- Email: [email protected]
Chemical Sensitivity: The Truth about Environmental Illness
OCTOBER 1998. VOL 68. NO 4
the chance of disaster. The authors develop a foundation for understanding planned change by presenting overviews of three widely accepted change theories and demonstrating their applicability to nursing. The book is divided into two parts that are separated by an “interlude.” Part one contains an introductory chapter and general considerations for choosing and using a planned change theory, as well as identifying problems, arriving at solutions. and determining if one’s goals were achieved. Sections on the role of power and ethics are timely, particularly in this era of cost-driven health care. The “interlude” provides information to help the reader apply the planned change theories discussed in part two. In this section, the authors review the Roy Adaptation Model and describe how it, and other nursing theories, can be integrated with change theories to facilitate their use in the clinical setting. Part two examines a number of change theories. The best known is Lewin’s “freeze, move, (re)freeze” theory, but also represented are Bennis, Benne, and Chin’s planned changes writings. The Rogers Diffusion Model is also represented. as is Bhola’s Configurations Model (eg, configurations, linkages, environment, and resources). For each theory or model, the authors provide an overview, an analysis and critique, and a discussion of how the theory can be employed in the context of the Roy Adaptation Model. The book presents complex subjects clearly and concisely and combines both general information and specific recommenda-
tions for planned change. A glossary and extensive references are additional resources. It should be noted that the appendix consisting of planned change literature in nursing periodical articles lists references dated 1992 or older. The authors comment that because no new trends were noted in the study on which the reference list is based, it would not have been a good use of resources to update the references. Given the profound and rapid changes in the health care industry since 1992, an updated list may be valuable. The book also provides an evaluation form for judging planned change theories and adapting them to nursing. For perioperative nurses, the book is useful for its emphasis on fostering research-based nursing practice and highlighting the role of technology. As the rate of change becomes more rapid, it is to our benefit to be prepared with concrete as well as conceptual plans; this book offers both. This book is available from Sage Publications, 2455 Teller Rd, Thousand Oaks, CA 9 1320; (805) 499-9774. PATRICIA C. SEIFERT RN, MSN, CNOR, CRNFA MANAQEREAROUC SURoERY HALIFAX MEDICAL CENTER DAVTONA BEACH,Fu
CHEMICAL SENSITIVITY: THE TRUTH ABOUT ENVIRONMENTAL ILLNESS By Ronald E. Gots 1998,212~~ $26.95 har-dmncr-
T
his book begins with the statement, “Americans believe that exposure to common food and chemicals 695 AORN JOURNAL
makes them ill. This book is about people who hold such beliefs but are wrong.” The book is an easy-to-read nine chapters that discuss “mistaken beliefs” about issues including sick building syndrome, the Gulf War syndrome, mercury-amalgam, and candidiasis, among others. I t explains that these are “fad diagnoses” that lack scientific recognition or have unknown causes. There are I0 appendices included that state the positions of the American Medical Association. the California Medical Association. varied legal cases and rulings, and reputable consultants on such issues. The book may be of interest to nurses who treat patients who have been diagnosed with one of these illnesses, although they will not be treating the patients directly for these problems. Perioperative nurses may find this an interesting book that provides information about what patients. family members, or acquaintances m8y face when they are diagnosed with a specific condition. As a health care expert, the nurse may be asked about the condition and therefore needs to be informed. The candidiasis epidemic, according to the book, is said to exist by proponents of candidiasis hypersensitivity. The author criticizes the use of medications to treat the condition because they may be dangerous or deadly for unproven diagnoses. For surgical personnel, this chapter reveals that there is a rush to judgment by clinical ecologists, who may treat candidiasis based on ii mere history of symptoms. The case studies presented in the book reveal that being treated by clinical ecologists may cause more harm to
OCTOBER 1998, VOL 68, NO 4
patients than good. The book examines other diagnoses, and the author concludes that what is happening is not only unethical but also unscientifically proven. This may lead to the exploitation of patients who have been diagnosed with multiple chemical sensitivity (MCS). The author’s fervent beliefs about the topic are echoed throughout the book. He is adamant about the extensive treatments (averaging two years)
and reports that, often, these patients become worse when treated. The book discusses legal cases in which expensive treatments were harmful to patients. Additionally, the court rulings against people who brought suit for sick building syndrome and against physicians treating for amalgam toxicity are well written and concise. Overall, the book may be of interest to health care professionals who have heard of MCS and have not had the opportunity to explore these
topics or to nurses who have little knowledge of environmental ecologists and their treatment of patients. This book is available from Prometheus Books, 59 John Glenn Dr, Amherst, NY 14228-2197; (800) 421-0351. SOPHIA M. SCHllD RN, EDD, CNOR EDUCATOR~SURGICAL SERVICES, AMBULATORY, POSTANESTHESIA CAREUNIT, ENDOSCOPY PHOENIXBAPTIST AND ARROWHEAD HOSPITAL
Getting in Shape? Avoid These Common Workout Mistakes The American Council on Exercise (ACE), a nonprofit organization committed to promoting active, healthy lifestyles, polled more than 3,000 ACE-certified fitness professionals on the worst mistakes they see people making while working out. These mistakes may simply mean the difference between an effective and ineffective workout. They could, however, be more costly, leading to strain and injury. The following are the 10 most common answers ACE collected. Not stretching enough. The best time to stretch is immediately before and after aerobic activity. Flexible muscles are far less likely to be strained or pulled than tight ones. Lifting too much weight. The way to guarantee an injury is to try to lift more weight than your muscles can handle. Gradual, progressive resistance is a more effective way to increase muscle strength. Not warming up before aerobic activity. Muscles need time to adjust to the new demands aerobic activity places on them. Rather than hitting the treadmill running, walk for a few minutes and then build up to a jog. Not cooling down after any type of workout. Take a few minutes to lower your heart rate and stretch your muscles. This will improve flexibility and help prepare the body for the next workout. Exercising too intensely. The expectation that a
workout must be intense to be effective can lead to burnout or injury. For weight loss, it is more effective to sustain a moderate workout for longer periods than to exercise intensely for only a few minutes. Not drinking enough water. Leaning heavily on the stairstepper. It is more effective and easier on the wrists and hands to lower the intensity so you can maintain good posture while lightly resting your hands on the rails for balance. Not exercising intensely enough. While not overdoing it, exercise hard enough to work up a light sweat, get your heart beating in a training zone, and feel a sense of satisfaction for having completed a workout. Jerking while lifting weights. The most effective way to train is to control the weight-not to be controlled by it. Having to jerk the weight is likely to jerk other muscles as well. Consuming energy bars and sports drinks during moderate workouts. These are not necessary for workouts that are less than two hours. A healthy, well-rounded diet and plenty of water are sufficient to meet most exercisers’ needs. Exercisers Beware: The American Council on Exercise’s Pros Divulge Most Common Workout Mistakes (press release, Son Diego: American Council on Exercise) Available from www.fitness.org. Accessed 27 Aug 1998.
696 AORN JOURNAL
the chance of disaster. The authors develop a foundation for understanding planned change by presenting overviews of three widely accepted change theories and demonstrating their applicability to nursing. The book is divided into two parts that are separated by an “interlude.” Part one contains an introductory chapter and general considerations for choosing and using a planned change theory, as well as identifying problems, arriving at solutions. and determining if one’s goals were achieved. Sections on the role of power and ethics are timely, particularly in this era of cost-driven health care. The “interlude” provides information to help the reader apply the planned change theories discussed in part two. In this section, the authors review the Roy Adaptation Model and describe how it, and other nursing theories, can be integrated with change theories to facilitate their use in the clinical setting. Part two examines a number of change theories. The best known is Lewin’s “freeze, move, (re)freeze” theory, but also represented are Bennis, Benne, and Chin’s planned changes writings. The Rogers Diffusion Model is also represented. as is Bhola’s Configurations Model (eg, configurations, linkages, environment, and resources). For each theory or model, the authors provide an overview, an analysis and critique, and a discussion of how the theory can be employed in the context of the Roy Adaptation Model. The book presents complex subjects clearly and concisely and combines both general information and specific recommenda-
tions for planned change. A glossary and extensive references are additional resources. It should be noted that the appendix consisting of planned change literature in nursing periodical articles lists references dated 1992 or older. The authors comment that because no new trends were noted in the study on which the reference list is based, it would not have been a good use of resources to update the references. Given the profound and rapid changes in the health care industry since 1992, an updated list may be valuable. The book also provides an evaluation form for judging planned change theories and adapting them to nursing. For perioperative nurses, the book is useful for its emphasis on fostering research-based nursing practice and highlighting the role of technology. As the rate of change becomes more rapid, it is to our benefit to be prepared with concrete as well as conceptual plans; this book offers both. This book is available from Sage Publications, 2455 Teller Rd, Thousand Oaks, CA 9 1320; (805) 499-9774. PATRICIA C. SEIFERT RN, MSN, CNOR, CRNFA MANAQEREAROUC SURoERY HALIFAX MEDICAL CENTER DAVTONA BEACH,Fu
CHEMICAL SENSITIVITY: THE TRUTH ABOUT ENVIRONMENTAL ILLNESS By Ronald E. Gots 1998,212~~ $26.95 har-dmncr-
T
his book begins with the statement, “Americans believe that exposure to common food and chemicals 695 AORN JOURNAL
makes them ill. This book is about people who hold such beliefs but are wrong.” The book is an easy-to-read nine chapters that discuss “mistaken beliefs” about issues including sick building syndrome, the Gulf War syndrome, mercury-amalgam, and candidiasis, among others. I t explains that these are “fad diagnoses” that lack scientific recognition or have unknown causes. There are I0 appendices included that state the positions of the American Medical Association. the California Medical Association. varied legal cases and rulings, and reputable consultants on such issues. The book may be of interest to nurses who treat patients who have been diagnosed with one of these illnesses, although they will not be treating the patients directly for these problems. Perioperative nurses may find this an interesting book that provides information about what patients. family members, or acquaintances m8y face when they are diagnosed with a specific condition. As a health care expert, the nurse may be asked about the condition and therefore needs to be informed. The candidiasis epidemic, according to the book, is said to exist by proponents of candidiasis hypersensitivity. The author criticizes the use of medications to treat the condition because they may be dangerous or deadly for unproven diagnoses. For surgical personnel, this chapter reveals that there is a rush to judgment by clinical ecologists, who may treat candidiasis based on ii mere history of symptoms. The case studies presented in the book reveal that being treated by clinical ecologists may cause more harm to
OCTOBER 1998, VOL 68, NO 4
patients than good. The book examines other diagnoses, and the author concludes that what is happening is not only unethical but also unscientifically proven. This may lead to the exploitation of patients who have been diagnosed with multiple chemical sensitivity (MCS). The author’s fervent beliefs about the topic are echoed throughout the book. He is adamant about the extensive treatments (averaging two years)
and reports that, often, these patients become worse when treated. The book discusses legal cases in which expensive treatments were harmful to patients. Additionally, the court rulings against people who brought suit for sick building syndrome and against physicians treating for amalgam toxicity are well written and concise. Overall, the book may be of interest to health care professionals who have heard of MCS and have not had the opportunity to explore these
topics or to nurses who have little knowledge of environmental ecologists and their treatment of patients. This book is available from Prometheus Books, 59 John Glenn Dr, Amherst, NY 14228-2197; (800) 421-0351. SOPHIA M. SCHllD RN, EDD, CNOR EDUCATOR~SURGICAL SERVICES, AMBULATORY, POSTANESTHESIA CAREUNIT, ENDOSCOPY PHOENIXBAPTIST AND ARROWHEAD HOSPITAL
Getting in Shape? Avoid These Common Workout Mistakes The American Council on Exercise (ACE), a nonprofit organization committed to promoting active, healthy lifestyles, polled more than 3,000 ACE-certified fitness professionals on the worst mistakes they see people making while working out. These mistakes may simply mean the difference between an effective and ineffective workout. They could, however, be more costly, leading to strain and injury. The following are the 10 most common answers ACE collected. Not stretching enough. The best time to stretch is immediately before and after aerobic activity. Flexible muscles are far less likely to be strained or pulled than tight ones. Lifting too much weight. The way to guarantee an injury is to try to lift more weight than your muscles can handle. Gradual, progressive resistance is a more effective way to increase muscle strength. Not warming up before aerobic activity. Muscles need time to adjust to the new demands aerobic activity places on them. Rather than hitting the treadmill running, walk for a few minutes and then build up to a jog. Not cooling down after any type of workout. Take a few minutes to lower your heart rate and stretch your muscles. This will improve flexibility and help prepare the body for the next workout. Exercising too intensely. The expectation that a
workout must be intense to be effective can lead to burnout or injury. For weight loss, it is more effective to sustain a moderate workout for longer periods than to exercise intensely for only a few minutes. Not drinking enough water. Leaning heavily on the stairstepper. It is more effective and easier on the wrists and hands to lower the intensity so you can maintain good posture while lightly resting your hands on the rails for balance. Not exercising intensely enough. While not overdoing it, exercise hard enough to work up a light sweat, get your heart beating in a training zone, and feel a sense of satisfaction for having completed a workout. Jerking while lifting weights. The most effective way to train is to control the weight-not to be controlled by it. Having to jerk the weight is likely to jerk other muscles as well. Consuming energy bars and sports drinks during moderate workouts. These are not necessary for workouts that are less than two hours. A healthy, well-rounded diet and plenty of water are sufficient to meet most exercisers’ needs. Exercisers Beware: The American Council on Exercise’s Pros Divulge Most Common Workout Mistakes (press release, Son Diego: American Council on Exercise) Available from www.fitness.org. Accessed 27 Aug 1998.
696 AORN JOURNAL