New Book by Suzanne Gordon "Nursing Against All Odds"

grannynurse FNP student · Jun 20, 2005

Sandy,
It's just what the "nurse ordered."
I love it and can't keep my nose out ot it though I am only 1/3 through it which is mainly her introduction (great "epiphany" story where she "nurses" a friend from same day surgery to home) and the history of the dynamics between nurses and docs (I hate to say it but I was pretty surprised reading some of the female docs take on us). Gordon does an impeccable job with detail and elaborating both sides of the coin. I highly recommend it to everyone from nursing/medical students to retired nurses and everyone in between I do believe it could be a prequisite read for anyone going into the medical field. Enjoy and I hope we can all continue a discussion in this thread and learn from it for our future.
Thanks for the responses.
OjoRN

I have read her other books. And just started her newest one. I enjoyed her opening chapter, kind of reminds me of my first few days home, alone, after being discharged from a rehab center. And it brings back memories of home health, when I worked, back in the dark ages. It is an interesting take on our healthcare sysetem.

Grannynurse :balloons:

pickledpepperRN · Jul 3, 2005

I'll post my opinion after I finish the book. I did find another review:

http://www.calnurse.org/?Action=Content&id=968

NURSING AGAINST THE ODDS, by Suzanne Gordon

The depressing cover of Suzanne Gordon's Nursing Against the Odds immediately sets the tone for the whole book: An extremely defeated, burned-out looking RN sits slumped with her head buried in her hands.

For years RNs (individually and in some instances collectively) have been engaged in changing the traditional image of being the physician's and administration's handmaiden into being a strong and decisive advocate for their patients and profession.

Gordon provides a very accurate description of how RNs are stereotyped in the media and, with a few exceptions, in the entertainment industry as well.

She is right on the mark in describing the unholy alliance of the nurse managers and administrators with the industry profit mongers, and how nurse managers and administrators have abandoned their patient advocacy duties in favor of promoting corporate interest -- creating tension within the nursing profession.

Gordon is also on point when she describes the appreciation of nurses by lay people.

The notion of caring, the holistic approach to patient interaction, and the special nurse patient relationship is particularly appealing.

It offers the promise of someone on your side who will escort you through an alien, scary world and "fight for you." This is what patient advocacy is all about.

Real patient advocacy got started in the early 1980s with the adoption of the primary nursing care model, where, for the first time in history, the RN direct care and patient advocacy role became intertwined. In primary nursing, RNs became patient advocates because RNs planned and provided the care, and collaborated with other nurses and health practitioners about the needs of their patients.

Don't tell an OR RN that the "captain of the ship" doctrine still exists. She'll eat you for breakfast.

We took this road in the '80s and never looked back.

But Suzanne Gordon spends too much time rehashing the handmaiden image. She should have used CNA's revolution as an example of what needs to occur in our profession in order to protect and promote our profession, patient safety, and patient advocacy. The American Nurses Association failed to lead the profession in seeking autonomy in advocacy and recognition in practice settings, choosing instead to focus on prestige versus real power.

No so with CNA. We seized the power.

Yet Gordon's book provides no anatomy of the most incredible achievements of CNA-sponsored landmark legislation, like the nation's first safe staffing ratio law. These accomplishments not only changed the manner in which RNs responded to the patient's clinical, therapeutic, and restorative needs, but also created social change in the RN culture, e.g. acting as lawful weapons to fight for our patients, our profession, and our well-being.

Gordon supports the BSN degree as the entry into practice and differentiation of practice. She also promotes the "magnet" hospital status, which is really just a money-making scheme by ANA and a marketing tool for the industry. Also, contrary to her recommendation, there is no need for further experimentation in nursing models. That's like the frog adapting to more and more heat, not realizing that he is being slowly boiled.

Finally, her focus on the RN being weak, a victim, and burned out is misplaced.The strategy to deal with these factors can be rather simple if there is a professional and political will. How does one deal with stress? Very simple, by changing the stress factors. What are the stress factors? On the clinical side, having the responsibility and accountability of too many patients without the authority. What is the solution? Representation by a progressive professional and labor organization fighting for better working conditions/benefits and achieving safe patient ratio standards, including the requirement to staff up based on patients' individual acuity as determined by the direct-care RN.

-- Hedy Dumpel, RN, JD

christvs, DNP, RN, NP · Jul 3, 2005

Hi,I haven't read the book you just mentioned but I have read another book by Suzanne Gordon called "Life Support." Great nursing book! It has a light blue cover with a stethoscope on it. Yeah, I couldn't believe she is not a nurse! she sounds like one to me! :) Now I want to read that other book you said she just came out with!

Genevieve RN · Jul 3, 2005

What exactly WERE the female doc's take on us?

TypicalFish · Jul 3, 2005

I agree with the above posted review-the book is on target and accurate, but also focuses too much on the negatives-I know that it is important, but in some ways all it does is continue the "nurses are victims of the management/media/doctors/public opinion. I am not verbalizing it very well, but I found it depressing to read. I just wish that she would of thrown in a few "But On The Positive Side...." or "Nurses are better educated, more utilized as health care practitioners and have more of a voice than ever before" chapters.....

pickledpepperRN · Jul 3, 2005

What exactly WERE the female doc's take on us?

I just read the last 2/3 of the book last night. It is in my lap now. I can neither remember nor find a quote attributed to female doc's. Not memoeable to me.

I'm not saying don't read it, just don't suspend your critical thinking skills.

I disagree with Ms. Gordon that ANA represents the profession. Her support of the BSN is moot. That topic has and continues to be rehashed for decades. I also disagree that Magnet status with its institutionalized TQM model that also demands the incorporation of shared governance can solve the shortage and burnout problems.

I KNOW shared governance. Nearly two dacades ago I perticipated in THAT distraction. Lip service only while NONE of our suggestions (We didn't even call them recommendations) were implemented. One "suggestion" was to have a Sharps container in each room. Management said it was too co$tly.

Later through the CNA educating lawmakers (also known as lobbying) it was the law. Management then took credit for implementing the placement of Sharps containers.

I agree with Ms. Dumpel that, "The ANA failed to lead the profession in seeking autonomy in advocacy and recognition in practice settings/ instead it continued to focus on prestige versus real power."

The ANA continues desperately trying to be like the "boys" (MDs) and kowtowing to the employers and politicians, greatful for a little crumb, and being recognized as a stakeholder.

They talk about empowerment which explicitly means that someone out there with greater power is willing to share some of it with you, but continues to keep you on a leash.

I am more heartened and encouraged by the review than the entire book. Here is again the last paragraph:

Finally, her focus on the RN being weak, a victim, and burned out is misplaced.The strategy to deal with these factors can be rather simple if there is a professional and political will.
How does one deal with stress? Very simple, by changing the stress factors.
What are the stress factors? On the clinical side, having the responsibility and accountability of too many patients without the authority.
What is the solution? Representation by a progressive professional and labor organization fighting for better working conditions/benefits and achieving safe patient ratio standards, including the requirement to staff up based on patients' individual acuity as determined by the direct-care RN.
-- Hedy Dumpel, RN, JD

lee1 · Jul 4, 2005

Code Green is another very interesint book. Tried to have a discussion about this last year but no takers. Anyone read this also???

ZASHAGALKA, RN · Jul 4, 2005

hi, i am not responding specifically to your request about this book but couldn't figure out how to post the following, thank you for your indulgence.

People tend to ignore completely off the thread topics. find the forum page and start your own thread. Small pox isn't a problem. It would be a stupid bio-weapon. Why? The US and Israel can vamp up our vaccination programs in literally hours. We can vaccinate most of both countries in pace with an outbreak. That leaves the virus to bounce back around the world and do most of its damage on the home populations of the terrorist stupid enough to unleash it.

~~~

Anyway, I read Nursing Against the Odds and liked it. Although she did advocate for BSN entry, she spent like 2 pages out of 400 on it, and everytime she hinted at it in the book, she hinted that it was one of the causes that keep nurses apart. And it is.

She also advocates Universal Healthcare - which will never happen. Maybe when the country was more blue state, but not now. And especially as Canada's system becomes more ineffective and cost-ineffective every passing year. Canada's system survives because America sits here as an outlet for many Canadians. Who's gonna be an outlet for us? I think we will get some kind of 'single' payor, or more likely, 'standardized' payor system, but that's as close to universal as we will get. And really, with insurance following DRGs, we're practically a standardized payor system now.

It's a good book. It made me think about nursing in terms that I hadn't considered before. I especially liked the thought about the languages symantic of Dr. So and So as compared to using our first names - we are holding ourselves down simply by accepting language that marginalizes us. As somebody here said, "only pets and children don't have last names".

Anyway, I strongly recommend the book. I might even read another of her books, but not for awhile, that book was a hard swallow and I need to digest it. (actually, I was so engrossed, I read the whole book in 2 days, when I said hard, I don't mean uninteresting, I just mean lots of concepts to absorb).

~faith,

Timothy.

epiphany · Jul 4, 2005

I am half way through it, and I think this book is very important reading (besides that, it is well written), coming from a new nurse. She answers a lot questions for me about this profession, and explores issues that have often confounded me, in well placed arguments.

pickledpepperRN · Jul 4, 2005

Code Green is another very interesint book. Tried to have a discussion about this last year but no takers. Anyone read this also???

Yes I did. Code Green is by Dana Beth Weinberg about the Beth Israel-Deaconess merger.

This book too praises the Primary Nursing Model. It was introduced at my hospital in 1980.

Jog my memory so i can contribute to a discussion, OK?

Ms. Gordon also wrote Nursing Against the Odds.

Well I've been thinking about the relevant aspects of RN history absent in the book. This is both from reading and from conversations with nurses.

For years RNs (individually and in some instances collectively) have been engaged in changing the traditional image of being the physician's and administration's handmaiden to strong and decisive advocates of their patients and their profession.

This traditional image dates back to the early 1900 when nursing students were trained and employed in indentured servitude environments by physician owned hospitals.

Graduate nurses were not employed by hospitals due to cost, and ended up doing private duty or worked in public health.

In the early 1900s the profession had an opportunity to undo the male dominance in the health care field and be recognized as professional equals of physicians with the right to practice independently. Unfortunately many shortsighted leaders (who were in the majority at the time) ignored the warnings from a small but vocal group of nursing leaders regarding the long term effect of women's subjugation to men. As a result nurses became accomplices of their own subordination. Finally the oppression of nurses was built into the law and the education system through the legalization of paternalism and the institutionalization of apprenticeship. The threats became a reality as male dominations progressed to a state of completion.

Nurses owned allegiance to the institution that trained and hired them than rather than the patients and their families.

For decades this image, as viewed by physicians, policymakers, employers and perpetuated by the movie industry and media, became entrenched and permeated every aspect of the RN professional life.

This is no longer the case since the women's equal rights movement and the demise of hospital based diploma programs. Nurses are now educated in institutes of higher learning (community colleges and universities).

A not so subtle change took place in the early 1980s with the adoption of the primary nursing care model.

In this model for the first time in history the RN direct care and patient advocacy role became intertwined.

Because primary nurses collaborate with other nurses and health practitioners about the need of their primary patients, primary nurses became patient advocates within the health care system.

In primary nursing the RN plans and provides the care. Many hospitals continued to make extensive use of the LVN and nursing aide. One major reason for its success was the support of nursing, hospital administration and physicians.

The profession does not need the rehashing of the handmaiden image by Ms. Gordon who claims to be an authority on the nursing strives to recognition and respect, and to have intimate knowledge of the socio-political and economic aspects of the profession.

With Primary Nursing we came into our own; patient advocates, experts, clinical specialist-independent in our practice; autonomous in our decisions-making, and assertive in demanding the ability to exercise independent professional judgment.

Unfortunately even when Ms. Gordon recognizes the public's appreciation of the work the RN does, she throws in the altruism and self-effacing factors.

The nursing profession has always ranked #1 or #2 when it comes to the public trust. So what is this trust?

How about - "I trust you with my life, and that you will make the right decisions on my behalf; protect me from harm by others and help me get back my health. Is there any higher standing?" The last quote is the words of a brilliant RN colleague

pickledpepperRN · Jul 5, 2005

Here are books we could discuss. I just orderd them.

Anyone want to come back here and discuss one in a month? Would September be better?

CRITICAL CONDITION: HOW HEALTH CARE IN AMERICA BECAME BIG BUSINESS & BAD MEDICINE, by Donald L. Barlett and James B. Steele, 279 pp., $24.95

DIABESITY: THE OBESITY-DIABETES EPIDEMIC THAT THREATENS AMERICA...quot;AND WHAT WE MUST DO TO STOP IT, by Francine R. Kaufman, MD, 336 pp., $27

THE LIFE AND DEATH OF SMALLPOX, by Ian and Jenifer Glynn, 278 pp., $24.95.

NURSING AMERICA: ONE YEAR BEHIND THE NURSING STATIONS OF AN INNERCITY HOSPITAL, by Sandy Balfour, 212 pp., $23.95.

SmilingBluEyes · Jul 5, 2005

I read the entire book, Code Green, while waiting to be seen in the ED once. ( I can ready pretty quickly, devouring books in a single night if they are good). It was pretty good......

I guess I am more looking for solutions than angry words and vitriol nowadays. There is a lot written about what is wrong with nursing.

I want to us to put our collective head together and come up with viable solutions these days, I guess. I want not to feel powerless and angry.

I admit, I have not read this latest book. Does the author provide some real solutions to the problems she outlines so well? Just asking... :)