Nursing [horizontal ellipsis] Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Modern Hubris Undermine Nurses and Patient Care, Suzanne Gordon, Ithaca, New York, Cornell University Press, 2005. 489 pages, hardcover, $29.95.
This author is a journalist who has written extensively about nursing since the 1980s. You might recall her 1997 book: Life Support: Three Nurses on the Front Lines. She has written for the New York Times, the Boston Globe, and other papers. She is also an assistant adjunct professor at the University of California - San Francisco. The author's major issue for nursing has been our inability to explain what we do to the public, complicated with a media that portrays us in unfavorable and untrue ways. Just recently, fall 2005, this portrayal was repeated by a recent episode of a popular Fox TV show, House. Four physicians care for one difficult-to-diagnose case. Rarely are nurses or any other discipline called in. With this current patient, he suffered a loss of bowel control. The camera focused in on the soiled sheets. The physician said: "We need a nurse." Suzanne Gordon is willing to say we need the media to portray us as nurse scientist as well as caregivers. If you liked Life Support: Three Nurses on the Front Lines, you will like this book as well.
Nurse researchers are making great strides in gathering data to support evidence-based practice and argue the case for nursing to both the healthcare establishment and the public. The author interviewed some of these researchers and is contributing to these efforts from a journalistic perspective. With healthcare getting increased attention in established journals such as The Times, the Wall Street Journal, and more, nursing is fortunate to have this kind of media support.
Early in the book, the author spends a great deal of time on the nurse/physician relationship. She gets at the roots of why and how nursing became the subordinate profession. The chapter on this issue alone is worth buying the book. Wherever you fall on this subject of nursing and perceptions, understanding this issue is critical to changing and promoting the profession of nursing. Minimally, it is intellectual food for dialogue among and between physicians and nurses. Particularly disturbing was to read her report on female physicians' reaction to nursing.
Other chapters address what is missing from the news-the restructuring of hospitals and managed care and the subsequent effect on nursing, major issues facing the healthcare systems such as infections and nursing, the growth of travel nursing, the need for nursing faculty, and much more. Most important, the author ends the book with a full chapter dedicated to "Changing the Odds" (pp. 401-450). This includes the challenge to nurses to fight for universal healthcare. The author's argument on how the Johnson and Johnson media campaign actually contributed to a weakened image of nursing is daring and challenging. The author has interviewed many recognized nurse leaders including Claire Fagin. In fact, the book is dedicated to Claire and Stan Fagin. The author also supplies 25 pages of notes and footnotes, broken down by chapter. Some of the issues, such as nurses leaving in droves, need to be countered by the numbers of people wanting to come into nursing. There should probably be more attention on the growth of Magnet Hospitals (minor mention) or the work of Diana Mason, editor of AJN, on nursing and the media (1 line). Why does the author think these efforts require only a passing mention? Why are they not enough? Are the odds so stacked against us, we cannot turn it around ourselves?
What is most compelling about this book is how the misunderstanding of nursing is contributing to major problems in healthcare. This is not just about nursing. It is about why nursing in order to have good healthcare [horizontal ellipsis] by a nonnurse. In addition to all of this good reporting, the book is a good read by a talented writer. All nurses should read this book, give thought to their reactions, Ethics in healthcare organizationsfor changing the odds [horizontal ellipsis] and then lend their copy to a physician and a policy maker.