1. Howland, Wendie MN, RN, CRRN, CCM

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Doug Olsen's caveats in the "Ethical Cautions for Nurses" sidebar were ironic (Ethical Issues, July). He stated, "but as a technique therapeutic reciprocity is difficult to perform and teach [horizontal ellipsis] It should not be taught to novice nurses, nor should it be widely promoted as part of standard practice."


Joan Vivaldelli's case example in the main article weakens Olsen's argument by giving a mixed message. She notes with great feeling how this "union through pain" was a relief for her and her patient. But therapeutic reciprocity is not about relieving the nurse's pain. This very important concept might have been better illustrated if the case described what not to do. Perhaps then the ethical cautions would work better.


This article is bound to have great appeal for new graduates who think they have an innate skill-just as Vivaldelli does. They might not take this article as cautionary but as validation-and believe that they have what Olsen describes as "more than compassion" and can see past their own biases and "judge the therapeutic value of their own disclosures."


Wendie Howland, MN, RN, CRRN, CCM


Pocasset, MA