Book Review
Patient and person. Developing interpersonal skills in nursing
Jane Stein-Parbury
ISBN: O 443 04253 5; 1993; 333 pages; Churchill Livingstone Melbourne;
Jan Horsfall
Associate Professor, Mental Health Nursing, Faculty of Nursing, University of Sydney, NSW
At the outset Stein-Parbury declares her awareness of the challenge of negotiating a sensitive and practical space in between the concrete recipe approach to interpersonal skills and an impractical abstract orientation. In my opinion she has situated the text in the viable middle ground and provided experiential learning activities for lecturers to facilitate and/or students to take up as individuals or in groups. I will outline the contents of the book because they convey most clearly how this text differs from others and where its strengths lie. In the very brief first chapter Stein- Parbury articulates some common problematic interpersonal patterns in nursing practice.
These include a focus on doing; controlling patients; not listening; speaking precipitously; and fear of feelings-our own and others'. This introduction could/should alert any student or practising RN to the importance of conscious awareness of communication intentions and outcomes. Having been convinced by her beginning exemplars I was easily led into the second chapter wherein the self of the nurse and the patient are placed on centre stage, and processes such as values clarification and reflection on and in practice are highlighted. The third chapter focuses on listening which is a simple but powerful aspect of communicating which can make the difference between patient satisfaction and patient disgruntlement. Chapter 4 devolves on empathy and other basic counselling skills.
Having concentrated on the processes intrinsic to therapeutic communication for four chapters the author leads into the fifth chapter on data collection wherein she confronts the perennial penchant asking 'why?'. In the sixth chapter she investigates the how of 'reassuring the patient' rather than reassuring the nurse. Continuing with issues vital for undergraduate students, the author compares and contrasts 'social' and 'professional' relationships and pursues the complex and practical aspects of 'closeness' vis-avis 'distance'.
The eighth chapter is contributed by Crisp and Nagy. They deal with the influence of culture and age on nursing activities. As a sociologist I find it disconcerting that gender is sues are outside the authors' agenda. Nursing is permeated with gender-power issues and it is most unfortunate that a complex text would ignore these facts and thereby deny their existence. Chapter nine investigates crisis intervention drawing on Donna Aguilera's excellent model.
It also deals, perhaps too succinctly, with patterns of human response to illness and hospitalization. The book concludes with an important chapter on collegial relations. Stein- Parbury discusses the serious issues of lack of time and support for nurses in the workplace. Proactive (rather than reactive) methods of confronting these factors will devolve on the confident and assertive use of the skills that the author has outlined in this superior textbook.
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