Nursing against the Odds

Nursing against the Odds

Author: Suzanne Gordon

Publisher: Cornell University Press

Published: 2012-05-15

Total Pages: 514

ISBN-13: 0801465001

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In the United States and throughout the industrialized world, just as the population of older and sicker patients is about to explode, we have a major shortage of nurses. Why are so many RNs dropping out of health care's largest profession? How will the lack of skilled, experienced caregivers affect patients? These are some of the questions addressed by Suzanne Gordon's definitive account of the world's nursing crisis. In Nursing against the Odds, one of North America's leading health care journalists draws on in-depth interviews, research studies, and extensive firsthand reporting to help readers better understand the myriad causes of and possible solutions to the current crisis. Gordon examines how health care cost cutting and hospital restructuring undermine the working conditions necessary for quality care. She shows how the historically troubled workplace relationships between RNs and physicians become even more dysfunctional in modern hospitals. In Gordon's view, the public image of nurses continues to suffer from negative media stereotyping in medical shows on television and from shoddy press coverage of the important role RNs play in the delivery of health care. Gordon also identifies the class and status divisions within the profession that hinder a much-needed defense of bedside nursing. She explains why some policy panaceas—hiring more temporary workers, importing RNs from less-developed countries—fail to address the forces that drive nurses out of their workplaces. To promote better care, Gordon calls for a broad agenda that includes safer staffing, improved scheduling, and other policy changes that would give nurses a greater voice at work. She explores how doctors and nurses can collaborate more effectively and what medical and nursing education must do to foster such cooperation. Finally, Gordon outlines ways in which RNs can successfully take their case to the public while campaigning for health care system reform that actually funds necessary nursing care.


Nursing Against the Odds

Nursing Against the Odds

Author: Suzanne Gordon

Publisher: Cornell University Press

Published: 2005

Total Pages: 514

ISBN-13: 9780801472923

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A leading health care journalist unravels the complexity of the current nursing shortage while offering possible solutions to the resulting health care crisis.


Life Support

Life Support

Author: Suzanne Gordon

Publisher: Cornell University Press

Published: 2012-07-15

Total Pages: 366

ISBN-13: 0801464994

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In this book, Suzanne Gordon describes the everyday work of three RNs in Boston—a nurse practitioner, an oncology nurse, and a clinical nurse specialist on a medical unit. At a time when nursing is often undervalued and nurses themselves in short supply, Life Support provides a vivid, engaging, and intimate portrait of health care's largest profession and the important role it plays in patients' lives. Life Support is essential reading for working nurses, nursing students, and anyone considering a career in nursing as well as for physicians and health policy makers seeking a better understanding of what nurses do and why we need them. For the Cornell edition of this landmark work, Gordon has written a new introduction that describes the current nursing crisis and its impact on bedside nurses like those she profiled in the book.


When Chicken Soup Isn't Enough

When Chicken Soup Isn't Enough

Author: Suzanne Gordon

Publisher: ILR Press

Published: 2011-01-15

Total Pages: 270

ISBN-13: 0801458641

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The reassuring bromides of "chicken soup for the soul" provide little solace for nurses—and the people they serve—in real-life hospitals, nursing homes, schools of nursing, and other settings. In the minefield of modern health care, there are myriad obstacles to quality patient care—including work overload, inadequate funds for nursing education and research, and poor communication between and within the professions, to name only a few. The seventy RNs whose stories are collected here by the award-winning journalist Suzanne Gordon know that effective advocacy isn't easy. It takes nurses willing to stand up for themselves, their coworkers, their patients, and the public. When Chicken Soup Isn't Enough brings together compelling personal narratives from a wide range of nurses from across the globe. The assembled profiles in professional courage provide new insight into the daily challenges that RNs face in North America and abroad—and how they overcome them with skill, ingenuity, persistence, and individual and collective advocacy at work and in the community. In this collection, we meet RNs working at the bedside, providing home care, managing hospital departments, teaching and doing research, lobbying for quality patient care, and campaigning for health care reform. Their stories are funny, sad, deeply moving, inspiring, and always revealing of the different ways that nurses make their voices heard in the service of their profession. The risks and rewards, joys and sorrows, of nursing have rarely been captured in such vivid first-person accounts. Gordon and the authors of the essays contained in this book have much to say about the strengths and shortcomings of health care today—and the role that nurses play as irreplaceable agents of change.


The Complexities of Care

The Complexities of Care

Author: Sioban Nelson

Publisher: Cornell University Press

Published: 2012-05-15

Total Pages: 225

ISBN-13: 0801465028

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"Nursing, everyone believes, is the caring profession. Texts on caring line the walls of nursing schools and student shelves. Indeed, the discipline of nursing is often known as the 'caring science.' Because of their caring reputation, nurses top the polls as the most-trustworthy professionals. Yet, in spite of what seems to be an endless outpouring of public support, in almost every country in the world nursing is under threat, in the practice setting and in the academic sector. Indeed, its standing as a regulated profession is constantly challenged. In our view, this paradox is neither accidental nor natural but, in great part, the logical consequence of the fact that nurses and their organizations place such a heavy emphasis on nursing's and nurses' virtues rather than on their knowledge and concrete contributions."—from the Introduction In a series of provocative essays, The Complexities of Care rejects the assumption that nursing work is primarily emotional and relational. The contributors-international experts on nursing- all argue that caring discourse in nursing is a dangerous oversimplification that has in fact created many dilemmas within the profession and in the health care system. This book offers a long-overdue exploration of care at a pivotal moment in the history of health care. The ideas presented here will foster a critical debate that will assist nurses to better understand the nature and meaning of the nurse-patient relationship, confront challenges to their work and their profession, and deliver the services patients need now and into the future.


From Silence to Voice

From Silence to Voice

Author: Bernice Buresh

Publisher: Ilr Press

Published: 2003

Total Pages: 294

ISBN-13: 9780801488689

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As nurses face the ongoing challenges of an increasing need for their services combined with economic pressures, members of the largest profession in health care must become more visible, vocal, and influential. The first communication guidebook designed expressly for nurses, From Silence to Voice helps nurses understand and overcome the self-silencing that often leads RNs to downplay their own expertise and their contributions to the care of the sick and the health of the public. Bernice Buresh and Suzanne Gordon teach nurses, nurse educators, and nurse researchers critical skills they can use to explain their work to other health-care professionals, journalists, policymakers, and political representatives. From Silence to Voice features stories about nurses who ensure that patients receive appropriate, timely, and even life-saving care, nurses who make all the difference while crises are underway but whose contributions are neglected in medical charts and thank-you notes, nurses who are left out altogether or obscured by the generic "nurse." However, the book also provides detailed accounts of nurses who do make their voices heard, who do make their concerns public-- and it shows how those successes can be duplicated. Buresh and Gordon draw on real-world examples that will help nurses to - gain respect for themselves as professionals, - communicate well with both patients and health-care colleagues, - understand how the news media work, - collaborate with public relations professionals, - write effective letters to the editor and publish op-ed pieces, - appear on television and radio, and - promote research on nursing.


Safety in Numbers

Safety in Numbers

Author: Suzanne Gordon

Publisher: Cornell University Press

Published: 2012-05-15

Total Pages: 285

ISBN-13: 080146501X

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Legally mandated nurse-to-patient ratios are one of the most controversial topics in health care today. Ratio advocates believe that minimum staffing levels are essential for quality care, better working conditions, and higher rates of RN recruitment and retention that would alleviate the current global nursing shortage. Opponents claim that ratios will unfairly burden hospital budgets, while reducing management flexibility in addressing patient needs. Safety in Numbers is the first book to examine the arguments for and against ratios. Utilizing survey data, interviews, and other original research, Suzanne Gordon, John Buchanan, and Tanya Bretherton weigh the cost, benefits, and effectiveness of ratios in California and the state of Victoria in Australia, the two places where RN staffing levels have been mandated the longest. They show how hospital cost cutting and layoffs in the 1990s created larger workloads and deteriorating conditions for both nurses and their patients—leading nursing organizations to embrace staffing level regulation. The authors provide an in-depth account of the difficult but ultimately successful campaigns waged by nurses and their allies to win mandated ratios. Safety in Numbers then reports on how nurses, hospital administrators, and health care policymakers handled ratio implementation. With at least fourteen states in the United States and several other countries now considering staffing level regulation, this balanced assessment of the impact of ratios on patient outcomes and RN job performance and satisfaction could not be timelier. The authors' history and analysis of the nurse-to-patient ratios debate will be welcomed as an invaluable guide for patient advocates, nurses, health care managers, public officials, and anyone else concerned about the quality of patient care in the United States and the world.


Beyond the Checklist

Beyond the Checklist

Author: Suzanne Gordon

Publisher: Cornell University Press

Published: 2012-11-20

Total Pages: 279

ISBN-13: 0801465788

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The U.S. healthcare system is now spending many millions of dollars to improve "patient safety" and "inter-professional practice." Nevertheless, an estimated 100,000 patients still succumb to preventable medical errors or infections every year. How can health care providers reduce the terrible financial and human toll of medical errors and injuries that harm rather than heal? Beyond the Checklist argues that lives could be saved and patient care enhanced by adapting the relevant lessons of aviation safety and teamwork. In response to a series of human-error caused crashes, the airline industry developed the system of job training and information sharing known as Crew Resource Management (CRM). Under the new industry-wide system of CRM, pilots, flight attendants, and ground crews now communicate and cooperate in ways that have greatly reduced the hazards of commercial air travel. The coauthors of this book sought out the aviation professionals who made this transformation possible. Beyond the Checklist gives us an inside look at CRM training and shows how airline staff interaction that once suffered from the same dysfunction that too often undermines real teamwork in health care today has dramatically improved. Drawing on the experience of doctors, nurses, medical educators, and administrators, this book demonstrates how CRM can be adapted, more widely and effectively, to health care delivery. The authors provide case studies of three institutions that have successfully incorporated CRM-like principles into the fabric of their clinical culture by embracing practices that promote common patient safety knowledge and skills.They infuse this study with their own diverse experience and collaborative spirit: Patrick Mendenhall is a commercial airline pilot who teaches CRM; Suzanne Gordon is a nationally known health care journalist, training consultant, and speaker on issues related to nursing; and Bonnie Blair O'Connor is an ethnographer and medical educator who has spent more than two decades observing medical training and teamwork from the inside.


First, Do Less Harm

First, Do Less Harm

Author: Ross Koppel

Publisher: Cornell University Press

Published: 2012-04-23

Total Pages: 301

ISBN-13: 0801464072

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Each year, hospital-acquired infections, prescribing and treatment errors, lost documents and test reports, communication failures, and other problems have caused thousands of deaths in the United States, added millions of days to patients' hospital stays, and cost Americans tens of billions of dollars. Despite (and sometimes because of) new medical information technology and numerous well-intentioned initiatives to address these problems, threats to patient safety remain, and in some areas are on the rise. In First, Do Less Harm, twelve health care professionals and researchers plus two former patients look at patient safety from a variety of perspectives, finding many of the proposed solutions to be inadequate or impractical. Several contributors to this book attribute the failure to confront patient safety concerns to the influence of the "market model" on medicine and emphasize the need for hospital-wide teamwork and greater involvement from frontline workers (from janitors and aides to nurses and physicians) in planning, implementing, and evaluating effective safety initiatives. Several chapters in First, Do Less Harm focus on the critical role of interprofessional and occupational practice in patient safety. Rather than focusing on the usual suspects-physicians, safety champions, or high level management-these chapters expand the list of "stakeholders" and patient safety advocates to include nurses, patient care assistants, and other staff, as well as the health care unions that may represent them. First, Do Less Harm also highlights workplace issues that negatively affect safety: including sleeplessness, excessive workloads, outsourcing of hospital cleaning, and lack of teamwork between physicians and other health care staff. In two chapters, experts explain why the promise of health care information technology to fix safety problems remains unrealized, with examples that are at once humorous and frightening. A book that will be required reading for physicians, nurses, hospital administrators, public health officers, quality and risk managers, healthcare educators, economists, and policymakers, First, Do Less Harm concludes with a list of twenty-seven paradoxes and challenges facing everyone interested in making care safe for both patients and those who care for them.