Review

Don’t forget the nurses

WORKING WITH OLDER PEOPLE AND THEIR FAMILIES
Mike Nolan, Sue Davies and Gordon Grant (eds)
Open University Press, 2001, £17.99

While geriatric nursing continues to be seen as a professional dead end, it will be difficult to raise standards of service delivery and levels of training. This and the knowledge that we have an increasingly ageing population led the English National Board for Nursing, Midwifery and Health Visiting to set up a three-and-a-half year longitudinal evaluation of the educational preparations for nurses working in the field.

This is the first big output of the study but there is more to come. Its central message is an important one: that the welfare of staff has to be considered alongside, and as part of, the welfare of service users. However, in all the hype about working towards empower the user, promoting choice and ever more partnership, there is little mention of staff, who are often simply left to get on with it.

The fact that there is a basic conflict between promoting user choice and keeping within inadequate budgets (flagged up early on by the authors) gets lost in the rhetoric. Staff get little recognition for what they have to go through, and even less guidance on how to cope with the double binds and mixed messages that result.

Good management, as the authors frequently note, should provide the necessary support, but the main focus of the research is the nursing professional not the manager. It may well be that basic professional courses should in future include a module on how to manage your manager.

Much of the book targets academic nursing, with surveys of the literature and lists and tables outlining good practice. This is heavy-going stuff, albeit very worthy. The aim has been to draw on the disparate literatures in the various relevant fields – nursing, medicine, psychology, social gerontology and social work – and focus on good practice in the care of older people.

There are useful specialist chapters on acute and rehabilitative care, continuing care, palliative care, mental health needs, and the needs of older people with learning disabilities. The book will be a good buy for workplace libraries, although mainstream professionals are likely to give it a miss.