Notes From the Waiting Room: Managing a Loved One's End-of-Life Hospitalization, by Bart Windrum. Boulder, CO: Axiom Action; 2008. 336 pages, $25.00 (paperback)

Notes From the Waiting Room is a critical review of the healthcare industry and the process of institutionalized dying from a family member's perspective. The stated purpose of the book is to provide information and guidance to lay persons advocating for their loved ones dying in an institutional setting. Windrum's style is easy to read and follow. He uses clear language to discuss difficult topics in a manner that is neither condescending nor banal. Terms and concepts are explained prior to their use, and a collection of additional resources is provided to further enhance the reader's knowledge.

Windrum chose an interesting manner in which to lay out the content of the text. He unconventionally placed the glossary of terms at the beginning of the book to familiarize the readers with healthcare jargon and personnel they may encounter while hospitalized. Vignettes are strategically placed to allow the reader's insight into the experience of the author's family throughout the terminal hospitalizations of his parents. Each chapter is prefaced by a synopsis specifically intended for those in acute crisis. This provides readers the opportunity to acquire the "take home message" in an expedited fashion, yet allows for more in-depth information to follow.

Specific content areas include the aforementioned glossary of terms, tips on how to be an effective patient advocate, guidance for managing a hospitalization, discussions of death and dying, policy, and reform. There are no tables or figures represented in Notes. He does, however, propose policy reform and education regarding death and dying.

Windrum is a layperson with no scientific or healthcare training. His experience comes from his role as medical power of attorney for his parents, when both were dying. The author's experiences with his parents' deaths were distressing and difficult. The subsequent frustration with the system and situation, although apparent in his writing, is inoffensive.

American healthcare can be a confusing and disempowering entity to those unfamiliar with its methods and procedures. For the layperson, the author provides valuable information and guidance toward understanding the intricacies of the healthcare system. This book is an invaluable resource for any family dealing with hospitalization. Ideally, readers would read the book prior to an acute need. If not, in a time of crisis, it can provide guidance to the uninformed as well as the seasoned healthcare provider.

Although harsh at times in his critic, Windrum echoes nurses' own findings that nurses are overextended and that communication between staff is often lacking. Windrum reminds the reader to be prepared, ask questions, and serve as an advocate for one's patient.

-Rebeka Watson Campbell, BSN, RN

Doctoral Student and Teaching Assistant, The University of Texas Medical Branch, Galveston, Texas