The need for caregiving is enormous. Thanks to extraordinary advances in medical technology, Americans are surviving illnesses and injuries that would have killed them a generation ago, and more of us are living into our eighties and nineties than ever before. Yet most people over sixty-five live with the burden of one or more chronic illness. The problems created by the caregiving needs of these and other groups are at the center of several of the most explosive political issues of our time: health care, welfare, child care, and family leave. These issues can be resolved, the editors of this volume contend, only when we as a society understand and value the work of caregiving and provide support for professional and family caregivers. The editors of this volume look not only at the financial, emotional, and physical demands of giving and receiving care but at the strengths and rewards inherent in the world of caregiving. This far-reaching book explores the depth and complexity of caregiving, from practice and personal experience, to ethics and policymaking, to home and institutional care.

We are on the verge of the nation's worst nursing shortage in history. Dedicated nurses are leaving hospitals in droves, and there are not enough new recruits to the profession to meet demand. Even hospitals that were once very highly regarded for the quality of their nursing care, such as Boston's Beth Israel Deaconess Medical Center, now struggle to fill vacant positions. What happened?

Dana Beth Weinberg argues that hospital restructuring in the 1990s is to blame. In their attempts to retain profit margins or even just to stay afloat, hospitals adopted a common set of practices to cut costs and increase revenues. Many strategies squeezed greater productivity out of nurses and other hospital workers. Nurses' workloads increased to the point that even the most skilled nurses questioned whether they could provide minimal, safe care to patients. As hospitals hemorrhaged money, it seemed that no one not hospital administrators, not doctors felt they could afford to listen to nurses.

Through a careful look at the effects of the restructuring strategies chosen and implemented by Beth Israel Deaconess Medical Center, the author examines management's efforts to balance service and survival. By showing the effects of hospital restructuring on nurses' ability to plan, evaluate, and deliver excellent care, Weinberg provides a stinging indictment of standard industry practices that underestimate the contribution nurses make both to hospitals and to patient care."

In Our Veterans, Suzanne Gordon, Steve Early, and Jasper Craven explore the physical, emotional, social, economic, and psychological impact of military service and the problems that veterans face when they return to civilian life. The authors critically examine the role of advocacy organizations, philanthropies, corporations, and politicians who purport to be "pro-veteran." They describe the ongoing debate about the cost, quality, and effectiveness of healthcare provided or outsourced by the Department of Veterans Affairs (VA). They also examine generational divisions and political tensions among veterans, as revealed in the tumultuous events of 2020, from Black Lives Matter protests to the Trump-Biden presidential contest. Frank and revealing, Our Veterans proposes a new agenda for veterans affairs linking service provision to veterans to the quest for broader social programs benefiting all Americans.

In Our Veterans, Suzanne Gordon, Steve Early, and Jasper Craven explore the physical, emotional, social, economic, and psychological impact of military service and the problems that veterans face when they return to civilian life. The authors critically examine the role of advocacy organizations, philanthropies, corporations, and politicians who purport to be "pro-veteran." They describe the ongoing debate about the cost, quality, and effectiveness of healthcare provided or outsourced by the Department of Veterans Affairs (VA). They also examine generational divisions and political tensions among veterans, as revealed in the tumultuous events of 2020, from Black Lives Matter protests to the Trump-Biden presidential contest. Frank and revealing, Our Veterans proposes a new agenda for veterans affairs linking service provision to veterans to the quest for broader social programs benefiting all Americans.

In The Battle for Veterans' Healthcare, award-winning author Suzanne Gordon takes us to the front lines of federal policymaking and healthcare delivery, as it affects eight million Americans whose military service makes them eligible for Veterans Health Administration (VHA) coverage. Gordon's collected dispatches provide insight and information too often missing from mainstream media reporting on the VHA and from Capitol Hill debates about its future. Drawing on interviews with veterans and their families, VHA staff and administrators, health care policy experts and Congressional decision makers, Gordon describes a federal agency under siege that nevertheless accomplishes its difficult mission of serving men and women injured, in myriad ways, while on active duty. The Battle for Veterans' Healthcare is an essential primer on VHA care and a call to action by veterans, their advocacy organizations, and political allies. Without lobbying efforts and broader public understanding of what's at stake, a system now functioning far better than most private hospital systems may end up looking more like them, to the detriment of patients and providers alike.

The U.S. healthcare system is now spending many millions of dollars to improve "patient safety" and "inter-professional practice." Nevertheless, an estimated 100,000 patients still succumb to preventable medical errors or infections every year. How can health care providers reduce the terrible financial and human toll of medical errors and injuries that harm rather than heal?

Beyond the Checklist argues that lives could be saved and patient care enhanced by adapting the relevant lessons of aviation safety and teamwork. In response to a series of human-error caused crashes, the airline industry developed the system of job training and information sharing known as Crew Resource Management (CRM). Under the new industry-wide system of CRM, pilots, flight attendants, and ground crews now communicate and cooperate in ways that have greatly reduced the hazards of commercial air travel.

The coauthors of this book sought out the aviation professionals who made this transformation possible. Beyond the Checklist gives us an inside look at CRM training and shows how airline staff interaction that once suffered from the same dysfunction that too often undermines real teamwork in health care today has dramatically improved. Drawing on the experience of doctors, nurses, medical educators, and administrators, this book demonstrates how CRM can be adapted, more widely and effectively, to health care delivery.

The authors provide case studies of three institutions that have successfully incorporated CRM-like principles into the fabric of their clinical culture by embracing practices that promote common patient safety knowledge and skills.They infuse this study with their own diverse experience and collaborative spirit: Patrick Mendenhall is a commercial airline pilot who teaches CRM; Suzanne Gordon is a nationally known health care journalist, training consultant, and speaker on issues related to nursing; and Bonnie Blair O'Connor is an ethnographer and medical educator who has spent more than two decades observing medical training and teamwork from the inside.

The reassuring bromides of "chicken soup for the soul" provide little solace for nurses and the people they serve in real-life hospitals, nursing homes, schools of nursing, and other settings. In the minefield of modern health care, there are myriad obstacles to quality patient care including work overload, inadequate funds for nursing education and research, and poor communication between and within the professions, to name only a few. The seventy RNs whose stories are collected here by the award-winning journalist Suzanne Gordon know that effective advocacy isn't easy. It takes nurses willing to stand up for themselves, their coworkers, their patients, and the public.

When Chicken Soup Isn't Enough brings together compelling personal narratives from a wide range of nurses from across the globe. The assembled profiles in professional courage provide new insight into the daily challenges that RNs face in North America and abroad and how they overcome them with skill, ingenuity, persistence, and individual and collective advocacy at work and in the community. In this collection, we meet RNs working at the bedside, providing home care, managing hospital departments, teaching and doing research, lobbying for quality patient care, and campaigning for health care reform.

Their stories are funny, sad, deeply moving, inspiring, and always revealing of the different ways that nurses make their voices heard in the service of their profession. The risks and rewards, joys and sorrows, of nursing have rarely been captured in such vivid first-person accounts. Gordon and the authors of the essays contained in this book have much to say about the strengths and shortcomings of health care today and the role that nurses play as irreplaceable agents of change."

Legally mandated nurse-to-patient ratios are one of the most controversial topics in health care today. Ratio advocates believe that minimum staffing levels are essential for quality care, better working conditions, and higher rates of RN recruitment and retention that would alleviate the current global nursing shortage. Opponents claim that ratios will unfairly burden hospital budgets, while reducing management flexibility in addressing patient needs.

Safety in Numbers is the first book to examine the arguments for and against ratios. Utilizing survey data, interviews, and other original research, Suzanne Gordon, John Buchanan, and Tanya Bretherton weigh the cost, benefits, and effectiveness of ratios in California and the state of Victoria in Australia, the two places where RN staffing levels have been mandated the longest. They show how hospital cost cutting and layoffs in the 1990s created larger workloads and deteriorating conditions for both nurses and their patients leading nursing organizations to embrace staffing level regulation. The authors provide an in-depth account of the difficult but ultimately successful campaigns waged by nurses and their allies to win mandated ratios. Safety in Numbers then reports on how nurses, hospital administrators, and health care policymakers handled ratio implementation.

With at least fourteen states in the United States and several other countries now considering staffing level regulation, this balanced assessment of the impact of ratios on patient outcomes and RN job performance and satisfaction could not be timelier. The authors' history and analysis of the nurse-to-patient ratios debate will be welcomed as an invaluable guide for patient advocates, nurses, health care managers, public officials, and anyone else concerned about the quality of patient care in the United States and the world."

Life Support offers an intimate and important look at what nurses do for patients and their families. It takes us right to the bedside on hospital wards and home visits, in clinics and emergency rooms, capturing the drama of nurses' work in the story of three RNs at Boston's Beth Israel Hospital. Gordon's heroines are nurse practitioner Ellen Kitchen, who bicycles through poor neighborhoods in Boston to visit elderly patients at home; oncology nurse Nancy Rumplik, whose technical skill and emotional support enable cancer patients to endure some of the most arduous high-tech medical treatments; and clinical nurse specialist Jeannie Chaisson, who helps new RNs and physicians begin their careers on a general medical floor. Life Support draws on the experience of these and other nurses to examine the history of their profession, the complex relationship between doctors and nurses, and the central role that nurses play in the final days of life, when care, not cure, is a patient's main concern. In addition, the book makes a powerful critique of hospital restructuring and managed care. Gordon shows how understaffing, shorter hospital stays, layoffs, and replacement of nurses by unlicensed personnel are threatening the quality of care and shifting more of its burden onto patients' families. She describes what consumers can do to resist these trends - through alliances with concerned providers.

"Nursing, everyone believes, is the caring profession. Texts on caring line the walls of nursing schools and student shelves. Indeed, the discipline of nursing is often known as the 'caring science.' Because of their caring reputation, nurses top the polls as the most-trustworthy professionals. Yet, in spite of what seems to be an endless outpouring of public support, in almost every country in the world nursing is under threat, in the practice setting and in the academic sector. Indeed, its standing as a regulated profession is constantly challenged. In our view, this paradox is neither accidental nor natural but, in great part, the logical consequence of the fact that nurses and their organizations place such a heavy emphasis on nursing's and nurses' virtues rather than on their knowledge and concrete contributions." from the Introduction

In a series of provocative essays, The Complexities of Care rejects the assumption that nursing work is primarily emotional and relational. The contributors-international experts on nursing- all argue that caring discourse in nursing is a dangerous oversimplification that has in fact created many dilemmas within the profession and in the health care system. This book offers a long-overdue exploration of care at a pivotal moment in the history of health care. The ideas presented here will foster a critical debate that will assist nurses to better understand the nature and meaning of the nurse-patient relationship, confront challenges to their work and their profession, and deliver the services patients need now and into the future.

Contributors: Sanchia Aranda, University of Melbourne and Peter MacCallum Cancer Centre; Rosie Brown, University of Melbourne; Sean Clarke, University of Pennsylvania and University of Montreal; Suzanne Gordon; Marie Heartfield, University of South Australia; Tom Keighley, Royal College of Nursing; Diana J. Mason, American Journal of Nursing; Lydia L. Moland, Babson College; Sioban Nelson, University of Toronto; Dana Beth Weinberg, Queens College, CUNY"

Through a careful look at the effect of restructuring strategies chosen and implemented by Beth Israel Medical Center, the author examines management's efforts to balance service and survival.

U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their "wounds of war" are treated by the largest hospital system in the country-one that has come under fire from critics in the White House, on Capitol Hill, and in the nation's media. In Wounds of War, Suzanne Gordon draws on five years of observational research to describe how the VHA does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. In the unusual culture of solidarity between patients and providers that the VHA has fostered, Gordon finds a working model for higher-quality health care and a much-needed alternative to the practice of for-profit medicine.

For more than a decade, From Silence to Voice has been providing nurses with communication tools they can use to win the resources and respect they deserve. Now, in a timely third edition, authors Bernice Buresh and Suzanne Gordon focus on how nurses can describe and frame their work to seize unprecedented opportunities to advance their profession and lead improvements in health care systems.

The authors, both journalists, argue that because nursing needs the support and cooperation of others to fulfill its potential, it is critical that nurses communicate the full scope of nursing practice. Nurses must go beyond describing nursing in terms of dedication and caring and articulate nurses' specialized knowledge and expertise.

From Silence to Voice helps nurses explain their contributions to patient safety, satisfaction, and outcomes. It shows how nurses can communicate with various publics about important aspects of their work, such as how they master and employ complex medical technologies and regimens, and how they use their clinical judgment in life-and-death situations. "Nurses and nursing organizations," the authors write, must go out and tell the public what nurses really do so that patients can actually get the benefit of their expert care.

This comprehensively revised and updated third edition helps nurses use a range of traditional and social media to accurately describe the true nature of their work. Its analyses of images that are projected by nursing campaigns and its detailed guidance in helping nurses construct positive and powerful narratives of their work make From Silence to Voice a must-read in nursing schools and organizations and by individual nurses in all areas of the profession. Because nurses are busy, many of the communication techniques in this book are designed to integrate naturally into nurses everyday lives and to complement nurses work with patients and families."

"Nursing, everyone believes, is the caring profession. Texts on caring line the walls of nursing schools and student shelves. Indeed, the discipline of nursing is often known as the 'caring science.' Because of their caring reputation, nurses top the polls as the most-trustworthy professionals. Yet, in spite of what seems to be an endless outpouring of public support, in almost every country in the world nursing is under threat, in the practice setting and in the academic sector. Indeed, its standing as a regulated profession is constantly challenged. In our view, this paradox is neither accidental nor natural but, in great part, the logical consequence of the fact that nurses and their organizations place such a heavy emphasis on nursing's and nurses' virtues rather than on their knowledge and concrete contributions." from the Introduction

In a series of provocative essays, The Complexities of Care rejects the assumption that nursing work is primarily emotional and relational. The contributors-international experts on nursing- all argue that caring discourse in nursing is a dangerous oversimplification that has in fact created many dilemmas within the profession and in the health care system. This book offers a long-overdue exploration of care at a pivotal moment in the history of health care. The ideas presented here will foster a critical debate that will assist nurses to better understand the nature and meaning of the nurse-patient relationship, confront challenges to their work and their profession, and deliver the services patients need now and into the future.

Contributors: Sanchia Aranda, University of Melbourne and Peter MacCallum Cancer Centre; Rosie Brown, University of Melbourne; Sean Clarke, University of Pennsylvania and University of Montreal; Suzanne Gordon; Marie Heartfield, University of South Australia; Tom Keighley, Royal College of Nursing; Diana J. Mason, American Journal of Nursing; Lydia L. Moland, Babson College; Sioban Nelson, University of Toronto; Dana Beth Weinberg, Queens College, CUNY"

U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their "wounds of war" are treated by the largest hospital system in the country-one that has come under fire from critics in the White House, on Capitol Hill, and in the nation's media. In Wounds of War, Suzanne Gordon draws on five years of observational research to describe how the VHA does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. In the unusual culture of solidarity between patients and providers that the VHA has fostered, Gordon finds a working model for higher-quality health care and a much-needed alternative to the practice of for-profit medicine.