330 Intensive a

Book Reviews

Manual of Conscious Sedation: A Manualfor NursesBy Michael Kost MSN, CRNAWB Saunders, Philadelphia, 1997, 21.95, 346 pp

Conscious sedation includes all patients undergoingprocedures which require an ability to maintain theirown airway and respond appropriately to physical andverbal stimuli. The scope of such procedures is rapidlyexpanding with the increase in minimally invasivesurgery and sophisticated diagnostic procedures. Thetext is directed towards the US Registered Nursepractising either as a nurse anaesthetist oranaesthetic/recovery nurse. The text draws on legalguidelines, and offers guidelines for auditing clinicalcompetencies and establishing an educational trainingprogramme – all of which could prove useful to the UKpractitioner within this field. For the intensive carenurse, this manual is most useful, however, for itsclinical content. Key areas such as airway management,resuscitation, pharmacokinetics, and patientmonitoring are described succinctly and illuminated bythe use of excellent diagrams throughout. The book isdesigned as a manual to use as a quick reference guide.It succeeds because the large volume of information itcontains is well laid out and easy to access. For thepractitioner in the field of conscious sedation, it is ofexcellent value. For the intensive care nurses, it wouldprove a useful addition to the unit library.

Pat Smedley MSc, RGN, ENB 100

Critical Care Nursing: Diagnosis andManagement, 3rd ednBy Lynne A. Thelan, Linda D. Urden, Mary E. Loughand Kathleen M. StacyMosby Inc., St Louis, MI, 1998, £42.00, 1220 pages

This excellent and stimulating textbook uses an ‘eye’illustration throughout to symbolize the ‘“vision” thatcritical care nurses embody every day in theirprofession’. It focuses clearly on the future of practicethrough nurse-led assessment, diagnosis andmanagement. The authors promote a holistic andmultidisciplinary approach towards the needs ofpatients and relatives. The third edition includes newsections on co-ordination of critical care, pain andsedation, perianaesthesia and special populationsincluding paediatric patients in adult units, obstetrics,and care of the elderly. The latter is particularlypertinent to all adult critical care areas. The book has awide variety of high level contributors including clinicalnurse specialists, researchers and outcome managementconsultants. This US text equates well with Britishmoves towards evidence-based practice and clinicaleffectiveness. In addition, the book advocates the use ofcase management, critical pathways and algorithms toguide care. Importantly, the recent Audit CommissionReport on critical care services in England and Wales(1999) identified these as suitable methods forimproving consistency of care in ITU.

The American emphasis on nursing diagnosis ismade very accessible to British readers by basing each

nd Critical Care Nursing (2000) 16, 330–331

chapter on detailed ‘nursing interventionclassifications’. These are examples of identifiablepatient problems, such as mechanical ventilation, alongwith the research-based interventions required to tacklethem. The authors encourage readers to use criticalthinking and problem-solving skills to make nursingdiagnoses and management strategies. For example, the chapter on invasive haemodynamic monitoringincludes patient diagnoses and causes, interpretation of associated clinical findings, haemodynamic profiles,treatment and expected responses, trouble-shootingguides and clear diagrams. The chapters arecomplemented with relevant pharmacology andmedications, therapeutic management plans, patient education information, protocols andcomprehensive references. The book is accessible tojunior and critical care course nurses, yet still providesadvanced information for more experienced nurses.Learning is enhanced by frequent cross-links to otherrelevant chapters, copious case studies, publishedresearch abstracts and the availability of instructors’manuals and multimedia aids. A few areas of nursingcare, such as the section on intra-aortic balloon pumps, are less detailed than comparable texts.However, this appears to be the only drawback. Overall this book is highly recommended for unitlibraries and critical care nurses, particularly thoseundertaking specialist practice courses, who want a textwhich addresses today’s nursing issues as well as thefuture.

Myrna Scott MSc, BSc, RGN, ENB 100 998 Critical Care Nursing Research Assistant

City University, St Bartholomew’s School of Nursing& Midwifery London, UK

Short Practice of AnaesthesiaEdited by Maldwyn Morgan & George HallEdward Arnold, London, 1995, £75.00 (HB), 831 pp

Global changes in healthcare have seen an increase inthe specialization of both medicine and nursing. Interms of reference material and books, this hasmanifested itself in a move away from ‘generic’ texts tomuch more specialized books individual to particularsystems or sub-specialties. This is particularly evidentin anaesthesia, where there are few general textbooksavailable. They are criticized for being too brief and notdetailed enough for the purposes of postgraduateexamination in anaesthesia. There are few good UKtexts for nurses working in anaesthetics and recoverywho often have to rely on medical textbooks forinformation. Unwittingly, Morgan and Hall haveproduced a fine textbook for those nurses starting outin anaesthetics and recovery, or are studying for ENB183 at degree or diploma level. They have made a boldattempt to write a generic text that is, in some parts,exceptionally detailed. The individually writtenchapters have been well edited to provide continuity, inan authoritative style. The chapters are referencedexclusively from medical sources, with clear diagramsand tables throughout. There are some chapters that aresparsely populated with photographs when this style of

© 2000 Harcourt Publ i shers Ltd

Book reviews

© 2000 Harcour

presentation would have added to the clarity of theexplanations. The section on Post Anaesthetic Recoveryis disappointing and is only salvaged by twointeresting and pragmatic chapters on Pain & PostOperative Nausea and Vomiting (PONV), and FluidTherapy. There is little reference to the psychologicalimpact of recovery and alternative methods formanagement of Pain & PONV, but this is not unusual for a text written from a medical perspectiveand certainly does not detract from the chapter.

t Publ i shers Ltd Intensi

Generally, the book is of use as a reference sourceand would be a welcome addition to any nursinglibrary. It is one of the better ‘generic’ anaesthesia textson the market and may have a place in a theatre unitfor day-to-day referencing. However, the cost (£75) andlimited scope for experienced practitioners wouldpreclude it from individual purchase.

Mark Radford BSc, RGN, ENB 183Vice Chairman, British Anaesthetic & Recovery

Nurses Association; Editor, British Journal ofAnaesthetic & Recovery Nursing

ve and Critical Care Nursing (2000) 16, 330–331 331