1. Ungvarski, Peter J. MS, RN, FAAN

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Thank you for publishing "Interactions of People with Disabilities and Nursing Staff During Hospitalization" by Suzanne C. Smeltzer and colleagues, as well as commentary by Lisa I. Iezzoni and Michael Ogg on their personal experiences ("Hard Lessons from a Long Hospital Stay"), both in the April issue. As a longtime nurse (Bellevue School of Nursing Class of 1964) and the partner for 37 years of a person who is a wheelchair-bound quadriparetic, I have lived through so many of these experiences.


When I reflect back on my much-maligned and now nonexistent diploma nursing education, I recall that the curriculum included neurologic and rehabilitation nursing as well as the study of ophthalmology and otolaryngology in regard to caring for the blind and hearing impaired. As students, we not only attended lectures on these subjects but also spent weeks on Bellevue's wards, learning to care for special-needs populations.


Over the past several decades, I've watched the nursing education process dissolve into lectures and the watching of videos. In some cases, second degrees-baccalaureates-are obtained in 14 months. What's the end product at graduation? Nurses who've never learned to care for patients with routine needs, much less special needs.


Life with my partner and his health care has been difficult, because providers lack the education and experience to care for the disabled. One of our most laughable and sad memories occurred when we were referred to one of New York City's premier rehabilitation hospitals. When I called to book the appointment and asked if the facility was wheelchair accessible, the answer was, incredibly, no. On another occasion, during a hospitalization for open reduction of a fractured tibia and fibula, the physical therapist showed up with a walker prior to discharge to teach my partner how to walk with the leg immobilizer. I asked the therapist which part of 'quadriparetic' and 'wheelchair' he didn't understand!


Sadly, this lack of knowledge and experience isn't unique to nursing but is pervasive across health care disciplines.


Peter J. Ungvarski, MS, RN, FAAN



New York City