Book Reviews
Freedom to Practise: The Development of Patient-centred Nursing
Binnie, A. & Titchen, A. Lathlean, J.
ISBN: 0-750640-75-8 1999 251 pages Butterworth-Heinemann, Oxford
Laurie S Bourke
Clinical Teacher, Tasmanian School of Nursing, Hobart Clinical School Division, University of Tasmania, TAS
Freedom to Practise provides an overview and insight into the potential for dynamic change that exists across a variety of nursing contexts. The authors Binnie and Titchen present an interesting and readable account of their experience and participation in re modelling the mode of nursing care delivery in an acute care ward. The text provides a description of the transition in the unit from delivering task driven and sometimes taken-for-granted "traditional" nursing care to implementing a "patient-centred" model of nursing care. This description explores the historical underpinnings of traditional nursing and the nursing culture that existed in the unit prior to the study. The authors then follow on to describe expectations for both the patient and nurse, of implementing a primary care nursing model in the ward.
During their journey the authors provide the reader with tangible connections between the concepts of what it is to care for patients and how nurses "go about" providing that care. Binnie and Titchen achieve this by using examples extracted from the in depth interviews and participant observation stages of the action research. These actual accounts go a long way to breathe life into explaining, for the non-nurse reader, the realities of what nurses experience when delivering care to their patients. For nurses engaged in practice these accounts provide examples of the lived experience of nursing and are therefore beneficial for reflecting upon, and further building upon pre-existing nursing knowledge.
Binnie and Titchen clearly set out the research journey traversed as an example for others to follow in modifying their own practice setting. The application of their research in areas other than acute hospital wards is not clearly articulated in the text and this focus on the acute care setting detracts to some extent from the stated potential of their findings for the larger and diversified nursing community. The reviewer also believes that the chapter exploring the emerging relationship between nurses and doctors neglected the relationships that would also have been changing between nurses and other members of the multidisciplinary team in the evolving practice setting.
Overall though, the text reads well and clearly sets out the author's aims, objectives and outcomes in undertaking the action research. The reviewer will be interested to read further accounts of the application of Binnie and Titchen's model by other practitioners to a variety of practice settings.
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