The Clinical Practice of Neurological and Neurosurgical Nursing
J. V. Hickey, Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins, 2008, 816 pages, $94.95, ISBN-10: 0-7817-9529-X; ISBN-13: 978-0-7817-9529-6.
This edition of Hickey's classic guide for neuroscience nursing practice comes 25 years after its first publication; in this latest "incarnation," Dr. Hickey draws on the exponential growth of basic science, pharmacological, and technological knowledge and nursing practice theory to provide the reader not only with a text that is current and evidence based but also with one that also captures and builds on the nuances of clinical reasoning and judgment. The book integrates key concepts related to the all-encompassing focus on healthcare safety as well.
The author briefly reviews healthcare trends, transitions in healthcare planning and services, and ethics before jumping into the sections discussing neuroanatomy and neurophysiology, diagnostics, and patient assessment and evaluation. The chapter "Neurological Assessment" includes a broad overview of assessment and very complete discussions of specific components of the broader examination. Charts, tables, and figures guide the reader through the various components and provide visual cues for the care provider. A discussion of vital signs, frequently assessed but not always appreciated for the information they can provide, is clearly linked to cerebral hemodynamics and the implications these carry for the patient and the nurse.
Before extensive discussions of common and disease- and injury-specific management problems with neuroscience patients, Dr. Hickey sets the stage by considering nutritional needs, fluid imbalances and metabolic disorders, and drugs commonly prescribed. She also looks holistically at our patient population as she considers behavioral and psychological responses to illness and the rehabilitation needs that often accompany neurological deficits.
Most of this book is devoted to the nursing practice and care of patients with specific neurological or neurosurgical disorders. Each section includes emergent or initial nursing management, assessment parameters, diagnostic considerations, standardized assessment tools and rating scales, and typical treatment options. Dr. Hickey very clearly highlights the major patient management responsibilities of the nurse. Interventions focus not only on acute, "physical" bedside care but also on patient and family education, discharge planning, and psychosocial support. "Clinical Pearls" incorporate expert advice from one peer to another. "Clinical Vignettes" in many chapters underscore important points of clinical care, judgment, and decision making.
Although this book provides an expansive survey of neurological illness and the care needed for patients who experience these, it will be useful for practitioners with various levels of expertise. For the novice practitioner, the book can serve as a basic care map; for the more experienced practitioner, it may become the initial starting point for care that is then individualized and focused to a greater degree on the subtleties of neuroscience nursing care and practice for specialized populations. Dr. Hickey includes both "brick and mortar" bibliographic references and Web-based resources to support and supplement the readers' understanding. The references are largely evidence based and include legal, ethical, regulatory, and clinical sources. Again, the author has included a wealth of visual aids to supplement the written text.
This book is an excellent, fundamental resource for neuroscience nurses. Adding it to individual and institutional libraries will provide us with a strong base for practice that is both clinically sound and compassionate.
Reviewed by V. Susan Carroll, MS RN CNE, Editor-in-Chief, Journal of Neuroscience Nursing.