nursing against the odds

I found this book in the nursing section @ Barnes & Noble today...

I was wondering if anyone out there has read the book: Nursing against the odds?

If so what do you think of it?

And on a side note: Am I the only person that signs checks and reciepts like you would when paper charting??? I realized that today.... hmm just wondering....

Have a good day.

:monkeydance:

Hello,

Someone from here mailed me that book, as *SOON* as I finish I plan to pay it forward.

Second item, oh yes, I sign my checks and reciepts with first intial and last name or else just the initials too.

Gen

I have the book, and highly recommend it. I'd go as far as to say it's a must-have for all nurses and nursing students. If you ever get a chance to see Suzanne Gordon speak, you should.

Haven't read the book but have heard Suzanne Goron speak on more then one occassion and highly recommend her.

I finished reading the book not to long ago. It is very depressing, but at least it gave me a much better understanding of nursing culture and history and how we got to where we are today. It changed my attitude on a lot of things. It is easy to read and understand and I highly recommend it for anyone in nursing or thinking of going into nursing.

Even though I found the book very depressing I am still glad I am a nurse and wouldn't change that.

We've discussed this book here before:

https://allnurses.com/forums/f257/opinions-about-suzanne-gordons-book-s-163085.html

In short, I liked the book, agreed mostly with her definitions of some of the problems of nursing but, ultimately, completely disagreed with her 'solutions'.

~faith,

Timothy.

I don't think Spacenurse would object to my requoting her critique of Nursing Against the Odds from the above linked thread. This is not my opinion, and I actually LIKED the book, but this is a very rational disagreement regarding the book.

I met Ms. Gordon when she signed books at a local bookstore. She is a fine writer and seems like a nice woman.

I think it is worth reading but I don't agree with much that is written and lots that was not. I'm plagerizing my own post written for allnurses.com about a year ago.

The book endorses the BSN entry level. It is not possible unless and until we create enough slots in generic BSN programs.

Also the book endorses the Magnet status which in turn endorses shared governance as a vehicle to improve the status of the nursing profession at the practice settings.

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 (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 focal 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 owed 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). Also, don’t tell an OR RN that the “captain of the ship” doctrine still exists. She’ll eat you for breakfast.

The 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.

We took the turn in the road in the 1980’s and never wanted to look back .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.

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. 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.

It is an opportunity lost. Not so however with the CNA; we seized the power.

ON the promotion of magnet status; in the world of collective patient advocacy magnet status means zilch. It is a money making scheme by the ANA and a marketing tool for the industry. Including the individual hospitals who have obtained magnet status. It is now an institutionalized TQM model that also demands the incorporation of shared governance.

The book does not capture the evolution of increasingly more professional models of nursing care, and after several hundred pages of “awfulizing” it peters out- deflates and ends up making a feeble attempt to changing the odds by suggesting generic solutions.

Contrary to her recommendation, there is no need for further experimentation in nursing models; that is like the frog adapting to more and more heat not realizing that he is slowly boiled.

The primary care model was a true professional model with all the trappings of respect and recognition, and it worked. But RNs became more autonomous, demanding greater recognition for their effective contributions to the patient’s therapeutic outcomes. Here is what is written about primary nursing: RN and patient satisfaction high; RN burnout and malpractice low; retention high; cost of recruitment and orientation low; patient length of stay low; and recidivism/readmission low.

For some in the health care industry it meant too much RN independence, therefore too much power and control.

This model got busted with the introduction and implementation of patient-focused-are and the re-engineering of the clinical nursing process.

There is no anatomy of the most incredible achievements of CNA sponsored landmark legislations, like the worldwide first safe staffing ratio legislation. Which not only changed the manner in which RNs responded to the patient’s clinical, therapeutic and restorative needs but it also created a social change in the RN culture,e.g., a lawful weapon to fight for our patients and our profession including our own wellbeing.

This whole focus on the RN being weak, being a victim and being burned out is so over the top.

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 (oppressive workloads) without the authority. What is the solution? Representation by a progressive professional and labor organization fighting for better working conditions and achieving safe patient ratio standards, including the requirement to staff-up based on the patient’s individual acuity; as determined (assessed and classified) by the direct care RN.

Even when she 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?

Finally, just looking at the depressing cover picture alone; an extremely defeated, burned-out looking RN in a slumped, victim position. Which planet did this one come from?