1. Keefe S. Saying goodbye: Nurses

help families cope with fetal loss.ADVANCE for Nurses 2008;10(4):31. t

give us the most support and thegreatest opportunity for a fulfill-ing career. Nursing residencyprograms benefit the nurse, theorganization, and most impor-tant, the patient.

Bill LoughnaneQuincy, MA

Denise SchwerzlerAshland, MALinda Steele

Needham, MA

REFERENCE1. Dracup K, Morris PE. Nurse residency

programs: preparing for the next shift.Am J Crit Care 2007;16(4):328-30.

‘WHAT REMAINS’Picking through the remains of a12-week fetus after dilation andcurettage presents a rather dis-turbing image, we thought as weread Susan Perry’s Reflections(“What Remains,” January). Assenior nursing students, we recog-

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Lilly Oncology on Canvas: Expressions of a Cancer Journey is an artcompetition and exhibition, presented by Eli Lilly and Company with theNational Coalition for Cancer Survivorship, honoring people confrontedwith cancer. The biennial competition invites people diagnosed with anytype of cancer, their families, friends, caregivers, and providers toexpress, through art and narrative, the changes that give their cancerjourney meaning. All entries for this competition, open to all U.S. andPuerto Rico residents, must be received by June 30. An independentpanel of judges will selectthree winners; prizes con-sist of money donated tothe cancer charities of thewinners’ choice. For infor-mation on entering thecompetition, call (800)734-4131 or visit www.LillyOncologyOnCanvas.com.

The deadline for entries is June 30.

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