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Many aspects of nursing have changed over the years. Increased knowledge, technology, and medical treatment have altered how we give nursing care. Changes  in health care policies and reimbursement have also led to changes in health care maintenance and treatment. As nurse educators, we alter our teaching strategies to incorporate change, but how can we ensure the survival of the important and unchanging foundations of nursing care? Harriet Forman emphasizes the need for a renewed focus on the patient.

Using phenomenology, a study of experiences, Forman interviewed patients and their families, listening with the “third ear” to understand their thoughts and feelings. She also spoke with managers, nurses, and support personnel. Presenting their stories. she shows how the breakdown of patient care happens and leads to complications in care. Nursing leadership can help bring about changes in nursing care. The main form of management Forman recommends is management by walking around, and educating employees by teaching by example. Forman reminds us that nurse managers were often great staff nurses, and the care they gave to patients should be shared with others.

Each chapter of this book teaches nurses how to make patient-centered care a priority. One chapter is on the three Cs (collaboration, cooperation, and communication), areas that, if absent, compromise patient care. In several eyeopening vignettes, Forman demonstrates how loss of the three Cs led to unhappy nurses and support staff, which developed into inadequate patient care. When nurses take their eyes off themselves and place them on the people they are there to care for, the three Cs improve and there is greater satisfaction.

Organization charts in most hospitals are hierarchal, starting with the CEO or president and continuing down to include all employees. There is no patient on this chart, something that needs to change. Patients need to be the focus of organizational charts, with all employees, including staff nurses, managers, and CEOs, basing their decisions of patient concerns. Other things that influence patient-centered care include union organizations, cultural differences, ethical dilemmas, personality differences, spiritual challenges, and grief. Each of these can affect patient-centered care and often have a negative impact if they are not given consideration. This book should be read by every nurse manager. Nursing students and faculty will benefit from reading it as well.

Lisa M. Young, MSN, RN, CNS, director of simulation, Ashland University Dwight Schar College of Nursing, Ashland, Ohio
Appeared in " Book Ends " , Nursing Education Perspectives, National League for Nursing, September/October Vol. 32 No. 5, (343).


I really like it. Good topics and issues. The vignettes provide  great examples that could lead to rich classroom  or workshop discussions. Perfect for leadership/management courses and in health care organizations...

I can envision the book being used for RN to BSN classes and for ongoing discussions among nurse managers in an organization that is trying to be more patient-centered and/or a nursing dept trying to develop its frontline managers, I certainly recommend it.

Diana Mason, PhD, C, FAAN, RN, Editor Emeritus, American Journal of Nursing, Professor of Nursing, Rudin Chair, Hunter-Bellevue College of Nursing,