strange when you consider that the nurse spends hours with a patient while the physician’s time with a patient may be limited to minutes? I feel it is a positive example to the patient showing that we are approachable and willing to invest of ourselves.

The authors go on to point out that nonverbal communication is four times more powerful than verbal interaction and that women are particularly sensitive to this form of communication. I think that nurses excel in this area, partially because of the time we spend with patients. I have participated in countless doctors’ rounds where the harried physician never makes eye contact with the patient and edges toward the door seconds after arrival. It is often the nurse who then listens to the patient’s concerns and explains what the doctor has said.

The article points out that the feminine qualities of caring and nurturing are foremost in the public’s view of nurses. I do not see that as a negative image. As the public is changing from a technology worshipping society that placed high value on tests and machines, to a more realistic and financially aware society that considers things such as quality of life, nurses are in a good position for the future. More consumers are learning that while health care inflation has increased nearly 30% over the last two decades, the costs of nursing care, when adjusted for acuity, actually decreased by 6% (Mahrenholz, 1990).

Clothing is brought up next. Nursing uniforms have become more informal and varied, sometimes not used at all. A study by Magnum, Garrison, Lind, Thackery, and Wyatt (1991) is used to show that patients prefer a nurse in white pants with a stethoscope around her neck and cap on her head. I see this as a positive finding. The preference for pants over a dress says to me that patients are becoming more aware of the active nature of nursing. I can easily understand why a cap is preferred as it is difficult to determine the roles of the many people in today’s hospitals. It is desirable to be able to quickly identify at least one member of the health team.

Although I disagree with the authors about nurse-patient relationships using first names, I do agree with their stance on using first names in the nurse-physician relationship. If a physician prefers to be called by his title and last name, then I expect the same courtesy extended to me. I have found that most physicians that I work with for any length of time prefer using first names, theirs as well as mine.

Beverly lhrner, Alpha Theta Alachua, Florida

References Magnum, S., Garrison, C., Lind, C., Thackery, R., & Wyatt, M. (1991).

Perceptions of nurses’ uniforms, IMAGE: Journal of Nursing Scholarship, 23, 127-130.

Mahrenhltz, D. (1990). Should costing out nursing services be mandated?: Part I. Nursing Connections, 3(2), 51-54.

Writing and Publishing to Improve Care I read “Contributions of Graduate Students to the Creation and

Dissemination of Nursing Knowledge,” by Lorys F. Oddi, Georgia Griffth Whitely, and Barbara J. Pool (IMAGE, Spring, 1994) with great interest. The authors should be commended for addressing a very important topic.

Although, not specifically addressed in this study are the numbers of graduate students who do not go on to disseminate knowledge from studies and projects. Of particular concern is the lack of publications by those who have clinical positions. The ultimate purpose of disseminating nursing knowledge is to improve clinical care. Those who have a clinical focus to their practice need to share the findings of clinical observations.

Graduate faculty may need to consider including content in their programs related to publication and other ways to disseminate findings. I will always be grateful for the guidance I received from an undergraduate teacher and a clinical preceptor in my master’s degree studies that resulted in my first two publications. Clearly, graduate nursing students can make significant contributions to knowledge and these contributions are enhanced by faculty support.

Suzanne M. Mahon, RN, DNSc, OCN, Delta Lambda Clinical Coordinator, Deaconess Cancer Screening Center

St. Louis, Missouri

Comparing Two Very Different Studies As a doctoral student in transcultural nursing, I was pleased

to see two articles focusing on care in the Spring 1994 edition of IMAGE. I especially enjoyed “Identijjing Types of Attending: Patterns of Nurses’ Work,” by Joan L. Bottorff and Janice M. Morse, an excellent example of how care behaviors can be identified through inductive, qualitative research and how ethnologic methods can be an exciting new approach to describing how nurses provide care for clients.

In contrast, I had some concerns when reading “The Ethic of Care: A Comparison of Nursing and Medical Students,” by Elizabeth Peter and Ruth Gallop. Concluding that a caring moral orientation is not unique to nursing by sampling undergraduate nursing and medical students who have yet to mature within their disciplines may lead to inconclusive results. In addition, the methodologic approach does not incorporate strategies for identifying client reaction to care, or the reality of caregiving in actual clinical practice.

June Miller, RN, MS, Lambda Wayne State University Detroit, Michigan

Send the Right Message to Policymakers The wholistic perspective of nurse practitioners described by

Diane Feeney Mahoney in “The Appropriateness of Geriatric Prescribing Decisions Made by Nurse Practitioners and Physicians,” (IMAGE, Spring, 1994) is an achievement to be proud of. However, rather than suggesting that “policymakers should be warned about adopting regulations that disproportionately burden nurses,” a more appropriate recommendation might be for policymakers to require continuing education in gerontologic pharmacology for physicians. It may in part be the pharmacologic training of nurse practitioners that deters them from using medication as a first- line intervention or renders their prescriptions most appropriate.

Michele L. Frank, RNC, MSN, Upsilon New York, New York

Volume 26, Number 3 , Fall 1994 173