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Ophthalmic nursing 2nd edition
Book Reviews Spiritual bereaved
care of dying people
and
P Wilcock SPCK 2996 ISBN 0 281 04877 0 105pp, L6.99 The author demonstrates an exceptional literary style which enhances the reader’s understanding of spiritual care. The text is permeated with meaningful components of the practical metaphor for ‘spirituality’ - the journey of life. There is also a depth to her writing that could only be borne out of intuitive awareness and the full maturity of experience. Although she gives no specific guidance for those who work in Accident and Emergency, our universal association with dying and bereavement predetermines its vital pertinence to us all. Spirituality itself is a subject which is meeting with resurgent interest amongst carers of all backgrounds. The book emerges not from a scientific background with sundry references to other material, but from a personal, Christian perspective - embracing all walks of life with acuity of insight and genuine compassion. It is lifted above others I have read in the genre by the author’s refreshing and clear, inspirational, honest expression of her vision of the spiritual dimension at the very heart of real human encounters. Marcus Naylor, RMN, RGN, Chavge Nurse, PsychiatryDepartment, Fairfield GeneralHospital, Rochdale Old Road, Bury BL9 LTD, UK
Health care systems democracies
in liberal
A Wall (ed) Routledge 1996 2lOpp ISBN HB: 0 415 11806 9 (A40), PB: 0 415 11807 7 (k12.99) Accident and Emergency nurses, in common with all health care St&, must occasionally wonder whether better ways of meeting ever increasing public
demands and expectations exist. Ann Wall and her team of contributors offer a valuable and interesting insight into health care systems, past and present, in the UK, Australia, Italy, Sweden, the Netherlands and the USA. These offer a broad perspective on health care issues and an awareness of the possible pitfalls and rationale underpinning different approaches. While some nurses may feel a little overwhelmed by the abundance of facts and figures crammed within its pages, others may find they facilitate more realistic comparisons between countries with problems of unequal magnitude along with an understanding of funding for health care provision. With the ever increasing pace of change in health care, and prevailing financial constraints, nurses ought to use this information-rich work in order to enable them to fully consider the implications of change in their own speciality and arrive at the best possible solutions. With increased knowledge of the political and philosophical standpoints upon which the systems are based, it will perhaps also help nurses anticipate the future direction for the UK. Jean Cummings, Sister,Accident and EmergencyDepartment, Bolton General Hospital, Bolton, UK
The Royal Marsden NHS Manual of clinical nursing procedures
Trust
J Malleh, C Bailey Blackwell Scientijic 0 632 04068 8, 662pp, Al5.99 Whether nursing staff are performing a procedure on a patient or assisting, this book is a comprehensive guide. Initially looking at a holistic approach to the patient, there is also a chapter on Assessment, Communication and Consent of both adults and minors, the latter an area which at times may cause concern in an Accident and Emergency (A & E) department. The material is of topical interest as it covers a wide range of skills nurses are already undertaking, or are currently developing their knowledge and skills to enable them to carry out. Approximately half the chapters have some relevance to my own experience in A & E. Some procedures I
Accident and Emergency Nursing ( 1998) 6, 6 I-63 0 Harcourt Brace & Co. Ltd I997
would carry out, others I may be assisting a doctor. However some of the chapters not directly relevant to A & E were still of interest to me, increasing my knowledge of areas I know little about. In chapter 28, Neurological observations, which is relevant to A & E nursing, I found the observations were somewhat in depth and I feel it would be inappropriate to go into such minutiae as actions 23, 25, 26 and 27, whilst in A & E. Also the Glasgow Coma Score chart does not allow for repetitive assessment and documentation of such actions in the acute assessment. There is a discussion of painful stimuli and where to apply pressure to illicit a response. I feel this needs a note that a patient with a high spinal cord lesion would not respond to a painful stimulus of a finger, and this, therefore, would not be an accurate assessment documenting that the patient’s response is nil. This book will be used in different ways by nursing staff, mainly by the newly qualified staff nurse or student nurse, who are developing skills and seeing or assisting with these procedures for the first time. Using this book as a resource will provide them with clear instructions how and why to carry out procedures, enabling them to develop skills and perform effectively. Its use by senior qualified staff will be somewhat limited, except if an unfamiliar procedure was being performed which was not common to that area. Dawn Abbiss, SRN, ONC, ATNC(P) Sister,Accident and EmergencyDepartment, Leeds GeneralInjirmavy, LeedsLSI 3EX, UK
Ophthalmic
Nursing
2nd edition
R Stollery Blackwell Science,1997, ISBN 0 632 03996 5, 288pp, kl9.95 The second edition of this very comprehensive Ophthalmic Nursing book is most welcome. I am pleased with the layout of the book and its userfriendly approach. This should encourage nurses within a general A & E department to use it not only when a particular problem arises but also to gain an insight into ophthalmic care. I was particularly impressed with
62 Accident and Emergency Nursing
the chapters that covered information regarding the ophthalmic nurse and ophthalmic nursing procedures. Much of the content in these chapters can be applied to the general A & E nurse, especially the sections on assessment of patients and patient information and teaching. Throughout the book a number of patient information leaflets and advice sheets are reproduced. These could well be used by nurses in general A & E departments as a guide for the development of ophthalmic discharge advice sheets. Chapters 5-13 are well laid out with the anatomy and physiology of the relevant section of the eye being followed by the related eye conditions, the assessment, patient’s needs, nursing and complications. I was action relieved to find that the chapters followed the logical journey from lids to intraoccular structures/conditions. Although the illustrations are in black and white, most work very effectively. A complete chapter is devoted to ophthalmic trauma which covers all the common and some of the less common injuries. The book is well referenced and also addresses some of the current controversial issues such as when and when not to pad a corneal abrasion. While primarily aimed at providing information for nurses working within the specialty of ophthalmology, this book is an excellent reference for all A & E departments. GaryJones, RGN, OND, DIPN (Lo&), FETC, TNCC(I), A G E Nurse Consultant and Lecturer, 18 Hogarth Road, Stgoyd Clays, Grays, Essex RM16 2XA, UK
The pulmonary artery catheter in critical care: a concise handbook. 2nd Edn. C Perret,
D Tagan, F Feihi, ] J Marini
Blackwell Science 1996. ISBN 0 6320 4212 5, L55.00
The ability to measure haemodynamic variables at the bedside using a pulmonary artery flotation (or SwanGanz) catheter has been a mainstay of critical care monitoring for the past 2 decades. Indeed, more than one million Swan-Ganz catheters are inserted each year in the USA alone. The technique has not met with universal approval, however, and
the controversial role of Swan-Ganz catheterization in influencing outcome from critical illness has recently received new airing in respected medical journals on both sides of the Atlantic. Some experts argue that the technique should be abandoned altogether, its function superseded largely methods such as by noninvasive echocardiography. In the UK the placement of a pulmonary artery catheter rests almost exclusively in the domain of the intensive care unit, and it is extremely unlikely that most Accident and Emergency nurses will have to care for a patient with a Swan-Ganz catheter in situ. The authors, to their credit, acknowledge criticism of the technique and seek to mount a defence, citing a lack of formal training as a potential factor. They seek to address this educational deficit by means of this handbook, asserting that ‘the quality of reference works takes on a particular importance’. And that it does, but not helped, I fear, by this particular book. Intentionally unconventional in layout and language, this book owes more to the tradition of car maintenance manuals than critical care vade-mecum or procedure book. The reader, coming unprepared to its pages, will (if they share my own experience) find the language turgid, the text disjointed and the deconstruction of patient care disorientating. While the authors’ motives are undeniably worthy, I do not think that this is the way to improve nurses’ and doctors’ knowledge and care of patients with a Swan-Ganz catheter in situ. This will require support f?om manufacturers, suppliers and expert clinicians, together with (perhaps) computer simulation and a more clearly presented troubleshooting guide. T. Quinn RN FESC, Specialist Nurse (Cardiology), West Midlands Evidence Supported Medicine Union, 27 Highjeld Road, Bl5 3DP, UK
Traumatic experiences of nurses: when your profession becomes a nightmare H Buyssen Jessica Kingsley 1996, ISBN 1 85302 377 9, A9.95
Effective staff support systems, to help
staff deal effectively with emotionally disturbing events, are a necessity and not just a luxury This is true for three reasons. Firstly, for too long we have accepted the fact that support systems such as debriefing are used only if we have the time, and only if it is a major incident. Secondly on too many occasions we are guilty of paying only lip service to the need for effective support systems; and thirdly this book effectively dispels the myth that recognizing the need for support is a sign of weakness. Divided into two parts, part one focuses on personal accounts from nurses and nursing assistants. They tell their own story and describe vividly the emotional aftermath of disturbing events. Part two is divided into three chapters. These highlight the theory of psychotrauma, self-help, and most importantly, support within an institution. After reading this book, the reader will realize that not all traumatic incidents adversely affecting staff need be as a result of exposure to major incidents. This clear message, as well as the sound practical advice provided, makes this a book well worth reading by students through to managers, but most particulary managers. Robert Sowney RGN BSc &IONS) PG CERT HGSSM ATNC (I), Charge Nurse, A fi E Department, South Tyrone Hospital, Dungannon BT71 4AI/; Northern Ireland, UK
Emergency S Miiller Chapman G Hull 1997, ISBN 4 12560 402
The book claims to be one of a series of easy to use pocket books, and it does not take up a lot of space. It contains a vast amount of practical, concise information in an easy to understand format which is up-todate, and takes into consideration the type of emergency situations which one would expect to deal with in the Accident and Emergency department. The interesting and clever use of two colours in highlighting tables, charts, diagrams and text, directs the reader’s attention to the important areas on each page. This would be important in an emergency, as one may not have time to read the whole page. However
care of dying people
and
P Wilcock SPCK 2996 ISBN 0 281 04877 0 105pp, L6.99 The author demonstrates an exceptional literary style which enhances the reader’s understanding of spiritual care. The text is permeated with meaningful components of the practical metaphor for ‘spirituality’ - the journey of life. There is also a depth to her writing that could only be borne out of intuitive awareness and the full maturity of experience. Although she gives no specific guidance for those who work in Accident and Emergency, our universal association with dying and bereavement predetermines its vital pertinence to us all. Spirituality itself is a subject which is meeting with resurgent interest amongst carers of all backgrounds. The book emerges not from a scientific background with sundry references to other material, but from a personal, Christian perspective - embracing all walks of life with acuity of insight and genuine compassion. It is lifted above others I have read in the genre by the author’s refreshing and clear, inspirational, honest expression of her vision of the spiritual dimension at the very heart of real human encounters. Marcus Naylor, RMN, RGN, Chavge Nurse, PsychiatryDepartment, Fairfield GeneralHospital, Rochdale Old Road, Bury BL9 LTD, UK
Health care systems democracies
in liberal
A Wall (ed) Routledge 1996 2lOpp ISBN HB: 0 415 11806 9 (A40), PB: 0 415 11807 7 (k12.99) Accident and Emergency nurses, in common with all health care St&, must occasionally wonder whether better ways of meeting ever increasing public
demands and expectations exist. Ann Wall and her team of contributors offer a valuable and interesting insight into health care systems, past and present, in the UK, Australia, Italy, Sweden, the Netherlands and the USA. These offer a broad perspective on health care issues and an awareness of the possible pitfalls and rationale underpinning different approaches. While some nurses may feel a little overwhelmed by the abundance of facts and figures crammed within its pages, others may find they facilitate more realistic comparisons between countries with problems of unequal magnitude along with an understanding of funding for health care provision. With the ever increasing pace of change in health care, and prevailing financial constraints, nurses ought to use this information-rich work in order to enable them to fully consider the implications of change in their own speciality and arrive at the best possible solutions. With increased knowledge of the political and philosophical standpoints upon which the systems are based, it will perhaps also help nurses anticipate the future direction for the UK. Jean Cummings, Sister,Accident and EmergencyDepartment, Bolton General Hospital, Bolton, UK
The Royal Marsden NHS Manual of clinical nursing procedures
Trust
J Malleh, C Bailey Blackwell Scientijic 0 632 04068 8, 662pp, Al5.99 Whether nursing staff are performing a procedure on a patient or assisting, this book is a comprehensive guide. Initially looking at a holistic approach to the patient, there is also a chapter on Assessment, Communication and Consent of both adults and minors, the latter an area which at times may cause concern in an Accident and Emergency (A & E) department. The material is of topical interest as it covers a wide range of skills nurses are already undertaking, or are currently developing their knowledge and skills to enable them to carry out. Approximately half the chapters have some relevance to my own experience in A & E. Some procedures I
Accident and Emergency Nursing ( 1998) 6, 6 I-63 0 Harcourt Brace & Co. Ltd I997
would carry out, others I may be assisting a doctor. However some of the chapters not directly relevant to A & E were still of interest to me, increasing my knowledge of areas I know little about. In chapter 28, Neurological observations, which is relevant to A & E nursing, I found the observations were somewhat in depth and I feel it would be inappropriate to go into such minutiae as actions 23, 25, 26 and 27, whilst in A & E. Also the Glasgow Coma Score chart does not allow for repetitive assessment and documentation of such actions in the acute assessment. There is a discussion of painful stimuli and where to apply pressure to illicit a response. I feel this needs a note that a patient with a high spinal cord lesion would not respond to a painful stimulus of a finger, and this, therefore, would not be an accurate assessment documenting that the patient’s response is nil. This book will be used in different ways by nursing staff, mainly by the newly qualified staff nurse or student nurse, who are developing skills and seeing or assisting with these procedures for the first time. Using this book as a resource will provide them with clear instructions how and why to carry out procedures, enabling them to develop skills and perform effectively. Its use by senior qualified staff will be somewhat limited, except if an unfamiliar procedure was being performed which was not common to that area. Dawn Abbiss, SRN, ONC, ATNC(P) Sister,Accident and EmergencyDepartment, Leeds GeneralInjirmavy, LeedsLSI 3EX, UK
Ophthalmic
Nursing
2nd edition
R Stollery Blackwell Science,1997, ISBN 0 632 03996 5, 288pp, kl9.95 The second edition of this very comprehensive Ophthalmic Nursing book is most welcome. I am pleased with the layout of the book and its userfriendly approach. This should encourage nurses within a general A & E department to use it not only when a particular problem arises but also to gain an insight into ophthalmic care. I was particularly impressed with
62 Accident and Emergency Nursing
the chapters that covered information regarding the ophthalmic nurse and ophthalmic nursing procedures. Much of the content in these chapters can be applied to the general A & E nurse, especially the sections on assessment of patients and patient information and teaching. Throughout the book a number of patient information leaflets and advice sheets are reproduced. These could well be used by nurses in general A & E departments as a guide for the development of ophthalmic discharge advice sheets. Chapters 5-13 are well laid out with the anatomy and physiology of the relevant section of the eye being followed by the related eye conditions, the assessment, patient’s needs, nursing and complications. I was action relieved to find that the chapters followed the logical journey from lids to intraoccular structures/conditions. Although the illustrations are in black and white, most work very effectively. A complete chapter is devoted to ophthalmic trauma which covers all the common and some of the less common injuries. The book is well referenced and also addresses some of the current controversial issues such as when and when not to pad a corneal abrasion. While primarily aimed at providing information for nurses working within the specialty of ophthalmology, this book is an excellent reference for all A & E departments. GaryJones, RGN, OND, DIPN (Lo&), FETC, TNCC(I), A G E Nurse Consultant and Lecturer, 18 Hogarth Road, Stgoyd Clays, Grays, Essex RM16 2XA, UK
The pulmonary artery catheter in critical care: a concise handbook. 2nd Edn. C Perret,
D Tagan, F Feihi, ] J Marini
Blackwell Science 1996. ISBN 0 6320 4212 5, L55.00
The ability to measure haemodynamic variables at the bedside using a pulmonary artery flotation (or SwanGanz) catheter has been a mainstay of critical care monitoring for the past 2 decades. Indeed, more than one million Swan-Ganz catheters are inserted each year in the USA alone. The technique has not met with universal approval, however, and
the controversial role of Swan-Ganz catheterization in influencing outcome from critical illness has recently received new airing in respected medical journals on both sides of the Atlantic. Some experts argue that the technique should be abandoned altogether, its function superseded largely methods such as by noninvasive echocardiography. In the UK the placement of a pulmonary artery catheter rests almost exclusively in the domain of the intensive care unit, and it is extremely unlikely that most Accident and Emergency nurses will have to care for a patient with a Swan-Ganz catheter in situ. The authors, to their credit, acknowledge criticism of the technique and seek to mount a defence, citing a lack of formal training as a potential factor. They seek to address this educational deficit by means of this handbook, asserting that ‘the quality of reference works takes on a particular importance’. And that it does, but not helped, I fear, by this particular book. Intentionally unconventional in layout and language, this book owes more to the tradition of car maintenance manuals than critical care vade-mecum or procedure book. The reader, coming unprepared to its pages, will (if they share my own experience) find the language turgid, the text disjointed and the deconstruction of patient care disorientating. While the authors’ motives are undeniably worthy, I do not think that this is the way to improve nurses’ and doctors’ knowledge and care of patients with a Swan-Ganz catheter in situ. This will require support f?om manufacturers, suppliers and expert clinicians, together with (perhaps) computer simulation and a more clearly presented troubleshooting guide. T. Quinn RN FESC, Specialist Nurse (Cardiology), West Midlands Evidence Supported Medicine Union, 27 Highjeld Road, Bl5 3DP, UK
Traumatic experiences of nurses: when your profession becomes a nightmare H Buyssen Jessica Kingsley 1996, ISBN 1 85302 377 9, A9.95
Effective staff support systems, to help
staff deal effectively with emotionally disturbing events, are a necessity and not just a luxury This is true for three reasons. Firstly, for too long we have accepted the fact that support systems such as debriefing are used only if we have the time, and only if it is a major incident. Secondly on too many occasions we are guilty of paying only lip service to the need for effective support systems; and thirdly this book effectively dispels the myth that recognizing the need for support is a sign of weakness. Divided into two parts, part one focuses on personal accounts from nurses and nursing assistants. They tell their own story and describe vividly the emotional aftermath of disturbing events. Part two is divided into three chapters. These highlight the theory of psychotrauma, self-help, and most importantly, support within an institution. After reading this book, the reader will realize that not all traumatic incidents adversely affecting staff need be as a result of exposure to major incidents. This clear message, as well as the sound practical advice provided, makes this a book well worth reading by students through to managers, but most particulary managers. Robert Sowney RGN BSc &IONS) PG CERT HGSSM ATNC (I), Charge Nurse, A fi E Department, South Tyrone Hospital, Dungannon BT71 4AI/; Northern Ireland, UK
Emergency S Miiller Chapman G Hull 1997, ISBN 4 12560 402
The book claims to be one of a series of easy to use pocket books, and it does not take up a lot of space. It contains a vast amount of practical, concise information in an easy to understand format which is up-todate, and takes into consideration the type of emergency situations which one would expect to deal with in the Accident and Emergency department. The interesting and clever use of two colours in highlighting tables, charts, diagrams and text, directs the reader’s attention to the important areas on each page. This would be important in an emergency, as one may not have time to read the whole page. However