Medicine And Books

Medicine and Nursing: Professions in a Changing Health Service

BMJ 1995; 311 doi: (Published 29 July 1995) Cite this as: BMJ 1995;311:339
  1. Alison Kitson

    Sylvia Walby, June Greenwell, Sage Publications, pounds sterling11.95, pp 224, ISBN 0 8039 87420

    Perhaps there is some comfort in realising that the massive changes we have experienced in the health service have been matched with similar levels of what one author describes as “grotesque turbulence” in almost every other public sector. For this reason alone Medicine and Nursing: Professions in a Changing Health Service is a timely and important book, of help to all of us facing our own type of change.

    Although derived from an academic research study looking at patterns of conflict and cooperation between doctors and nurses in acute hospitals, the book is written in a style that is both accessible and absorbing. In many respects it comes as no surprise that the sensitive areas between doctors and nurses relate to different opinions on treatment, differences in priorities, and the different experiences of caring for patients in many wards (doctors) as opposed to one (nurses).

    What is very helpful is how the authors use the evidence from their study to construct hypotheses as to how doctors and nurses are coping with the NHS reforms. Their description of the decentralised, flexible, multiskilled approach characterised by new management in the NHS is contrasted with the old habits and behaviour patterns. They ask the question, and the reader has to consider, whether, given the reality of many doctor's and nurse's experiences, the quest for a new management culture is nothing more than a puff of smoke masquerading as a “grotesque turbulence.”

    Medicine and Nursing is a thought provoking book that has wide appeal and will help all members of the multiprofessional team think through their roles and responsibilities, particularly in the light of changes in junior doctor's hours and the expansion of the nurse's role.—ALISON KITSON, director, centre for practice development and research, National Institute for Nursing, Oxford

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