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Against the Odds
How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine
Nurses and Patient Care
Suzanne Gordon
In the U.S. and other advanced countries, 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 patients be affected by the lack of skilled,
experienced caregivers?
These are the questions addressed in Suzanne
Gordon’s definitive
account of the world’s nursing crisis. Written by one of North
America’s leading health care journalists, Nursing Against
The Odds draws on in-depth interviews, research studies, and extensive
first-hand reporting to help readers better understand the myriad causes
of the current crisis—and what can be done about it.
The book examines health care cost cutting and
hospital restructuring—and
explains how both are undermining the working conditions necessary
for quality care. Mining the historical record, she shows how troubled
workplace relationships between RNs and physicians, become even more
dysfunctional in modern hospitals. Meanwhile, the public image of nurses
continues to suffer from negative media stereotyping in TV medical
shows to shoddy press coverage of RNs’ important role in health
care delivery.
Gordon also identifies the class and status
divisions within the profession itself that now hinder a much-needed
defense of bedside nursing. She explains why some policy panaceas—hiring
more temps, importing RNs from less developed countries—fail
to address the forces driving nurses out of their workplaces To promote
better quality care, Gordon calls for a broader agenda—safer
staffing, improved scheduling, and other personnel policy changes
that would give nurses a greater voice at work. The author 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 that RNs can successfully take their
case to the public—while
campaigning for health care system reform that actually funds necessary
nursing care.
Praise for Nursing Against the Odds
“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 wellas 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. Rep 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
scientifi c evidence for the conclusions reached and fi nishes
with constructive suggestions for steps that can be taken to correct
the situation.”
—Margaret L. McClure, RN, EdD, FAAN
“The journalist Suzanne Gordon provides a powerful depiction
of nurses’ struggles to keep patients alive in an unsafe health
care system. Read this book to see why national health care quality
goals will not be achieved until nurses’ work environments are
fundamentally transformed.”
—Linda H. Aiken, University of Pennsylvania
“In contrast to other insiders writing about the nursing industry.
. . Gordon applies an award-winning journalist’s perspective
on the causes of the current nursing shortage and on the policies that
erode a nurse’s ability to deliver competent care. Using interviews,
research studies, and firsthand reporting, the author raises
a litany of concerns about entry-level nursing education, the expanded
roles of nurses, the needs of front-line caregivers, and the impact
of healthcare cost cutting and hospital restructuring on nurses. Gordon
argues that changing the odds in favor of nurses involves obvious but
diffi cult choices: pay increases, improved staff-patient rations,
better scheduling, mandating magnet hospitals, and the reconciliation
of the nurse physician relationship. As reformers struggle to improve
a dysfunctional healthcare system, up-to-date investigations like Gordon’s
should be required reading for nursing students, public healthcare
advocates, and all medical interns.”
—Library Journal, March 15, 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, The New York Times, May
17, 2005
“The nurses Gordon describes in multiple anecdotes are almost
always clinically astute and are frequently the fi rst, 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, JAMA, 294:7, August 17, 2005
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