1. Anthony, Maureen PhD, RN

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July is the month we celebrate Independence Day-a commemoration of the signing of the Declaration of Independence. Our freedom and birth as an independent country would not have been possible if not for the sacrifices of those who fought in the Revolutionary War. Since that time the United States has been involved in numerous conflicts, the most notables being the Civil War, two World Wars, the Korean War, the Vietnam War, the Gulf War, and wars in Iraq, and Afghanistan. Dr. Brenda Elliott, a Veteran and former home care nurse and current nurse educator brings us an article on home care of the Vietnam Veteran. As she explains in the article, the Vietnam Veterans are the largest group of Veterans in the United States. They are at or are quickly approaching 65 years of age, making them eligible for social security and Medicare. Because of the large size of this group, and their age, we can expect home care clinicians will be seeing many men and women who are Vietnam Veterans. Unlike wars prior to and since the Vietnam War, this group of military men and women returned home to war protests and jeers from the public rather than accolades and patriotic parades. These warriors took the brunt of the anger of a country that had begun to oppose the war in Southeast Asia. I didn't understand it then, and I still don't today. Why did we take our war weariness out on the men and women, most of whom were drafted, and who had no part in the decisions that led to the war in the first place?

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When I'm in airports these days I often see military men and women in uniform. It isn't unusual to witness folks thanking them for their service. It is clear we as a country recognize the error of our ways in the past and are attempting to make amends. It's great for the military men and women of today, but what about those Vietnam Veterans? Have they ever been sufficiently thanked for the price they paid? Having lost my only brother to the Vietnam War, Veterans from this era have a special place in my heart and I was very happy when Dr. Elliott submitted her manuscript. The effects of that war linger today, with posttraumatic stress disorder, anxiety and sleep problems, homelessness related to psychiatric, drug and alcohol problems, and health issues related to Agent Orange. So when you see a man or woman at the 4th of July parade, proudly wearing a military hat that identifies them as a Vietnam Veteran-thank them for their service and sacrifice. After returning to the United States, Vietnam Veterans felt unwelcome joining the Veterans of Foreign Wars and the American Legion. That is how the Vietnam Veterans of America got its start. I'm sure there's a chapter near you. It isn't too late to send them a note thanking them for their service. And when you see home care patients and learn they are Vietnam Veterans, be sure to thank them for their service. It's a pleasure to finally get the opportunity to serve those who served their country so many years ago.


In other feature articles this issue, editorial board member Mary McGoldrick brings us a practical article on safely transporting and storing medical supplies in vehicles, a practice we are all very familiar with. New author Elizabeth Flott writes about guiding patients through the difficult process of smoking cessation. Author Cynthia Walker describes an initiative by the Baltimore Wound, Ostomy, Continence Nursing Affiliate to improve care of patients returning home with a new ostomy. Author Susan Burt and colleagues describe how their agency implemented a transitional care program to reduce hospital readmission within 30 days of discharge, and finally, author Amy Beasley writes about management of hospice patients experiencing dyspnea.


Our regular departments are back as well. The Institute for Safe Medication Practices brings us an important reminder about the danger of using parenteral syringes to measure oral or enteral medications. The Institute has received reports that these syringes have been connected to intravenous lines, and products intended for oral use have been injected into intravenous lines with serious outcomes. Author Ann Shastay reminds readers that oral syringes should be used exclusively when measuring oral or parental doses. Our diabetes experts, Drs.Burson and Moran write about bariatric surgery for patients with diabetes. We have an interesting Consult PRN column by Jaclyn Conelius on frequently asked questions about implantable cardioverter defibrillators. Authors Margaret Terry and Molly Smith bring us this month's VNAA's Voice on quality measures in home care. Finally, be sure to read the heart warming Commentary this month by patient John Stanton who pays tribute to his home care nurse.

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