Nursing against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care
http://www.100md.com
《新英格兰医药杂志》
As with much that has been written about the nursing profession, this book comes during one of the cycles of a national shortage of registered nurses. It is probably not coincidental that the shortages occur at the same time people become interested in understanding more about the nursing profession. Nursing against the Odds makes abundantly clear some of the important problems of the work and work environment of registered nurses and other nursing staff in acute care hospitals.
(Figure)
Florence Nightingale, Considered by Many to Be the Founder of Nursing.
Reproduction of wood engraving, 1872, by T. Cole after Goodman, 1858.
Wellcome Library, London.
The first of the book's three main sections details the complex relationship between nurses and doctors; the second explores how nurses are depicted by the media; and the third explains the relationship between hospitals and organized health systems and nurses. This well-written book seems to be aimed at a lay audience but would also be of interest to health care professionals in the medical, nursing, and administrative fields.
In the first section, Suzanne Gordon offers one of the most comprehensive and insightful discussions I have read regarding the historical context of the complex set of relationships that have developed over the years between doctors and nurses. The thoughtful exploration of these relationships as they started and continued explains the reluctance of nurses to be in the limelight, the "parallel universes" in which nurses and doctors exist, and the concerns about power. Perhaps because of my own experiences, I found myself agreeing with most of this section of the book. It should be required reading for all nurses, doctors, and nursing and medical students.
Section 2 explores the portrayal of nurses by the media. Gordon notes what other writers have had to say about the image of nurses in the media, whether it is the invisible helper in ER, the sex kitten in Nightingales, or the sadist in One Flew over the Cuckoo's Nest. But she also makes additional, provocative observations. She points out that some nurse leaders and scientists speak of nursing in "sentimental terms" and downplay the highly technical medical knowledge that is necessary to perform nursing care. Even nurse leaders often talk about "nurturing, kindness, niceness, and thoughtfulness" as being the primary attributes of nursing care. Gordon explores the idea that the nursing profession's attempt to elevate the status of nurses by emphasizing "critical thinking, not just tasks, decision-making, and judgment" — discounting the capacity for manipulating complex equipment, the manual skills needed to provide physical care, and other interventions requiring advanced knowledge — may lead to confusion about what nurses actually do. She also discusses nurses' lack of training and their lack of understanding about how to deal with the media.
Section 3 discusses the work environment of nurses in hospitals. While reading this section, I became aware of the author's selective bias in the use of references that substantiate her points. Although there is much accurate information in this section, there are several instances of inaccuracies or of presenting only one side of an issue, such as the discussion of the nurse assistant "practicing under the RN's license" or the discussion of the idea that nurses are proficient only when they have been in the same role in the same place for months or years.
Although Nursing against the Odds cannot be considered a scholarly work, it is very informative. Nurses, physicians, and others interested in the work of nurses will find this book both provocative and enlightening.
Jean Ann Seago, Ph.D., R.N.
University of California, San Francisco
San Francisco, CA 94143
jean.ann.seago@nursing.ucsf.edu((The Culture and Politics)
(Figure)
Florence Nightingale, Considered by Many to Be the Founder of Nursing.
Reproduction of wood engraving, 1872, by T. Cole after Goodman, 1858.
Wellcome Library, London.
The first of the book's three main sections details the complex relationship between nurses and doctors; the second explores how nurses are depicted by the media; and the third explains the relationship between hospitals and organized health systems and nurses. This well-written book seems to be aimed at a lay audience but would also be of interest to health care professionals in the medical, nursing, and administrative fields.
In the first section, Suzanne Gordon offers one of the most comprehensive and insightful discussions I have read regarding the historical context of the complex set of relationships that have developed over the years between doctors and nurses. The thoughtful exploration of these relationships as they started and continued explains the reluctance of nurses to be in the limelight, the "parallel universes" in which nurses and doctors exist, and the concerns about power. Perhaps because of my own experiences, I found myself agreeing with most of this section of the book. It should be required reading for all nurses, doctors, and nursing and medical students.
Section 2 explores the portrayal of nurses by the media. Gordon notes what other writers have had to say about the image of nurses in the media, whether it is the invisible helper in ER, the sex kitten in Nightingales, or the sadist in One Flew over the Cuckoo's Nest. But she also makes additional, provocative observations. She points out that some nurse leaders and scientists speak of nursing in "sentimental terms" and downplay the highly technical medical knowledge that is necessary to perform nursing care. Even nurse leaders often talk about "nurturing, kindness, niceness, and thoughtfulness" as being the primary attributes of nursing care. Gordon explores the idea that the nursing profession's attempt to elevate the status of nurses by emphasizing "critical thinking, not just tasks, decision-making, and judgment" — discounting the capacity for manipulating complex equipment, the manual skills needed to provide physical care, and other interventions requiring advanced knowledge — may lead to confusion about what nurses actually do. She also discusses nurses' lack of training and their lack of understanding about how to deal with the media.
Section 3 discusses the work environment of nurses in hospitals. While reading this section, I became aware of the author's selective bias in the use of references that substantiate her points. Although there is much accurate information in this section, there are several instances of inaccuracies or of presenting only one side of an issue, such as the discussion of the nurse assistant "practicing under the RN's license" or the discussion of the idea that nurses are proficient only when they have been in the same role in the same place for months or years.
Although Nursing against the Odds cannot be considered a scholarly work, it is very informative. Nurses, physicians, and others interested in the work of nurses will find this book both provocative and enlightening.
Jean Ann Seago, Ph.D., R.N.
University of California, San Francisco
San Francisco, CA 94143
jean.ann.seago@nursing.ucsf.edu((The Culture and Politics)