Midlife Crisis in Nursing

Even in the specialty of OGN nursing, nurses are leaving the field searching for more profes- sional recognition, better financial compensation, and new chal- lenges. Recently, I have ques- tioned whether there is a place in OGN nursing practice where I can meet my career goals; or, whether I am destined to join the growing population of nurses not working as nurses.

I found the answer to my ques- tion by looking at our patient pop- ulation. The fact that baby boomers are booming is not news to OGN nurses. But what about those who have not been able to boom? A quick review of the litera- ture reveals a growing number of articles and research pertaining to the increased incidence, causes, and treatments of infertility. Today, one out of four to six cou- ples (depending on the study) are diagnosed as being infertile. Infer- tility clinics are opening up across the country in response to the needs of infertile women and cou- ples. Research, scientific, and medical advancements are caus- ing technical interventions to be- come increasingly complex and sophisticated. Couples seeking medical assistance to achieve pregnancy are being propelled into a maze of costly medical man- agement which, in many cases, may still be experimental in na- ture. The emotional stress, physi- cal demands, and expenses are all high, while the success rates are still relatively low. For example, the success rate of in vitro fertil-

ization (IVF) is only about 20% and costs approximately $6,000 per trial. In the State of Washington, costs for this procedure, as well as almost all other infertility treat- ments, are not covered by medical insurance.

Within this growing and com- plex field, I see an alternative for the OGN nurse, like myself, who has been considering jumping the ship in search of more challenging seas. I believe each infertility center or clinic, will, or does have a need for a nurse with a specialty in infertility and advanced train- ing in counseling and teaching. The nurse’s role in this setting is to function as a patient care coor- dinator. The psychosocial and ed- ucational needs of infertile pa- tients cannot be ignored or iso- lated from medical management. Of equal importance is the nurse’s understanding and ability to counsel on the legal, ethical, and financial ramifications of various options available to infertile women and couples. Simply, infer- tility clients need nursing care that can adequately meet all of their needs.

JOGNN editorial staff welcome readers’ comments. Anyone inter- ested in publishing a letter to the editor, should write to Editor, JOG”, 409 12th Street, S.W., Washington, DC 20024-2191. All let- ters should be short, to-the-point, and signed by the author. Letters will be published at the editor’s discretion, and JOG” reserves the right to edit all letters.

The idea of working in this ex- panded nursing role is promising to me. I believe the role will meet my career goals and provide bet- ter financial compensation. For these reasons, I have decided to augment my nursing ski l ls and knowledge with a masters’ degree in social work. I am interested to know whether there are other nurses who share my interest, currently work in the capacity I have described, and agree or dis- agree with my projections for the future needs in infertility patient care. I would appreciate their con- tact, comments, and advice.

GRETCHEN SEWALL, RN, BSN 4270 Whitman Avenue, North Seattle, WA 981 03

HIV Precautions Update

In response to our article “Human Immunodeficiency Virus and Precautions for Obstet- ric, Gynecologic, and Neonatal Nurses” (May/June 1988)’ we re- ceived a telephone call seeking clarification of our statement that “Nurses should wear latex gloves.” When we wrote the arti- cle, our intent was to say WEAR GLOVES-vinyl o r latex-when handling blood or other body fluids. We also want to emphasize that gloves are not a substitute for handwashing. Upon removal of gloves, hands must be washed im- mediately.

KATHERINE WILEY, RNC, EDD JOY GROHAR, RNC, MS Chicago, Illinois

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September/October 1988 JOGNN 305