Book Review
Mental health nursing: Strategies for working with the difficult client
D Arthur, J Dowling and R Sharkey
ISBN: 978-0729512091; 1992; 260 pages; WB Saunders, Sydney;
Michael Clinton
Faculty of Nursing and Faculty of Medicine, University of Calgary, Calgary AB, Canada; School of Nursing, American University of Beirut, Beirut, Lebanon
The authors set out to provide a book for students of nursing, mental health nurses and the consumers of mental health services. Their intention is to present and demonstrate the application of a model for mental health nursing practice, a model that addresses current and future needs of nurses working in the evolving field of mental health nursing practice.
Whilst the book is primarily aimed at the 'comprehensive' student, this work has been designed to help nurses make the transition to more traditional areas of psychiatric nursing. A final aim is to empower clients and their families to respond to political and economic changes. The authors make it clear that it is not their intention to use the term 'mental health nursing' as a euphemism for psychiatric nursing. They set out to operationalize their belief that '...every nursing situation involves mental health nursing, and that many examples of disturbed behaviour encountered by nurses occur not only in specialised mental health institutions but also in 'general' or community facilities' (p.1). A practical approach to systems-based nursing practice is then set out stressing the dual nursing roles of advocacy and empowerment.
The text includes chapters on the Arthur, Dowling and Sharkey (ADS) Model of nursing, and theories of the causes and treatment of aggression, non-cooperation, withdrawal, confusion, self-harm, anxiety, and grief. The authors have achieved a readable book and provide a synthesis of a wide range of literature. Their realistic case studies and valuable references will stimulate further reading and assist students to understand the scope of mental health nursing practice. The discussions of the problems nurses face in practice are followed up in each chapter by a step-to-step guide to formulating nursing diagnoses and interventions using the ADS Model.
The book is clearly written and amply supported by diagrams, its structure is consistent, and it provides documentation for nursing assessments. However, it attempts to achieve too much, perhaps at the expense of a more detailed consideration of the perspectives of consumers. Some mental health nurses may also take exception to the book's focus on 'problematic behaviours'. Overall, this is a clearly structured, simply written, informative text. However I am not convinced that the material is organized in a way that will be helpful to clients due to the many references, the amount of assumed knowledge, and the scant discussion of complex issues, and I would encourage the authors to write a companion book for clients and their families. Nevertheless the work includes useful appendices on psychiatric terminology, NANDA and related nursing diagnosis, psychopharmacology and an appropriate index.
This book is therefore highly recommended for students of mental health nursing and those who teach them.
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