I hope you are all keeping safe and well. I’m not quite back to my usual activity yet (more on that tomorrow), but I had to share this book.
Rituals & Myths in Nursing: A Social History by Claire Laurent
Nursing is a complex profession steeped in tradition and history. Tried and tested ways of working have been the mainstay of how and why nurses do what they do. Completing tasks in a certain way because Sister says so describes the custom and practice of nursing, passed on through the generations that existed for most of the 20th Century and can still hold sway today. Science and evidence-based practice have weakened the hold on tradition but ritual is still part of the fabric of nursing. Packed with amusing and sometimes poignant reminiscences this book paints a picture of nursing from the first registration of SRN No 1, Ethel Bedford Fenwick in 1919, to the present day. Each chapter follows a theme, explores the historical background and brings it to life with stories told by nurses from different eras. We have tales of alcohol prescribed to dilate blood vessels or simply for the feel good factor. Enemas were less fun, given for almost all bowel conditions; High, hot and a helluva lot!’ was the phrase for remembering this ritual. Written with humour and a light touch, readers don’t need a nursing background to enjoy these stories, but those who trained as nurses will identify with many of the amusing and often eccentric traditions retold by generations of nurses.
Claire Laurent is a writer and nurse with a family rich in nurses, medics and midwives. After qualifying from St Bartholomew’s Hospital, London, Claire trained as a journalist with Nursing Mirror. Years as a freelance health journalist followed, as well as a Masters in Public Health with several roles in that field. However, it was a partial return to clinical nursing that inspired this book recognising the complexity of modern nursing versus its strong traditions.
Thanks to Rosie Croft, from Pen & Sword, for providing me a paperback copy of this book, which I freely chose to review.
This is not the first book about nursing from Pen & Sword that I review, but it seems a particularly appropriate moment to read it and comment on the changes that have taken place in a profession that is right now at the forefront of everybody’s mind. The hard work all the healthcare professionals are doing, at a high personal risk, should not be underestimated, and I hope this health crisis (the coronavirus pandemic) will make governments realise that there are certain things that we should never try to make savings on, because the consequences can be catastrophic. But, let’s talk about the book.
The above description captures perfectly the essence of this book. It is packed full of anecdotes by nursing staff from different generations, as the long list of acknowledgments at the beginning of the book reflects. It is a wonderful combination of fun, bizarre, and touching episodes, memories of uniforms, strange cures (and I’ve heard of some of them, so yes, fashions change over the years), strict cleaning routines that would have made army sergeants proud (including how to make a bed properly), ghosts, cooking breakfast in the wards, what used to pass for medication… all of them steeped up in the social circumstances of the period and reflecting the changes, not only in Medicine and Nursing (from learning on the job, nursing became a university degree, and from tradition and usage they moved onto evidence-based practice), but in society at large. Although I haven’t worked in a hospital for a few years, one of my best friends is a nurse; I have worked and met many nurses, and all the stories rung true for me.
The book includes some wonderful black and white illustrations, a bibliography (with blogs and websites as well as books and articles), a detailed index and even a chart of medical slang. The book is divided into twelve chapters: Without Rhyme or Reason (talking about training and the reasons why women [and later on, men also] decided to go into the job, in many cases out of family tradition); Nurses Who Rustle (uniforms, badges and related items); Handover and Hierarchy (times have changed and the way things are done have also changed, mostly for the better, although there is plenty of nostalgia and some true characters most nurses will never forget); Hygiene and Hijinks (cleaning protocols have changed in so many ways…); Egg White and Oxygen (treatments that had very little, if any, scientific base, but were followed religiously at the time); Bladders, Bowels and Bodily Functions (I don’t think I need to explain this); Medicines and Mystical Powers (this chapter deals not only with medications and drugs that would never be used now and were probably quite dangerous, but also with the procedures and routines imposed in the past that are almost impossible to believe now); Things that go Bump in the Night (ghosts stories… What proper old hospital does not have one ghost or many? And of course, the ghosts of nurses are hard at work ensuring the wellbeing of patients even after death); Dust, Dirt and Domesticity (cleaning protocols past and present); Once the Dust has Settled (gloves, potions, kits…); Theatre theatricals (being in a surgical theatre is an experience as nurses know only too well); Life and Death (births, deaths and everything in between).
This book is a delight. It’s full of many voices, from different eras, from nurses that had worked in a variety of specialties, all sharing personal stories or stories that they had heard on their jobs. Some are emotional, some funny, and I must warn people who are squeamish about illnesses and bodily functions, as there are some anecdotes that might make them cringe. But anybody who enjoys books about nursing, social history, or just a genuine story with plenty of heart, should read this book. And if you know any nurses or anybody interested in the topic don’t forget to recommend it. It’s a great homage to a profession that has always been and remains, a true caring profession.
Thanks to Rosie, the author, and all the nurses, doctors, and health professionals, and others helping us these days (as always), thanks to all of you for reading, and remember to keep reading, smiling, and especially, keep safe.
I bring you and intriguing a scary book, although it is not a horror novel. Another one from Rosie’s fabulous Book Review Team.
Collateral Carnage: Money. Politics. Big Pharma. What could go wrong? by Chris Saper
Money. Politics. Big Pharma. What could go wrong? As PTSD therapist Claire Wilheit is about to learn, a whole helluva lot. A chance after-hours encounter with a fellow therapist reveals falsified patient files and thrusts Claire into a conspiracy poised to revolutionize treatment for US veterans now and for future generations, with deadly collateral damage. Trapped in an avalanche of events over which she has no control, Claire is locked into a race against time in preventing the sweeping, irreversible and fatally flawed policies that Congress is about to set into play. Collateral Carnage is Chris Saper’s debut novel, a gripping thriller set in a future near enough to be all too terrifying.
I’m lucky enough to have had three pretty diverse careers spanning forty years. But solving puzzles has been at the heart of each one.
As a masters prepared health care administrator, I worked as a strategic planner, hospital administrator and implemented the pre-hospital/categorization program in Central Arizona.
A bachelor’s degree in fine arts, put on the back burner for seventeen years, served me well as second career as a commissioned portrait artist. After all, what’s a blank canvas except another big puzzle to solve? To date, I’ve completed nearly 400 commissions nationwide, and authored four books and four DVDs teaching other artists about my craft – and helping them develop their own.
As a voracious fiction reader, a relentless grammar nut, and Scrabble junkie, I love communicating clearly and with the best style I can.
And here we are! My first novel, set in the near future, about corruption and conspiracy within the government’s delivery of mental health service to PTSD patients in the VA system.
Sound far-fetched to you? Not to me. I care about this stuff, deeply, and this is one way for me to elevate not only my own concerns, but those of so many of my fellow citizens.
I write this review as a member of Rosie’s Book Review Team (authors, check here if you want to get your book reviewed), and thank her and the author for the ARC copy of the book, which I freely chose to review.
Having worked in the health services (although in the UK) for a number of years, and having treated some patients suffering from PTSD (although I’m no specialist), I was intrigued by this debut novel. I was even more interested when I read the author’s biography and learned of her first-hand experience as a healthcare administrator, as that promised to bring an insider’s perspective into the topic and add complexity to the plot.
This novel is perfect for readers who love conspiracy theory plots and also spy novels. I must confess that I am not much of a reader of spy novels, because I tend to get lost in the huge number of names, where characters often swap identities, and sometimes find it difficult to tell the different players apart. There is some of that here, because we are thrown at the deep end from the beginning. There’s no gentle easing into the subject or much background information provided before we get into the nitty gritty of the story, and the fact that we don’t know what’s happening parallels the experience of the main character, Claire Wilheit.
The story is narrated in the third person, but from a variety of points of view (I’d say almost as many as characters, or at least as many as characters that have some bearing into the outcome of the novel), and although some characters appear often and we become somewhat familiar with them, there are others that only make a fleeting appearance. The point of view, although clearly signalled, can change even within a chapter, and not all readers feel comfortable with so many changes. Chapters are short, the story moves at a quick pace, and although the language is straightforward, and there are no unnecessarily long descriptions, readers need to remain alert and attentive. This is not an easy and relaxed read; the plot has many strands that might appear quite entangled and confusing at first, but if one keeps reading, the story becomes clearer and the subject is both compelling and gripping.
Personally, I felt that this is a story heavier on plot than on characters. There are quite a number of characters I liked (mostly on the “good” side, although I felt some sympathy for the motives of some of the characters on the “bad” side as well), especially Claire, who is determined, intelligent, resourceful, and has managed to overcome pretty difficult circumstances, but because there are so many characters, and they all take their turn, it is difficult to get to know most of them in depth. I think that was in part the reason why, at times, I felt like an observer of the plot and the story, rather than being fully involved and sharing in the experiences of the characters. The end of the novel hinted at the possibility of further adventures involving Claire and some of the other characters (I’m trying to avoid spoilers here), so readers might learn much more about them.
I “enjoyed” (well, it worried me, but you know what I mean), the insight into the pharmaceutical industry, the way the novel spells out the relationship between Big Pharma and politics, and the reflections on how the healthcare system works (or rather, might end up working) in the USA. One of the aspects of the novel that I found captivating was the dystopian edge of the story. I haven’t seen it listed as a dystopia, but it is set in the very near future, with a social order very similar to the current one, but with subtle differences, or perhaps one could call them “developments” that, unfortunately, fit in well with recent events and with the way things are progressing. In the book, the efforts to control costs have resulted in the privatization of ever more services —the police force in Phoenix, for instance, deals with certain kinds of crimes, but at night there is a Militia in charge, and there is a curfew in place—, including the healthcare of the veterans of the many wars that the American military has participated in, and there are large interests involved in all these services. And, of course, those can be manipulated by less than scrupulous people. The most worrying part of the story is that it feels very realistic. It does not take a big stretch of the imagination to see something like this happening, and perhaps with an end far less satisfying than that of the novel (which I liked).
In summary, this is a novel for lovers of conspiracy theories and/or fairly realistic spy thrillers, that like puzzles and complex plots and don’t shy away from hard topics. The author injects her knowledge into the story without overwhelming it and the research is well integrated into the plot. There is no graphic violence and no romance here but a dire warning of how things could end up if money continues to be the governments’ (not only that of the USA) only consideration when dealing with people’s wellbeing. The characters are not as important as the story, but I think there is room for their development in future instalments. As a note to the author, I wonder if a list of characters might help people not to get lost, especially at the beginning of the book. I know that because of the nature of the plot, it might be difficult to do that without spoiling some of the surprises, although there might be ways around it. I will keep a close watch on the author’s writing career.
Thanks to Rosie and to her team for the ongoing support, thanks to all of you for reading, and remember to like, share, comment, and review, if you’re so inclined, but always keep smiling!
The first book for the general public about mindfulness and medical practice, a groundbreaking, intimate exploration of how doctors think and what matters most—safe, effective, patient-centered, compassionate care—from the foremost expert in the field.
As a third-year Harvard Medical School student doing a clinical rotation in surgery, Ronald Epstein watched an error unfold: an experienced surgeon failed to notice his patient’s kidney turning an ominous shade of blue. In that same rotation, Epstein was awestruck by another surgeon’s ability to avert an impending disaster, slowing down from autopilot to intentionality. The difference between these two doctors left a lasting impression on Epstein and set the stage for his life’s work—to identify the qualities and habits that distinguish masterful doctors from those who are merely competent. The secret, he learned, was mindfulness.
In Attending, his first book, Dr. Epstein builds on his world-renowned, innovative programs in mindful practice and uses gripping and deeply human clinical stories to give patients a language to describe what they value most in health care and to outline a road map for doctors and other health care professionals to refocus their approach to medicine. Drawing on his clinical experiences and current research, and exploring four foundations of mindfulness—Attention, Curiosity, Beginner’s Mind, and Presence—Dr. Epstein introduces a revolutionary concept: by looking inward, health care practitioners can grow their capacity to provide high-quality care and the resilience to be there when their patients need them.
The commodification of health care has shifted doctors’ focus away from the healing of patients to the bottom line. Clinician burnout is at an all-time high. Attending is the antidote. With compassion and intelligence, Epstein offers a crucial, timely book that shows us how we can restore humanity to medicine, guides us toward a better overall quality of care, and reminds us of what matters most.
“This book is phenomenal, and will be phenomenally useful to physicians and to all of us who are desperately in need of true health care and caring. It is hard for me to imagine a doctor reading it and not immediately recognizing, taking to heart, and implementing its messages in any number of different ways, being so commonsensical, clear, innately transformative, and healing. And it is equally hard for me to imagine that it will not energize all of us, when we find ourselves in the role of ‘the patient,’ to demand greater mindfulness from our care-givers across the board, and know what we mean by that.”—Jon Kabat-Zinn, author of Full Catastrophe Living and Mindfulness for Beginners
“As a student admissions committee member reviewing Ron Epstein’s application to medical school, I knew he was special, a view surpassed by his visionary achievements illuminating the important nature of how physicians care for their patients, and how they can best care for themselves. Attending is the book every medical caregiver needs to strengthen their minds and harness their resilience to care for others—and every patient needs to understand how doctors think. This is a work of heart and head, a beautiful synthesis of inner wisdom and hard earned scientific empirical findings that point the way to proven methods for improving the lives of both giver and receiver of medical care. With clear explanations, captivating stories, and well-described challenges and approaches to their solutions, this book is exactly what the field of medicine needs.”—Daniel J. Siegel, M.D., author of Mind and The Mindful Brain and Executive Director, Mindsight Institute Founding Co-Director, UCLA Mindful Awareness Research Center
“I recommend Attending for anyone interested in health. In a most accessible way, Epstein makes a very convincing case for how doctors and patients would prosper from doctors becoming more mindful.”—Ellen Langer, PhD, Professor of Psychology, Harvard University, author of Mindfulness and Counterclockwise: Mindful Health and the Power of Possibility
“This powerful and inspiring book opens the pathway to bringing care, wisdom, and mindfulness into practice of medicine. A must-read for all clinicians and for lay readers as well.”–Joan Halifax, PhD, author of Being With Dying
“Ronald Epstein cuts through the cacophony and illuminates the heart of the medical enterprise—the attentive and compassionate connection between doctor and patient. In a world awash with medical error, patient dissatisfaction, and burned-out doctors, this attention to mindfulness is much needed balm. Attending is at once penetrating, counterintuitive, and profoundly humbling.”–Danielle Ofri, MD, PhD, author of What Patients Say, What Doctors Hear
“Attending got my attention from the opening paragraphs. Beautiful, compelling, and wise stories of how medicine and care-taking can be, (should be) when approached with common sense, a fierce sense of what is best for both the doctor and patient, and a compassionate heart. A timely and important book!”–Marc Lesser, CEO of Search Inside Yourself Leadership Institute (SIYLI) and author of Know Yourself, Forget Yourself and LESS: Accomplishing More By Doing Less
“Ronald Epstein truthfully and powerfully describes the challenging and changing worlds of both the physician and and the patient. Attending will encourage the recognition that mindfulness and compassion training contribute to effective medicine. The book clearly demonstrates how these contemplative practices can help enrich the lives of everyone involved in health care.”–Sharon Salzberg, author of Lovingkindness and Real Happiness
“Epstein presents for general readers a concise guide to his view of what mindfulness is, its value, and how it is a skill that anyone can work to acquire.”–Library Journal
“A deeply informed and compassionate book…[Dr. Epstein] tells us that it is a ‘moral imperative’ to do right by our patients. And he shows why and how.”--Lloyd Sederer, New York Journal of Books
“Vivid… Epstein’s candor and courage…that makes the book so compelling.”–Pharos
“Among the best books about how to teach the humanistic aspects of doctoring. Epstein weaves together an insightful collection of experiences that examine the clinician’s situation starting from inside her own mind and ending at the system in which she practices.”–Gold Foundation
“Thoughtful company in times when we’ve never needed thoughtful company more.”–Harvard Medicine
Dr. Ronald Epstein is a practicing family physician, is a professor of family medicine, psychiatry, and oncology at the University of Rochester School of Medicine and Dentistry, where he directs the Center for Communication and Disparities Research and codirects Mindful Practice programs. He is an internationally recognized educator, writer, and researcher whose landmark article, “Mindful Practice,” published in the Journal of the American Medical Association in 1999, has revolutionized physicians’ view of their work. Dr. Epstein has been named one of America’s Best Doctors every year since 1998 by U.S. News & World Report. Visit Dr Epstein at RonaldEpstein.com.
Thanks to Net Galley and to Scribner for providing me with an ARC copy of this book that I freely chose to review.
If they asked me to provide a single word review of this book, I would write AMEN.
Ronald Epstein, the author and practising doctor with his own clinic, after years of studying a variety of disciplines (including music, meditation, Philosophy, Zen, Medicine…) and of trying to find the best way to maintain a practice sensitive to the needs of patients, compassionate, focused on well-being and avoiding suffering, rather than on billing, money and the business-side of things, published an article called ‘Mindful Practice’ in 1999. The article was very well received and resulted in the author becoming a speaker and offering training to other health professionals, emphasising the important of being mindful of one’s practice. In this book, the author shares his insight and knowledge to help other physicians avoid errors, burnout, and remember what Medicine should really be about. He offers plenty of background research and information (with abundant notes that take up more than a third of the book and a useful bibliography for those who want to check the original sources) interspersed with case stories that illustrate the topics. These include cases Dr Epstein had personal experience of (both as a physician and as a patient) and others that he’s accumulated over years of educating other professionals and talking to friends and colleagues. These cases not only reinforce the theoretical points but also add a practical and personal touch that can be lost in purely theoretical texts.
The book is written in a fluid and clear style, accessible and interesting also to those who might not work in healthcare, although it is particularly geared towards health professionals. Due to the themes and subjects touched upon, this book would be useful to individuals and institutions heavily invested in helping people and dealing with the public, in particular, those offering care. Although many of the reflections are particularly pertinent to individuals, the emphasis on education and the fact that many of the qualities discussed, like compassion and resilience can be taught, are particularly important for organisations and institutions that manage human resources. As Dr Epstein explains, they would go a long way to help avoid professional burnout.
Although Attending mentions Zen, neurocognitive studies, philosophers’ books, mindfulness and meditation, the overall message does not require an in-depth knowledge of any of those subjects and I cannot imagine anybody who would not find something useful in this volume.
As a doctor and one who left the job a few years back less than enamoured with the way health care is organised, I kept nodding all the way through. I highlighted so many sentences and quotes that I cannot share them all, but I will choose a few ones that I felt were particularly pertinent:
Medicine is in crisis. Physicians and patients are disillusioned, frustrated by the fragmentation of the health care system. Patients cannot help but notice that I spend more and more time looking at computer screens and less time face-to-face. They experience the consequences of the commodification of medicine that has forced clinicians’ focus from the healing of patients to the mechanics of health care —productivity pressures, insurance regulations, actuarial tasks, and demoralizing metrics that measure what can be counted and not what really counts, sometimes ironically in the name of evidence-based and patient-centered care.
Maslach found that burnout consisted of three factors: emotional exhaustion, depersonalisation (treating people as objects), and a feeling of low personal accomplishment.
But now, in the age of the corporatization and widgetization of medicine, there is a new kind of burnout, a slow, relentless “deterioration of values, dignity, spirit and will” that comes from the structure of health care itself.
The problem is not only overwork; it’s a crisis of meaning, resilience, and community.
As I said, I think this book should be required reading for medical students, qualified doctors and also for other professionals working in healthcare and those who manage staff and organise the educational programmes of institutions, not only those providing healthcare but also any that deal with the public and its problems on a regular basis.
If I were to make a suggestion, it would be that the book could easily be made even more relevant to other disciplines by adding examples pertaining to other professions (not only nurses or paramedics but also social workers, counsellors, teachers…). It is clear from the content that although the principles can be applied individually, organisations would also do well adopting the ideals and attitudes highlighted by the research. Becoming attentive, compassionate, curious and mindful would help patients and staff increase their wellbeing and avoid burnout and complaints.
I recommend this book to all healthcare professionals, and those interested in how to improve healthcare and increase the resilience and wellbeing of staff. I think that anybody could potentially benefit from this book, and I’d recommend checking the sample if you think it might help you. I will definitely recommend it to some of my previous work colleagues.
Thanks to Scribner and to the author, thanks to all of you for reading and remember to like, share, comment and CLICK! And don’t forget to leave a review if you read a book.
Strictly Necessary Cookies
Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.
If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.