Book reviews

Post Modern Nursing and Beyond by Jean Watson. 1999.

Churchill Livingstone, London. ISBN 0443 05744 3 Pp. 303.

£21.95.

This long awaited book is a collection of Jean Watson's work as it

has evolved over the last few years. In many ways, this text is a

philosophical work which goes `beyond theory' as it challenges the

reader to ask the eternal questions, `What will nursing look like in

the post-modern era' and `How will it meet the needs of the

population we claim to serve?' As Dossey and Dossey state in the

forewords `It is not a question of whether the health care

professions will change but what the change will be' (page ix).

Watson uses her unique gift of blending the highly academic and

scienti®c with text that is often deeply personal, to create a

beautifully balanced and `reader friendly' book. She uses an

interesting approach in taking the reader from text to margin and

back again, juxtaposing poetry, literature and her own journal

entries with philosophical debate.

The content of this book is rooted in Watson's transpersonal

caring-healing model. There are 18 chapters which take the

reader on a journey through deconstruction and post-modernism,

drawing throughout on feminist literature. There are chapters

on arts and aesthetics in post-modern nursing which are

beautifully illustrated by the work of the artist Alex Grey.

Paradoxically, though not surprisingly to those who know her

work, Watson is inspired in her post-modern approach by women

of history, most notably Florence Nightingale and Hildegard of

Bingen.

This book is one of the most exciting and challenging nursing

texts I have read in recent years. It is not a typical nursing theory

textbook and, indeed, those unfamiliar with Watson's earlier work

on transpersonal caring may ®nd it bene®cial to refer to previous

publications before embarking upon the post-modern challenge of

this, her most current work.

Post Modern Nursing and Beyond demonstrates how nursing is

constantly changing and developing its theory and practice and this

text must be stocked in all libraries and should become familiar to all

students studying at Master's level.

In this book, Watson presents some searching questions to the

reader. It is true that for some the presentation and content will be

meaningless and possibly frustrating. It is not a book that will appeal

to the concrete thinker, but for those who love nursing and who

believe that we are the architects of our own future, this book is a

must.

ANNA BILEY MSc, RN, DipN, BRCP

Nursing Consultant

Cardiff

Medical-Surgical Nursing by W. J. Phipps, J. K. Sands, J. F.

Marek & M. S. Ledbetter. 1999. C. V. Mosby, St Louis. ISBN

0 323 00311 7. Pp. 2388. £29.95.

It would be true to describe this book as an encyclopedia for nursing

practice and it should de®nitely be located alongside other volumes

of its class. The authors focus on providing a comprehensive review

of the changes in the delivery of healthcare. The contributors to this

text on medical-surgical nursing draw together two perspectives:

nursing care of acutely ill adults and alterations in human

functioning.

The book contains an impressive list of contributors, many of

whom are clinical experts in their ®eld, thus ensuring the reader that

the information is current and relevant.

Each chapter identi®es key learning objectives, main conceptual

ideas, critical thinking questions and summaries, and presents

information in a format which provides a structured learning

programme for both students and quali®ed nurses. The book is

clearly written for an American nursing audience, with minimal

reference to English journals namely the Nursing Times and the

Journal of Advanced Nursing. However, nurses should not be put off

as there is much that can be adapted and applied here in the United

Kingdom.

The book is divided into two sections. In section one the

inquisitive learner is introduced to the subject and then follows a

comprehensive pathway from aetiology and medications used, to

nursing assessment and family involvement. One disturbing issue is

the missing pages from 295 to 326, which indicates an ineffective

quality assurance system at the publisher.

From a personal perspective, section two contains a range of

extremely relevant subjects. Each chapter, yet again, follows a

logical progression: the contribution of nursing features in the form

of clinical pathways, nursing diagnoses, designing careplans, or

describing nursing care. Perhaps using the same nursing model or

theory for each chapter would have been appropriate.

This in-depth book embraces concepts of modern technology and

includes both a CD-ROM and access to its web site, which is a clear

indication that the authors are addressing the innovations by which

information is being disseminated to nursing professionals. The

CD-ROM companion is one of the book's major strengths. Twelve

subjects, which range from vital signs to management of insulin

shock, provide miniature workshops for any practitioner who wishes

to advance and test their knowledge. It is also good to see that a

glossary of terms with de®nitions is included. The case studies lean

heavily towards the American population which, if viewed pos-

itively, exposes European nurses to the American culture. Perhaps

incorporating European perspectives would enable the user of this

learning tool to take a wholesome view of the subject concerned.

Journal of Clinical Nursing 2000; 9: 649±653

Ó 2000 Blackwell Science Ltd 649

In summary, this is a comprehensive text aimed at students of

nursing and applicable to those who are undertaking post graduate

quali®cations. Despite being a rather weighty tome, I would

recommend it as a useful addition to students' and quali®ed nurses'

libraries.

JANE RYAN BSc, RGN, PGCE

Lecturer in Nursing

School of Nursing Studies

University of Wales College of Medicine

Cardiff

Pain: Clinical manual (2nd edn) by M. McCaffrey & C. Pasero.

1999. C. V. Mosby, St Louis. ISBN 0 8051 5609 X. Pp. 796.

£21.95.

The claim of this well-written American textbook is to give up-

to-date, evidence-based, practical information on pain management.

It is intended for multidisciplinary use. It accomplishes this through

its thorough and systematic approach to a comprehensive range of

pain management issues. Its depth, appropriate illustrations and

reference guides throughout the text make this book ideal for the

evidence-based practitioner involved in pain management as well as

a resource at ward level.

The book begins with a `user's guide' including the use of

abbreviations and short cuts to certain information, charts and

management guidelines. It gives information on accessing print-

outs, via the Internet, that can be used in clinical practice. It

also includes two separate `pocket guides', which are both

succinct and informative. The ®rst is an equianalgesic chart, the

other a dosing chart for both NSAIDs and adjuvants in chronic

pain.

The content of the text follows a logical progression from

common pain management problems through mechanisms of pain,

assessment and pharmacology. Each section has good diagrammatic

representation, tables on common misinterpretations, dosing charts

or reproducible clinical documentation, e.g. a 24-h pain manage-

ment chart. Also included are paediatric icons (to make items

pertinent to childcare easily accessible) and summary boxes.

The text goes on to cover practical pain procedures, non-

pharmacological and type-speci®c pain management, e.g. pain

management in infants and pregnancy as well as disease/injury-

speci®c pain management problems and care. It ends with an

informative chapter on building a multidisciplinary commitment to

improving pain management.

Some of the innovative inclusions to this text embrace such issues

as pain assessment of non-English speaking patients. This section

includes reproducible pain assessment charts in some of the most

commonly spoken languages. Some more common languages

pertinent to the UK are excluded, e.g. Urdu, Somali and Hindi,

but this is nonetheless a helpful section. Another section system-

atically covers the harmful effects of under-treating pain.

This textbook also offers comprehensive coverage of the subject

of pharmacology, including all types of therapy (opiate, NSAIDs

and adjunctive), to a depth uncommon in general pain textbooks.

Its disadvantages are minor. The fact that it is American makes

some of the pharmaceutical names different to our own, as well as

some terminology. The book is ring-bound, which does not make it

as sturdy as hardback, but this is perhaps re¯ected in the reasonable

price of £21.95. Finally the use of colour diagrams would, in my

opinion, have enhanced the appearance of the text overall.

Although this text could be useful to anyone involved in pain

management in the multidisciplinary team, it is particularly relevant

to nurses. This is, in part, due to its holistic, patient-centred

approach including the use of patient care scenarios and the

inclusion of a wide range of non-pharmacological methods of pain

relief.

This textbook could prove to be the de®nitive one in its class for

those with all levels of knowledge. This is due to its internationally

recognized authors, content width, depth of coverage, ease of use

and price.

CLAIRE HERBERT BN, RGN

Staff Nurse

Neurosurgical Unit

University Hospital of Wales

Cardiff

Promoting positive practice in nursing older people by

Sharon Pickering and Jeanette S. Thompson. 1998. BaillieÁre Tindall

(with RCN), London. ISBN 0 7020 2080 X. £14.95.

If you pick up this book expecting to ®nd how to care for someone

with a particular pathology, put it back; it continues the signi®cant

move away from the `Geriatric Medicine' approach to nursing

elderly people which was prevalent in the past and continues to be

evident in some contemporary books. It could be argued that much

of what is said in the book is `just' adult nursing, which is to say that

much of caring for older people is accepting that older people are

`just' adults who have been successful in staying around for longer

than most of those caring for them.

This book (to coin a phrase) does just what it says on the cover: it

promotes positive practice in nursing older people. This notion runs

particularly strongly through the ®rst (Values, attitudes and beliefs)

of the four sections which make up the book. This section deals with

the consideration of cultural perspectives on ageing and discusses

the promotion of ordinary living in old age, promoting choice and

independence and managing risk situations. The focus in this ®rst

section might be summed up as emphasizing the `normality' of older

people, even the ordinariness of being old. This is a commendable

section to begin with and a clear way in which to introduce a

teaching programme on care of older people.

Beginning with a discussion of a variety of perspectives (cultural

and sociological to biological) on old age, the ®rst chapter

incorporates the use of a case study to apply theory to practice in

a clear and interesting way. The case study is interspersed with

short sections relating back to the basic text. The strategies used in

this chapter to enhance the understanding of ideas and application

to practice progress throughout the book. In addition to the use of

case studies, the text is peppered with questions and points to

consider, each highlighted with an appropriate symbol to attract the

reader's attention. These devices are used well to make this a

`reader-friendly' book.

The second section moves on to maintaining optimum health in

later life and has chapters on sexuality, spiritual needs and social

networks in old age. In this way the personal and social needs of

individuals are again emphasized and particularly those aspects

which, it may be argued, are commonly given minimal attention in

650 Book reviews

Ó 2000 Blackwell Science Ltd, Journal of Clinical Nursing, 9, 649±653