"Burgers or Bruises?" (Viewpoint, September 2004) was very informative. As a trainer of nursing assistants, I see hundreds of people who seek out this training as a first step into the health care field. Students seek training for many reasons, such as preparing for nursing school and having a job with benefits. Many are new immigrants with a limited command of English, and this is their entry into the U.S. workforce.

Many of the students are unfamiliar with nursing homes because such facilities don't exist in their native countries. It can be very troubling to a foreign student to see elderly people in such a setting, and it's our responsibility as instructors to help them understand and accept this type of care. It's important that these students learn what it's like to care for agitated residents with dementia. Having well-trained nursing assistants can only help the older adults in hospitals, nursing homes, and their own homes.

Elizabeth Reichman, RNC

Boston, MA