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September 26, 2005 -- Today the Globe and Mail (Toronto) ran a simple but powerful "comment" by Corinne LaBossiere about the value of nursing. LaBossiere's piece compared the expert palliative care that her dying mother's nurse provided without fanfare, on the one hand, to the images on the TV in her mother's room, which showed celebrity Pamela Anderson getting quite a bit of male attention simply for parts of her body. The headline asked: "What assets do we value most?"

Ms. LaBossiere describes the scene in her mother's room at what appears to have been a hospital or hospice. Her mother, who is on oxygen and seems to be very ill, likes the sound of talking. When the real people run out of things to say, that means the TV. Pamela Anderson's new show "Stacked" begins. As LaBossiere comforts her mother, she notices that her mother appears to be starting to "feel pain again." A nurse soon arrives with an "array of needles" for pain, nausea, and relaxation, and she administers each, "slowly and gently, so the solutions don't burn as they enter Mom's body." The nurse adjusts the covers and sees that Mom's catheter has leaked, so she and an assistant change the sheets, "wash Mom's frail body, massage her skin with lotion and clothe her in a fresh nightie." They remake the bed, "moving Mom as gently as possible so her fragile body hurts as little as possible," then "rearrange all of her pillows to adjust the pressure points." In a few minutes, the nurse returns to check on her mother. Mom is still frowning and moaning, so the nurse "slowly injects another needle with pain medication into her arm." The nurse swabs Mom's lips and mouth with a moisturizing wash, then studies her face carefully, puts her mouth to Mom's ear and asks if she is comfortable. Mom makes the sound that "we have come to understand as yes." The nurse nods to LaBossiere, who "thank[s] her in a whisper," and the nurse "leaves the room soundlessly."

LaBossiere alternates this unusually perceptive description of what the nurse is doing with reports on what Anderson is doing, and the reaction from her show's characters: Pamela bends over a counter, and a man on the other side "swoons:" she flicks her hair, and a character "drools;" she swings her legs out of a sports car, and "two fellows stumble as they walk past." At the end, LaBossiere wonders how much Anderson makes in a year ("$10 million?"), and how much a palliative care nurse makes ($50,000?"). "Life's funny," she observes, and "find[s] the remote and change[s[ the channel." The author information piece at the end notes that LaBossiere's mother died "peacefully, thanks to the support, over many months, of dozens of palliative care professionals at CancerCare Manitoba, St. Boniface Hospital's palliative care unit and The Salvation Army Grace Hospice."

This piece makes the obvious point about the apparent superficiality of modern society's value system, where people may receive 200 times as much money for being physically attractive as they do for sensitive, life-changing skill and endless hard work. It might have added that Anderson is on television and her "work" is known to tens of millions, while palliative care nurses labor in relative obscurity, though this piece, commendably, at least brings them a small part of the acclaim they deserve.

But the piece does more. It gives readers a sense of why and how nurses do their work--skilled work that is generally ignored or undervalued--and the real difference it makes to patients and families. On TV dramas and even most documentaries, we would have probably seen a physician doing virtually all of the thinking, talking and decision-making. But in this account of bedside reality, it is the nurse who monitors the patient, expertly assesses and addresses her condition, and makes subtle but vital adjustments to her medication and physical environment. Of course, most of the media doesn't much care what a patient like Mom is going through or what can be done about it; it's not flashy or exciting. Only the people who actually go through this care. And for those of us who survive, it's easy to forget in the endless daily barrage of media and social influences telling us that nurses are nice but insignificant physician helpers.

This short piece is a valiant effort to help us remember. We thank Ms. LaBossiere and the Globe and Mail.

See the article "What assets do we value most?" in the September 26, 2005 edition of the Globe and Mail.

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