Appreciative Inquiry in Healthcare: Positive Questions to Bring Out the Best

Reviewed by: Sarah Pangarakis, MS, RN, CCNS, CCRN

By Natalie May, Daniel Becker, Richard Frankel, Julie Haizlip, Rebecca Harmon, Margaret Plews-Ogan, John Schorling, Anne Williams, and Diana Whitney. Brunswick, Ohio: Crown Custom Publishing; 2011. 131 pp. $19.95. ISBN 978-1-933403-23-6.

Today's healthcare is changing. Change, if not channeled or received well, can often bring feelings of apprehension, resistance, and negativism. How do healthcare providers adapt to the change for their patients, their colleagues, themselves, and their organization? "Appreciative Inquiry in Healthcare: Positive Questions to Bring Out the Best" is a strategy to help healthcare providers positively adapt to change by asking strength-building questions about the past and the future. Any healthcare professional can use the thought-provoking questions to open his/her eyes to view a situation in a new light.

Appreciative Inquiry focuses on beliefs that people and organizations function in patterns of importance, study, and life. The 4 D's cycle of Appreciative Inquiry includes the elements of discovery, dream, design, and destiny coupled with the actions of appreciating, imagining, delivering, and innovating with a positive radiating core. These elements are intertwined throughout the positive question asked within this book to help bring out excellence. The authors provide 12 ways to use the questions in healthcare.

The book is divided into 3 parts. The first portion concentrates on patients and their stories. By listening to the stories, healthcare providers can learn the patient's history, find the strengths, focus on their best assets, and redefine change based on the patient's experiences. The second part is about colleagues working together. It directs attention to healthy work environments, optimism, caring for coworkers, and learning from one another. Reflection questions allow the reader to pause and consider times of feeling valued and valuing others, to draw out organizational characteristics that would entice someone to want work there and to recall positive daily experiences to focus on the good.

The third section focuses on organizational fineness such as engaging employees, visioning a perfect work place, and using humor "as the other vital sign."

This book can be used at meetings, retreats, day-to-day discussions, at the bedside, or even in the break room to stimulate positive discussions to cultivate optimism and creatively rethink situations to embrace change.

Compact Clinical Guide to Acute Pain Management

Reviewed by: Kerstin McSteen, MS, RN, ACNS-BC, ACHPN, FHPN

By Yvonne D'Arcy. New York: Springer Publishing Company; 2011. 334 pp. $45. ISBN 978-0-8261-0549-3.

This is one of a series of books about pain in the Compact Clinical Guide series. This particular book focuses on acute pain, including physiology and etiology, assessment, treatment, and current information from national guidelines. It also discusses advanced pain management techniques, such as regional anesthesia and epidural/intrathecal interventions and considerations with special pain populations, such as patients with sickle cell, acute on chronic pain, and substance abuse issues.

This well-written and well-organized book is a much needed "middle ground" resource between oversimplified introductions to pain management and a thick textbook. It is easy to read in its entirety but also has clearly titled chapters, so a practitioner could easily skip directly to the topic of interest. It is intended for use in primary care, internal medicine, and acute- and long-term-care settings, and I would not hesitate to recommend it to advanced practice nurses and graduate students who need a concise and current resource about pain to augment their clinical experiences. I could easily envision keeping this book close to my desk for easy access when challenged with a patient with a pain syndrome I am less familiar with or am preparing or updating a presentation about pain management.

I especially appreciated D'Arcy's emphasis on the use of evidence-based approaches to pain management, reminding the practitioner that although this clearly improves patient outcomes, unfortunately only a small percentage of practitioners are actually incorporating research-based findings into patient care. She consistently references current literature and systematic reviews to support her points.

A growing body of research in pain is focused on how a person's gender and genetic makeup affect how opioids are metabolized and utilized, offering some explanation for individual differences in response to pain medicines. There is a full chapter on this topic, and although it is not exhaustive, it is a good introduction to the issue and is enough information to keep the reader looking for more as the research progresses.

The book makes good use of charts, tables and illustrations, and side boxes of "Clinical Pearls" that serve to highlight new terms or concepts or especially important points to drive home. To encourage the reader to apply the information, D'Arcy also ends each chapter with a case study and questions to consider. I did find myself wishing she had also offered her own comments to the case to affirm or correct my responses, but this a minor complaint in an overall refreshing and informative read on the topic of acute pain management.