Rehabilitation Nursing for the Neurological Patient.

Rehabilitation Nursing for the Neurological Patient

Hanak M. New York, NY 10012-3955, Springer Publishing Co Inc, 1992, hardback, 299 pp, illus, $32.95.

The stated purpose of this book is "to serve as a resource to maximize each nurse's effectiveness in this multifaceted role of teacher, coordinator, care provider, counselor, and facilitator." Part 1 focuses on the summaries of three areas of responsibility for the rehabilitation nurse: several health and wellness models that are holistic in focus, a neurophysiological basis for learning, and factors that modify the nurse's ability to provide effective patient education. A brief review of elementary neuroanatomy and pathophysiology is included. Part 2 reviews the physiology, pathophysiology, and nursing management of the neurogenic bladder, the neurogenic bowel, dysphagia, and problems associated with sexuality. Part 3 includes the pathophysiology and nursing interventions for the specific disabilities of traumatic brain injury, spinal cord injury, cerebro vascular accident, multiple sclerosis, amyotrophic lateral sclerosis, and Parkinson's disease.

The scope of the book is broad, but its brevity (207 pages of text) does not allow for sufficient coverage of each topic. All of the illustrations are anatomical diagrams taken from older texts. Some conflict between the written text and the tables was noted. An example of this is when the reader is advised to avoid using baby food in the diet of a person with dysphagia, as this can undermine his or her self-concept, yet Table 6-2, titled "Dysphagia Diet Progression," lists baby food fruits, vegetables, and meats as foods of choice for diet level 1. Another conflict in the information presented could result in confusion and a possibly significant error in the thinking of the reader. The sequential analysis of language tasks, mathematical calculations, and abstractions arc assigned to the left hemisphere of the brain in one reference early in the book and, by inference, to the right hemisphere later in the book where it is stated: "A person with right hemisphere damage is most likely to have difficulty with verbal learning, math calculations and abstractions."

References are listed at the close of each chapter, but few are cited in the actual text. Also included are a short glossary and two appendixes that contain an additional reference list and a list of organizations. The book is indexed.

It is difficult for me to assess accurately how well the book serves its stated purpose, as I am not a nurse. It seems that a well-prepared nurse with good technical skills may find the asessment, diagnosis, outcome, and intervention lists included in each chapter of parts 2 and 3 useful as memory cues concerning what should be considered or done for each patient problem or diagnosis. I do not believe, however, that the book would be useful to a practicing physical therapist or physical therapist assistant, as the content deals specifically with the role of the rehabilitation nurse. It does not address the relationships that should exist between the rehabilitation nurse and other members of the rehabilitation team. The role of supervisor is implied for the rehabilitation nurse because several tasks are assigned to the physical therapist.