- Email: [email protected]
Simply Successful Surgery: A Holistic Approach to a Conventional Procedure
Reviews
SEPTEMBER 2006, VOL 84, NO 3
this book. It is a must for every RNFA’s library. Registered nurse first assistant practice is dynamic and continues to evolve within the health care environment. The fourth edition of this book is a base on which to build RNFA education and practice. The book was published in 2005, however, so readers will need to continually add articles that are pertinent to RNFA practice to the fourth edition bibliography to keep their resources current. This book is available from AORN, Inc, 2170 S Parker Rd, Suite 300, Denver, CO 80231. C. J. WELTER RN, BSN, CNOR, CRNFA RN FIRST ASSISTANT BELFAIR, WASH
Simply Successful Surgery: A Holistic Approach to a Conventional Procedure Linda Voyles 2005, 157 pages $15.95 softcover This is a very informative book that any patient who is about to undergo a surgical procedure will find useful. It is intended to be a guide to empower patients to direct their surgery, to not be afraid to ask questions, and to expect answers. The author,
who has more than 20 years of perioperative experience, gives patients suggestions for mentally and physically preparing themselves for the best surgical outcome. In the first part of the book, the author provides a holistic overview of surgery, starting with the possibility of surgery all the way through recovery. The author also gives readers an idea of what questions they should ask and considerations they should think about before undergoing surgery. She gives a general explanation of each step of the process from the discussion of surgery to the preoperative visit to the differences between the various levels of postoperative care. She provides many helpful suggestions and resources, as well as examples of dialogues with health care professionals to ask for and receive what is desired. The suggestions regarding preparing oneself for surgery are excellent and really empower the patient to ask for and receive the healing environment they want and deserve. In part two of the book, the author goes into greater detail regarding tools and techniques that patients can use to prepare themselves before, during, and after surgery. She reminds patients that they are entitled to ask for and receive a positive and therapeutic environment and that they can request
that family and friends be allowed to help them during this time. It is the patient’s time to concentrate on preparing his or her body for surgery and healing. The author uses examples throughout the book that help to illustrate her points and show that empowering patients can work. One of the examples involves one of the author’s friends who was facing life-altering surgery. The author helped to guide this friend in asking for and receiving things that made her feel comfortable and achieved a therapeutic environment before, during, and after surgery. The patient was very specific in the requests she made of her health care team, asking for a peaceful and quiet room, that prayers be said for her, and that only positive affirmations be said in the room. To the author’s pleasant surprise, even the most resistant person complied with the wishes of the patient and even went so far as to tell someone who noisily burst into the room that the health care team was keeping the environment positive, quiet, and therapeutic for the patient and that they could talk later. The author comments on how pleasant the experience was not only for the patient but also for everyone else in the room. The book is written in a clear, concise, and easy-to-read format, and it includes many examples of strategies that can AORN JOURNAL •
503
Reviews
SEPTEMBER 2006, VOL 84, NO 3
work for patients and health care professionals to help patients achieve their therapeutic goals. The book also includes a detailed bibliography as well as a helpful appendix with a checklist of items to take to the hospital on the day of the surgery. Although it is written mainly for surgical patients, this book also is helpful for
health care providers because it reminds us that patients will ask questions that need to be answered. I highly recommend this book to any health care professional who would like to make a difference in the way patients view the perioperative environment and especially for any nurse in the perioperative field or considering a
perioperative career. This book is available from iUniverse, Inc, 2021 Pine Lake Rd, Suite 100, Lincoln, NE 68512. NANCY J. SHATTO RN, MSN, CNOR, CNA-BC NURSE MANAGER, OR AND POSTANESTHESIA CARE UNIT
VETERAN’S ADMINISTRATION EASTERN COLORADO HEALTH CARE SYSTEM DENVER, COLO
Physician Shortage Raises Concerns
T
he number of physicians entering practice is inadequate to meet the demand for medical services, according to a June 4, 2006, article in the Los Angeles Times. This demand is being driven by a growth in population, the relative health of the economy, and an increase in technology that makes more procedures available to patients (eg, joint replacement, liposuction). Twelve states currently report or are expected to report a shortage of physicians. Patients often have long waits for appointments in many specialties, including cardiology, radiology, and several pediatric and surgical subspecialties. With the aging of the Baby Boom generation, demand for physicians’ services is expected to increase, especially in the fields of urology, geriatrics, and ophthalmology. With a shortage of physicians, patients will experience much longer wait times than in the past, and nurses, physician assistants, and other ancillary health care providers may be required to take on a greater proportion of patient-care services. One explanation for the impending shortage is that a third of the physician workforce is older than 55 years of age and will soon retire. By the year 2020, 22,000 physicians are expected to retire annually, compared to an annual rate of 9,000 in 2000. Enrollment in medical schools, however, has remained virtually unchanged for the past 25 years because medical schools limited enrollment in response to an anticipated decline in the demand for physicians’ services. That decline has not materialized. Many health care analysts believed that health maintenance organizations (HMOs) would lower the
504 • AORN JOURNAL
demand for physicians by promoting preventive care and reducing the number of required tests. A negative consumer response to the HMO system has led to a decline in HMOs, and preferred provider organizations, which make health care more accessible, have become more common. This has resulted in an increased demand for physicians. Health care analysts also anticipated that technological advances in the medical industry would reduce demand for physicians’ services; instead, these advances have created an increased demand for surgeons. Today’s surgeons are able to perform surgical procedures on patients who are older and sicker than previous surgical patient populations. In addition, older patients generally are healthier than they were in the past, so surgeons are being more aggressive in treating this age group. In response to the impending physician shortage, medical schools are being encouraged to increase enrollment. Many schools are considering expanding existing facilities or building new ones to accommodate more students. Lawmakers also are under pressure both to abolish the limitation on funding for physician training and to relax the limits on immigration of foreign physicians. These measures eventually may ease the shortage of physicians, but the shortage is expected to continue for at least the next decade. L Girion, “Needs of Patients Outpace Doctors,” Los Angeles Times, 4 June 2006, http://www.latimes.com /business/la-fi-doctors4jun04,1,4376194,full.story ?ctrack=1&cset=true (accessed 12 June 2006).
SEPTEMBER 2006, VOL 84, NO 3
this book. It is a must for every RNFA’s library. Registered nurse first assistant practice is dynamic and continues to evolve within the health care environment. The fourth edition of this book is a base on which to build RNFA education and practice. The book was published in 2005, however, so readers will need to continually add articles that are pertinent to RNFA practice to the fourth edition bibliography to keep their resources current. This book is available from AORN, Inc, 2170 S Parker Rd, Suite 300, Denver, CO 80231. C. J. WELTER RN, BSN, CNOR, CRNFA RN FIRST ASSISTANT BELFAIR, WASH
Simply Successful Surgery: A Holistic Approach to a Conventional Procedure Linda Voyles 2005, 157 pages $15.95 softcover This is a very informative book that any patient who is about to undergo a surgical procedure will find useful. It is intended to be a guide to empower patients to direct their surgery, to not be afraid to ask questions, and to expect answers. The author,
who has more than 20 years of perioperative experience, gives patients suggestions for mentally and physically preparing themselves for the best surgical outcome. In the first part of the book, the author provides a holistic overview of surgery, starting with the possibility of surgery all the way through recovery. The author also gives readers an idea of what questions they should ask and considerations they should think about before undergoing surgery. She gives a general explanation of each step of the process from the discussion of surgery to the preoperative visit to the differences between the various levels of postoperative care. She provides many helpful suggestions and resources, as well as examples of dialogues with health care professionals to ask for and receive what is desired. The suggestions regarding preparing oneself for surgery are excellent and really empower the patient to ask for and receive the healing environment they want and deserve. In part two of the book, the author goes into greater detail regarding tools and techniques that patients can use to prepare themselves before, during, and after surgery. She reminds patients that they are entitled to ask for and receive a positive and therapeutic environment and that they can request
that family and friends be allowed to help them during this time. It is the patient’s time to concentrate on preparing his or her body for surgery and healing. The author uses examples throughout the book that help to illustrate her points and show that empowering patients can work. One of the examples involves one of the author’s friends who was facing life-altering surgery. The author helped to guide this friend in asking for and receiving things that made her feel comfortable and achieved a therapeutic environment before, during, and after surgery. The patient was very specific in the requests she made of her health care team, asking for a peaceful and quiet room, that prayers be said for her, and that only positive affirmations be said in the room. To the author’s pleasant surprise, even the most resistant person complied with the wishes of the patient and even went so far as to tell someone who noisily burst into the room that the health care team was keeping the environment positive, quiet, and therapeutic for the patient and that they could talk later. The author comments on how pleasant the experience was not only for the patient but also for everyone else in the room. The book is written in a clear, concise, and easy-to-read format, and it includes many examples of strategies that can AORN JOURNAL •
503
Reviews
SEPTEMBER 2006, VOL 84, NO 3
work for patients and health care professionals to help patients achieve their therapeutic goals. The book also includes a detailed bibliography as well as a helpful appendix with a checklist of items to take to the hospital on the day of the surgery. Although it is written mainly for surgical patients, this book also is helpful for
health care providers because it reminds us that patients will ask questions that need to be answered. I highly recommend this book to any health care professional who would like to make a difference in the way patients view the perioperative environment and especially for any nurse in the perioperative field or considering a
perioperative career. This book is available from iUniverse, Inc, 2021 Pine Lake Rd, Suite 100, Lincoln, NE 68512. NANCY J. SHATTO RN, MSN, CNOR, CNA-BC NURSE MANAGER, OR AND POSTANESTHESIA CARE UNIT
VETERAN’S ADMINISTRATION EASTERN COLORADO HEALTH CARE SYSTEM DENVER, COLO
Physician Shortage Raises Concerns
T
he number of physicians entering practice is inadequate to meet the demand for medical services, according to a June 4, 2006, article in the Los Angeles Times. This demand is being driven by a growth in population, the relative health of the economy, and an increase in technology that makes more procedures available to patients (eg, joint replacement, liposuction). Twelve states currently report or are expected to report a shortage of physicians. Patients often have long waits for appointments in many specialties, including cardiology, radiology, and several pediatric and surgical subspecialties. With the aging of the Baby Boom generation, demand for physicians’ services is expected to increase, especially in the fields of urology, geriatrics, and ophthalmology. With a shortage of physicians, patients will experience much longer wait times than in the past, and nurses, physician assistants, and other ancillary health care providers may be required to take on a greater proportion of patient-care services. One explanation for the impending shortage is that a third of the physician workforce is older than 55 years of age and will soon retire. By the year 2020, 22,000 physicians are expected to retire annually, compared to an annual rate of 9,000 in 2000. Enrollment in medical schools, however, has remained virtually unchanged for the past 25 years because medical schools limited enrollment in response to an anticipated decline in the demand for physicians’ services. That decline has not materialized. Many health care analysts believed that health maintenance organizations (HMOs) would lower the
504 • AORN JOURNAL
demand for physicians by promoting preventive care and reducing the number of required tests. A negative consumer response to the HMO system has led to a decline in HMOs, and preferred provider organizations, which make health care more accessible, have become more common. This has resulted in an increased demand for physicians. Health care analysts also anticipated that technological advances in the medical industry would reduce demand for physicians’ services; instead, these advances have created an increased demand for surgeons. Today’s surgeons are able to perform surgical procedures on patients who are older and sicker than previous surgical patient populations. In addition, older patients generally are healthier than they were in the past, so surgeons are being more aggressive in treating this age group. In response to the impending physician shortage, medical schools are being encouraged to increase enrollment. Many schools are considering expanding existing facilities or building new ones to accommodate more students. Lawmakers also are under pressure both to abolish the limitation on funding for physician training and to relax the limits on immigration of foreign physicians. These measures eventually may ease the shortage of physicians, but the shortage is expected to continue for at least the next decade. L Girion, “Needs of Patients Outpace Doctors,” Los Angeles Times, 4 June 2006, http://www.latimes.com /business/la-fi-doctors4jun04,1,4376194,full.story ?ctrack=1&cset=true (accessed 12 June 2006).