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Nursing against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care (The Culture and Politics of Health Care Work)
 
 
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Nursing against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care (The Culture and Politics of Health Care Work) [Paperback]

Suzanne Gordon (Author)
4.6 out of 5 stars  See all reviews (23 customer reviews)

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Book Description

March 9, 2006 080147292X 978-0801472923 1

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.


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Editorial Reviews

Review

"The nursing profession lacks many things, like decent working conditions, recognition, and respect on the job. But, with Suzanne Gordon, it has something other professions can only envy-a skilled reporter, brilliant analyst, and steadfast advocate."-Barbara Ehrenreich

"Nursing is one of the most honorable professions I know. I'm proud of the service I provided during my nursing days. I learned so much about my beliefs, values, and passions as well as learning about others. Anyone who has spent time in a hospital knows that nurses are the true caregivers, the backbone of our health care system. Most doctors spend only a few minutes with their patients while nurses are there around the clock. This is an important book and needs to be required reading in all our medical schools."-Naomi Judd, RN

"The shocking real-life stories Gordon describes in Nursing against the Odds echo what our members experience every day. Readers will not only learn how the nursing profession has suffered over the years due to the many pressures of the nation's evolving health care system-they'll understand exactly what needs to be done to meet the challenges nurses and patients continue to face today. Gordon takes a candid look at the current nursing shortage and paints a vivid picture of how nurses are uniting throughout the profession to raise patient-care standards. This book is a must-read for anyone involved in the healthcare industry."-Andrew Stern, SEIU International President



"Nursing against the Odds is a brilliant and long-overdue assessment of nursing at a time of crisis in health care-what has gone wrong and what can be done to restore this once-esteemed profession to a position of equality with doctors. It should be read by anyone interested in the hierarchy of medicine, and the reasons why the nurse is becoming an endangered species."-Richard Selzer, MD, author of Letters to a Young Doctor



"Suzanne Gordon's book contains a wealth of ideas for legislators and policymakers who want to protect patients from the consequences of managed care and hospital restructuring. Gordon shows that real health care reform requires strong coalitions between nurses and the communities they serve."-U.S. Representative Bernard Sanders (I-VT)



"Suzanne Gordon provides new and important insights into the complexities involved in the current nursing shortage. Nursing against the Odds contains the right mixture of patient/nurse anecdotes and scientific evidence for the conclusions reached and finishes with constructive suggestions for steps that can be taken to correct the situation."-Margaret L. McClure, RN, EdD, FAAN



"One of the most comprehensive and insightful discussions . . . of the complex set of relationships that have developed over the years between doctors and nurses. Nursing against the Odds should be required reading for all nurses, doctors, and nursing and medical students, . . . who will find this book both provocative and enlightening."-New England Journal of Medicine, 29 September 2005



"Exhausted by heavy work, mandatory overtime, and the stress of looking after hospital patients who are sicker, frailer, and in need of ever more high-tech intervention, nurses are leaving the bedside faster than they can be replaced. . . . People who are interested in the health care system or in their own health care should pay attention to the issues Ms. Gordon raises in this book. But nurses especially should read it."-Cornelia Dean, New York Times, 17 May 2005



"Gordon uses anecdotes, research findings, and statistics to develop the list of contributing factors and potential resolutions to the current nursing shortage in more developed countries. She offers a comprehensive, international overview of the key issues."-Ellen Zupa, The Lancet, 27 August 2005



"Gordon's detailed information in the form of interviews, documented research, groundbreaking advances and setbacks, statistics, and opinions about the state of nursing are compelling. . . . You will recognize that there isn't any issue related to nurses and nursing that Gordon hasn't examined. . . . This book isn't just for nurses. It is a comprehensive depiction of how nursing is indeed working against the odds to provide a safe, caring environment for patients. Nurses hold the key to the solutions. Gordon gives us the data and talking points to move to the action stage."-Kay Bensing, Advance for Nurses, 1 August 2005



"Suzanne Gordon, a national award-winning journalist, author, and adjunct professor, is an advocate for all nurses. Gordon isn't a nurse, but believes nursing to be an honorable profession and the backbone of our health care system. . . . This book addresses the main forces that drive nurses out of their workplace; the crucial issues that deprive communities of adequate care of the sick, and the class and status divisions within the profession. But Gordon doesn't focus only on the problems, past and present, facing the nursing profession, but the remedies as well."-Terry Ratner, RN, MFA, Nurseweek, 9 May 2005



"The nurses Gordon describes in multiple anecdotes are almost always clinically astute and are frequently the first, occasionally the only, professionals to observe, interpret, and respond appropriately to signs and symptoms that foretell disaster for the patient. Despite the horror stories of disasters and averted disasters, Gordon fortunately places the issues of nurses and doctors at work in a larger historical and sociological context."-Barbara A. Mark, Ph.D., RN, FAAN, Journal of the American Medical Association, 17 August 2005

From the Inside Flap

"The nursing profession lacks many things, like decent working conditions, recognition, and respect on the job. But, with Suzanne Gordon, it has something other professions can only envy-a skilled reporter, brilliant analyst, and steadfast advocate."-Barbara Ehrenreich

"Nursing is one of the most honorable professions I know. I'm proud of the service I provided during my nursing days. I learned so much about my beliefs, values, and passions as well as learning about others. Anyone who has spent time in a hospital knows that nurses are the true caregivers, the backbone of our health care system. Most doctors spend only a few minutes with their patients while nurses are there around the clock. This is an important book and needs to be required reading in all our medical schools."—Naomi Judd, RN --This text refers to the Hardcover edition.


Product Details

  • Paperback: 512 pages
  • Publisher: ILR Press; 1 edition (March 9, 2006)
  • Language: English
  • ISBN-10: 080147292X
  • ISBN-13: 978-0801472923
  • Product Dimensions: 9.2 x 6.9 x 1.4 inches
  • Shipping Weight: 1.8 pounds (View shipping rates and policies)
  • Average Customer Review: 4.6 out of 5 stars  See all reviews (23 customer reviews)
  • Amazon Best Sellers Rank: #299,084 in Books (See Top 100 in Books)

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Average Customer Review
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87 of 89 people found the following review helpful:
5.0 out of 5 stars The Failure of Nurses to Take Care of Self threatens Us All, September 8, 2005
By 
Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care (Suzanne Gordon, ILR/Cornell University Press)is a first rate work of journalism, the beginning of a civilian audit that should have been documented by the profession itself, either in its primary practice venue (hospitals) or by its primary proponents of its own value (academics and the American Nurses Association).

Nursing Against the Odds documents not only the manipulation of nursing by the hospital industry, the medical profession and the media (reinforced by drug and device manufacturer Johnson & Johnson). It documents that nurses themselves think so little of their own contribution that they are unable or afraid to speak up when given the chance.

Nursing Against the Odds also documents the real tragedy of the hospital reengineering movement of the 1990s. This response to the challenge to health providers by the Managed Care companies to show their value in the marketplace was the wrong tactic at the wrong time by the wrong people. Michael Hammer and James Champy made a point to warn (in Reengineering the Corporation: A Manifesto for Business Revolution, 1993) that the chief financial officer should never be tasked to manage the reengineering effort, simply because it was not about cutting costs but raising quality. Since the big accounting firms had the ear of the hospital CFOs this is exactly what happened. So the same folks that brought us Enron messed up hospitals and nursing so thoroughly that neither has yet to recover.

The contribution of Nursing Academia and the American Nurses Association during this cascading iatrogenesis has been less than helpful. Nursing schools teach care planning using a methodology that is largely an intellectual fraud. The Nursing Diagnosis Model demands so many mental gyrations that most students don't get it by the time they graduate. Nursing documentation in the clinical record using this method invites ridicule by other health professionals. Consequently Nursing Diagnosis does not inspire care planning and assist in documenting progress. Nursing care plan documentation is simply ignored or mindless phrases show up in clinical documents ("buffing the chart") that no one reads. Nursing Diagnosis phrases like "situational low self-esteem" or "ineffective coping" are more descriptive of Nursing's present state of affairs and its inability to assert itself as an independent profession.

While many academics look down their noses at union membership by calling it unprofessional, they forget that most professions bill for their time in fractions of an hour and produce quantifiable outcomes for their work. (Not many nursing graduates recognize the SF-36 or the FIM, common health outcome measurements tools.) Most professionals have figured out ways to protect themselves and their families, either by bargaining units or individual, enforceable contracts that protect against the hazards of their work or the vicissitudes of their employer. The fact that Nursing is unable to protect itself, and that this leaves anyone who is subjected to a hospital stay in grave danger, should be enough to give us all some motivation to put Nursing Against the Odds at the top of everyone's reading list.

Michael Newell, RN, MSN

Haddonfield, NJ
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25 of 25 people found the following review helpful:
5.0 out of 5 stars A Hard Read, February 11, 2006
By 
Renee V. Kennedy (British Columbia, Canada) - See all my reviews
(REAL NAME)   
I have become a shameless, devoted Suzanne Gordon "follower" since reading her: "From Silence to Voice".

Suzanne has grabbed the bull by the horns, "put the blame on Mame" for the nursing crisis and offers constructive solutions in order to recruit and retain nurses.

"Nursing against the Odds", is a book that management/administration, government, nurses,student, patients and potential patients/the public - should read in order to understand "what" exactly is going on within the healthcare setting and how to make amends.

"Nursing Against the Odds" was extremely hard for me to read...emotionally. It has taken me months of picking up and putting down the book...especially getting through "Part 3" in such chapters as: "Mangling Care" and "Nurses on the Ropes".

I felt such rage reading what I know is to be so true.

Suzanne details the many players who are " not just supporting good [nursing] practice, they are undermining good practice" and notes that "when nurses believe that exit is their only option, they are really expressing their profound sense of defeat."

And exiting with their feet, they are.

It's deafening and deadly.
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12 of 12 people found the following review helpful:
5.0 out of 5 stars Reality 101, June 10, 2006
This review is from: Nursing against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care (The Culture and Politics of Health Care Work) (Paperback)
While of benefiit to nurses everywhere in just reminding us we are not alone, this book also reminds us how we may be our own worst enemy in promoting change.

Sadly, those who could benefit most from this book, consumers, CEO's and physicians will probably never read it. In light of the JCAHO white paper on the nursing shortage, why isn't JCAHO also implenting and assessing facilities based on their own strategy recommendations? Without nurses at the bedside, medicine is headed for the rocks!

This is a very powerful book on nursing today.

Lisa Jones RN IBCLC
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It was the first week in July at the Beth Israel Hospital in Boston and a new crop of interns has just arrived in the teaching hospital. Read the first page
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United States, Beth Israel, New York, United Kingdom, Nurses Week, Boston Globe, British Columbia, American Nurses Association, Nurse Ratched, Jean Chaisson, Florence Nightingale, San Francisco, Sioban Nelson, Massachusetts Nurses Association, Carol Youngson, Institute of Medicine, Larry Harmon, Philip Wilson, University of Pennsylvania School of Nursing, Emily Lowry, North America, Alan Sager, American Hospital Association, Anne Dolan, California Nurses Association
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