Nursing against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care
Rutherford, Marcella, Nursing History Review
Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care By Suzanne Gordon (Ithaca, NY: Cornell University Press, 2005) (489 pages; $19.77 cloth)
Are we "Nursing Against the Odds"? In her book of this tide, Suzanne Gordon offers compelling arguments to support this concept. As a journalist, the author has spent a number of years interviewing and reporting about nursing. She categorizes her book into three main foci: the nurse and doctor relationship, the media and nursing, and health care cost cutting. In so doing, she presents the odds that stack up against the nursing profession. Gordon draws on in-depth interviews of staff nurses, nursing managers, physicians, administrators, and technicians. She includes information from research studies by economists, sociologists, historians, and nursing leaders; and she provides extensive firsthand reporting of observations of health care delivery to help the reader understand today's nursing environment.
Gordon identifies her mantra, "recruitment and retention," as a prime motivating passion for writing this manuscript. After reading her book, however, this reviewer was left feeling saddened at the negative but often true depiction of the nursing profession. Reflecting on the author's message - the support of nursing recruitment - leads one to pondet whether or not an eighteen-year-old person looking at nursing today might seek other career choices after reading Nursing Against the Odds.
Gordon clearly describes the dysfunctional relationship between nurses and physicians. She argues that physicians have historically prevented nurses from gaining prestige and have blocked their ability to maintain a direct revenue stream. Stories abound relating to physicians belittling, disrespecting, and openly devaluing the role nurses play in patient care. Indeed, poor communication and lack of physician respect are cited as impacting patient safety in several firsthand stories offered by nurses in Gordon's book.
Nursing Against the Odds also challenges nurses to communicate more effectively with physicians, arguing that nurses need to tell physicians what they do when the doctor is not present. Nurses often fail to take credit for preventing things from going wrong, Gordon argues. She further explores aspects of nursing language that hinder good communication. Nurses' notes, for example, highlight this communication void. One basic question is: Why are physician's not reading nurses notes, even though nurses have important patient care information to share? Her answer: Only nurses understand "nursing language," and this is problematic. Nurses must connect with all members of the medical team to be effective.
Gordon also questions the theoretical caring aspects of nursing by quoting Sioban Nelson, "If you read the caring discourse in nursing closely, you'll find rhat many theorists of caring actually put down the technical and medical" (p. 139). This "moral refraining," Gordon offers, is done to place nurses on a higher moral ground than physicians. Does this send the message that other members of the medical team are not as caring as nurses? Caring is an important aspect of nursing, but caring without technical skills and medical knowledge could not be called nursing.
Regarding nursing and the media, the author argues that nurses are often the brunt of journalistic humor and are exploited to spice up a plot line. Angel or sex nymph, villain or sweet but dumb, drunkards, and battle-axes are among the character types portraying nurses on screen or in print. Nurses have reacted to television selling a negative portrayal of the nurse role, such as their protests when ER's character Abby Lockart solved her frustration with nursing by entering medical school. …