National Nurses United

perhaps, the willingness to perform these satisfying jobs if there were salaries at living wages to pay them. The baby boomer generation begins to turn 65 this year, which will create many challenges for our healthcare system. This genera- tion of older adults will be the most socioeconomically and racially diverse the nation has ever seen. They are more educated, with more widely dispersed families, and increased longevity. The majority will suffer from one or more chronic conditions and will need to rely on healthcare services with a greater frequency than other segments of the population. It is estimated that the number of older adults in the United States will almost double between 2005 and 2030, yet there is a dramatic shortage of all types of healthcare workers, especially those in long-term care settings. In 2008, the Committee on the Future Health Care Workforce for Older Americans published a report titled, "Retooling for an Aging America: Building the Health Care Workforce." The report asserted that federal agencies should provide support for the devel- opment of technological advancements, to include the use of assis- tive health information technologies and remote monitoring technologies "that may reduce the need for formal care" and "enable health professionals to be more efficient." The committee's report, and its title, all but eerily foreshadows the subject matter of Turkle's comprehensive body of research. It is against this "embrace technology" backdrop and the industri- al-manufacturing encroachment into the for-profit acute-care and long-term care environments that Turkle's book should become required reading for all who value the art and science of nursing. Turkle observes that technology presents itself as a one-way street; discontents about its direction are dismissed because it's assumed their reactions are borne of nostalgia, or a Luddite impulse, or simply in vain. But when we ask what it is we'll "miss," we may discover what we care about, what we believe to be worth protecting. Technologies 14 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T 2 0 1 1 A s a prominent, successful San Diego trial lawyer, Brian Monaghan was a pro at being a fierce advocate and winning big cases for his clients. But the tables turned in May 1998 when Monaghan learned that he had Stage IV melanoma and two metastasized tumors in his brain. Now he was the one that needed an advocate. Luckily for him, his smart and strong wife Gerri filled that role perfectly. After a 13-year battle involving much research; consulting of specialists for second and third opinions; Gamma Knife, brain, and other surgeries; experimental vaccines; and intensive therapy, Monaghan is still alive, doing well, and his cancer appears to be indefinitely in remission. He attributes his success in fighting such a devastating diag- nosis to having such a powerful personal advocate, Gerri. To help other patients facing serious medical challenges and share all the lessons they learned while battling Monaghan's can- cer, he and his wife wrote When A Loved One Falls Ill: How to be an Effective Patient Advocate. Every patient needs an advocate, they argue, "to have someone other than the patient question what's being done and why. You need to have someone stand up for you when something doesn't sound right, some- one who's not intimidated by the fact that the person standing in front of her is wear- ing a white coat." Written in a colloquial style, When A Loved One Falls Ill is a great book that simul- taneously tells their story from both Brian and Gerri's perspec- tives, and offers 50 "advocate tips" to fol- low. Some of the tips address practical mat- ters, such as starting an advocate's notebook to keep all of the patient's information in one place or making sure to get copies of every record. Some of the tips address mat- ters of the spirit, such as advising readers to trust their intuition, to stay optimistic through inspirational stories, and to keep laughing in order to stay sane. Some of the tips, such as using your networks and every contact available to you to get what you need, are just common sense yet something that people don't apply when it comes to their medical treatment. Very importantly, they remind readers through tip #40 to treat doctors, nurses, and medical staff well! Even as an RN, I learned a lot from this book. It really brought home for me how the medical system offers so little support for patients, how much the medical system needs to change, and how much the country needs single-payer health- care so that people can marshall all their resources toward fighting the illness and not worry about money or the insur- ance company. As an RN with many friends and colleagues still working in the healthcare system I mainly use, the book opened my eyes as to just how inadequate my resources would be if I had to navigate this world without my connections— as most patients do. What I liked best about this book was that it laid out all the things patients and advocates need to be aware of, as well as answering those questions and supplying the resources to address those concerns. My only quibble about the book is that it was written from the perspective of an unusually prominent and wealthy person who was able to do things like call up CEO friends to get appointments with specialists and go on European vacations in between treat- ments—hardly the situation of most patients. Still, the lessons and advice ring true. Since we will all be patients one day, this book is well worth the read. —Kay McVay, RN When A Loved One Falls Ill: How to be an Effective Patient Advocate By Gerri & Brian Monaghan; Workman Publishing Books_REV 2 8/16/11 5:16 PM Page 14

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