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Expertise in nursing practice: caring, clinical judgement and ethics
I74
Accident and Emergency Nursing
looks at several fields of health care in order to emphasize the central focus of the work; that is, the difficulty in reconciling these three approaches for practice. Many of the points made are not new, however, it is refeshing to read them in a single publication. The text addresses issues that impinge closely on health care in the Accident and Emergency setting, such as the promotion of health, child abuse and neglect, and mental health care. However, it would be unfair to over-emphasise its value to nurses working in this field. The text would be a useful starting point for nurses wishing to explore contemporary approaches to nurse education and their relevance to patient care. Pauline Daniels, RGN, SCM, RCN1; RN?; BEd(Hons), MSc, Nurse Tutov, Eastern Area College oj Nursing (Southside), 301 Saintjield Road, Be&t BT8 8BH, IV Ireland
The final three chapters deal with nurse-physician relationships, implications for basic nursing education and nursing administration and practice. The chapter dealing with the role of nurses and their experience in negotiating clinical knowledge with their medical counterparts and how to change the balance is fascinating. This book is useful for nurses at all levels, from the bedside to senior management, and would be particularly useful for those involved in theoretical teaching and clinical supervision. It will leave the reader with a ‘good’ feeling about nurses, nursing and its practices. It is worth reading and rereading. Professor C. 111.Dufield RN BScN DNE, MHe PhD, FCN (NS W), FCHSE, Faculty of Nursing, University of Technology, New South Wales, Australia
The emotionally neglected child
abused
and
D lwaniec
Expertise in nursing practice: caring, clinical judgement and ethics
Wiley
P Benner, CA Tanner, CA Chesla Springer Publishing
Co 1996. ISBN
0 8261
1995.
ISBN
0 471
95579
5,
206~~
LIZ.99
8700
5, 4lOnJ
The central theme of this book is that nursing is a socially embedded practice requiring a vast array of skills and knowledge. It obviously builds on the authors’ previous work dealing with the acquisition of clinical expertise. It raises many issues and challenges the way we view the world and the way nurses make decisions. While not providing the answers to many of the questions raised in their first text, it does provide direction to educational providers endeavouring to encourage and enhance clinical expertise. This book is based on a 6-year (1988-1994) interpretive study of nursing practice involving 30 hospital nurses, mostly from critical care units. It outlines the ethical dilemmas faced when nurses argue for caring in providing comfort, such as pain relief for the unconscious when painful procedures are required. In getting to know patients, nurses are able to understand what they want and advocate for them in such decisions. The four stages (novice to expert) are briefly reviewed and then explored in more depth, with exemplars which graphically describe how nurses view the world at each stage, how they relate to other nurses and the health care team and how we can assist in skills acquisition. Variables which effect and shape knowledge development, for example, the unit’s culture or styles of medical practice provide valuable insight.
The Emotionally Abused and Neglected Child has been written for professionals dealing in child protection and abuse. It is presented in Identification, Assessment and Intervention categories. The psychological and physical welfare of the child is looked at in depth, to encourage professionals to recognize that child protection is enhanced by the promotion of positive parenting and social skills. There has been increased public and professional awareness and understanding of child maltreatment coinciding with the Children’s Act 1989. The author uses her own research and knowledge gained over the last 20 years to give a historical perspective of attitudes and developments linking research and practice to outline the radical changes in the approach to child neglect. While this subject is of topical and general interest, this book is aimed at and is probably of value to the professional involved in preventative psychotherapy. As a tool for the Accident and Emergency (A & E) nurse, it is of limited value, as the presentation of children in the A & E department is more often due to an injury or illness which takes medical precedence. Whilst A & E nurses are aware of maltreated children and can recognize symptoms of the same, I feel the book is aimed more at professionals involved in long-term care of children and their carers. MS Helen Bailey, Registered Nurse, Accident and Emergency Department, Scarborough Hospital, Woodlands Drive, Scarborough YO12 6QL, UK
Accident and Emergency Nursing
looks at several fields of health care in order to emphasize the central focus of the work; that is, the difficulty in reconciling these three approaches for practice. Many of the points made are not new, however, it is refeshing to read them in a single publication. The text addresses issues that impinge closely on health care in the Accident and Emergency setting, such as the promotion of health, child abuse and neglect, and mental health care. However, it would be unfair to over-emphasise its value to nurses working in this field. The text would be a useful starting point for nurses wishing to explore contemporary approaches to nurse education and their relevance to patient care. Pauline Daniels, RGN, SCM, RCN1; RN?; BEd(Hons), MSc, Nurse Tutov, Eastern Area College oj Nursing (Southside), 301 Saintjield Road, Be&t BT8 8BH, IV Ireland
The final three chapters deal with nurse-physician relationships, implications for basic nursing education and nursing administration and practice. The chapter dealing with the role of nurses and their experience in negotiating clinical knowledge with their medical counterparts and how to change the balance is fascinating. This book is useful for nurses at all levels, from the bedside to senior management, and would be particularly useful for those involved in theoretical teaching and clinical supervision. It will leave the reader with a ‘good’ feeling about nurses, nursing and its practices. It is worth reading and rereading. Professor C. 111.Dufield RN BScN DNE, MHe PhD, FCN (NS W), FCHSE, Faculty of Nursing, University of Technology, New South Wales, Australia
The emotionally neglected child
abused
and
D lwaniec
Expertise in nursing practice: caring, clinical judgement and ethics
Wiley
P Benner, CA Tanner, CA Chesla Springer Publishing
Co 1996. ISBN
0 8261
1995.
ISBN
0 471
95579
5,
206~~
LIZ.99
8700
5, 4lOnJ
The central theme of this book is that nursing is a socially embedded practice requiring a vast array of skills and knowledge. It obviously builds on the authors’ previous work dealing with the acquisition of clinical expertise. It raises many issues and challenges the way we view the world and the way nurses make decisions. While not providing the answers to many of the questions raised in their first text, it does provide direction to educational providers endeavouring to encourage and enhance clinical expertise. This book is based on a 6-year (1988-1994) interpretive study of nursing practice involving 30 hospital nurses, mostly from critical care units. It outlines the ethical dilemmas faced when nurses argue for caring in providing comfort, such as pain relief for the unconscious when painful procedures are required. In getting to know patients, nurses are able to understand what they want and advocate for them in such decisions. The four stages (novice to expert) are briefly reviewed and then explored in more depth, with exemplars which graphically describe how nurses view the world at each stage, how they relate to other nurses and the health care team and how we can assist in skills acquisition. Variables which effect and shape knowledge development, for example, the unit’s culture or styles of medical practice provide valuable insight.
The Emotionally Abused and Neglected Child has been written for professionals dealing in child protection and abuse. It is presented in Identification, Assessment and Intervention categories. The psychological and physical welfare of the child is looked at in depth, to encourage professionals to recognize that child protection is enhanced by the promotion of positive parenting and social skills. There has been increased public and professional awareness and understanding of child maltreatment coinciding with the Children’s Act 1989. The author uses her own research and knowledge gained over the last 20 years to give a historical perspective of attitudes and developments linking research and practice to outline the radical changes in the approach to child neglect. While this subject is of topical and general interest, this book is aimed at and is probably of value to the professional involved in preventative psychotherapy. As a tool for the Accident and Emergency (A & E) nurse, it is of limited value, as the presentation of children in the A & E department is more often due to an injury or illness which takes medical precedence. Whilst A & E nurses are aware of maltreated children and can recognize symptoms of the same, I feel the book is aimed more at professionals involved in long-term care of children and their carers. MS Helen Bailey, Registered Nurse, Accident and Emergency Department, Scarborough Hospital, Woodlands Drive, Scarborough YO12 6QL, UK