This time the book review column is taking a different twist. Several books have come across my desk over the summer. There is so much going on in health care, we need a book on almost everything. Therefore, please peruse the column much like you would do in a bookstore. See whether there is something that you need right now.

For those looking to improve their health:

Nurses in Shape, Helen Neville, 2009. Self published. Soft cover, 243 pages, $19.95. It can be found at http://www.nursesinshape.com.

Helene Neville, RN, after surviving cancer and 3 brain surgeries, set foot on a 2520-mile run across the country on May 1st, 2010 (finished August 1) to deliver the essential message of healthy living. Her book, Nurses in Shape, is how she became healthy. There is no index, nor major publishing firm, or set of references. Instead, there is a long list of acknowledgments from people who have advised her on her journey. There are 18 chapters and a call to all nurses to take their health in their own hands. With no index, I used the "flip the pages test." I would flip through pages and see how often I learned something. My first flip brought me to detoxification and a way to measure your BTW (bowel transit time). The average is 12 to 24 hours. Too long and toxins can be absorbed rather than eliminated. Too fast means less time to absorb critical nutrients. This was something I intuitively knew but had not drilled down to such a simple explanation. So, it passed the test. In other chapters you can discover exercises, diet tips, how to manage stress, etc. For me, one book does not do it all, but this one comes pretty close and is a very easy read.

For those who think if they could just get their budget straight or modify their variances:

Financial Management for Nurse Managers and Executives, 3rd edition, Steven A. Finkler, Christine T. Kovner, Cheryl B. Jones. St Louis, MO: Saunders Elsevier; 2007. Softcover, 518 pages, $79.95.

Budgeting Concepts for Nurse Managers, 4th edition, Steven A. Finkler and Mary L. McHugh. St Louis, MO: Saunders Elsevier. 2008. Softcover, 501 pages, $76.95.

Teaching finance to nurses can be tricky. No one went into nursing for either personal or professional financial gain. However, with health care reform and the subsequent challenges to cost and quality, finance is something we need to understand and apply to decision making. As more Registered nurses (RNs) move into nurse practitioner provider roles and leadership oversight roles from charge nurses to chief executive officer, finance quickly becomes a tool for managing tight resources to deliver quality patient care. Nurses have always been innovators. Their workarounds are among the best. And with National Database of Nursing Quality Indicators, we are well into quality. Finance is akin to another language. Once you understand definition and context, you can engage. Nurse leaders should always be at the table when budgets are negotiated for delivery of patient care. The authors have provided education in this arena for years. Finkler's books or equivalent should be in every nurse manager's library. Whether it is a manager or director, whoever is sitting at the budget table, he/she needs input from the frontline leaders to interpret clinical needs for finance people. When asked about variance from budget, who could be better to explain than the charge nurse, who had the big picture of the unit that shift or day? As the Centers for Medicare & Medicaid Services turn to value added (or pay for performance) to reimburse for care, nursing will be at the center of the bottom line. This is moving nursing slowly from being seen as pure cost to related revenue. The conversation around cost requires we speak both financial and clinical language. At first, it will seem like a burden. But in fact, it is an opportunity. Keep books on hand to help guide you through your journey of financial knowledge. All RNs from the bedside to the boardroom can align themselves with the right knowledge.

For those, both service and educators, struggling with the question of levels of education for RNs:

Educating Nurses ... A Call for Radical Transformation, Patricia Benner, Molly Sutphen, Victoria Leonard, and Lisa Day. The Carnegie Foundation for the Advancement of Teaching ... Preparation for the Professions. San Francisco, CA: Jossey-Bass; 2010. Hardcover, 260 pages, $40.

Whatever shape health reform takes, the complexity of patient care is increasing, not decreasing. Hospitals, in particular, are concerned about this. Universities are fast preparing faculty, advance degrees, including doctoral programs, and entry into practice degree programs. States are looking at making the bachelors of science in nursing in 10 as the entry into practice, while community hospitals depend heavily on associate degree in nursing. Who can be better to lead this debate than the nurse who gave us from Novice to Expert, Patricia Benner. This is not going to be an easy conversation. Rachel Rotkovitch, RN, MS, approached the question back in the 1980s with differentiated practice at Yale University. Since the end of diploma schools of nursing, there continues to be divisions between service and education as to preparation of the nurse at the bedside and what to pay whom for what. The authors, with more of a focus on education itself, recommend 4 controversial but essential shifts needed to transform nursing education (chapter 4).

1. From a focus on decontextualized knowledge to an emphasis on teaching for a sense of salience, situated cognition, and action in clinical situations

2. From a sharp separation of classroom and clinical teaching to integrative teaching in all settings

3. From an emphasis on critical thinking to an emphasis on clinical reasoning and multiple ways of thinking that include critical thinking

4. From an emphasis on socialization and role taking to an emphasis on formation.

While this is not an easy read, it is heavily researched and well thought through. We are not all nurse educators but these changes require input from all circles of nurses. Perhaps in this dialogue, more nurses will be called to become much needed faculty and patients will get the nurse they need.

- Elizabeth (Betty) Falter, MS, RN, CNAA, BC

President, Falter & Associates Inc, Georgetown, Delaware Tucson, Arizona