Lavish praise for the nursing profession interwoven with dire warnings about the threat to its future posed by the growth of managed care. At Boston's Beth Israel Hospital, Gordon (Off Balance: The Real World of Ballet, 1983; Prisoners of Men's Dreams: Striking Out for a New Feminism, 1990; etc.) spent over two years following the daily routines of three registered nurses: Nancy Rumplik, an outpatient nurse in an ambulatory cancer clinic; Jeannie Chaisson, a clinical nurse specialist on a general medical floor; and Ellen Kitchen, a nurse-practitioner in the hospital's home-care service. Gordon shows us Nancy dealing with angry, frightened patients, Jeannie sharing her wisdom with younger nurses, and Ellen bicycling to the homes of Boston's homebound elderly poor. By describing in detail the work of three highly skilled and experienced RNs- -together they have a total of more than 50 years of experience- -Gordon shows us nursing at its very best. Empathic, sensitive, knowledgeable, and conscientious, they seem exceptional, but Gordon stresses that there are hundreds of thousands like them. Nursing, she reminds us, is the largest profession in health care and the largest female profession in America. The catch is, bedside RNs are an endangered species. Long regarded as physicians' handmaidens, they are now, reports Gordon, seen as expendable luxuries by the managers of for-profit hospitals seeking to maximize their bottom line. Hospital patients are increasingly likely to be tended by unlicensed ``patient care technicians'' or by temporary and floating staff unfamiliar with either the patients or the hospital's routines. Gordon's paean to nurses thus also serves as a call to arms. In order to protect ourselves, she warns, we must act now to protect the nursing profession. A convincing demonstration that, in a world of impersonal and complex high-tech treatments, a real nurse is the best medicine.
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