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摘要
摘要
The rise of the nurse practitioner as a new kind of health care professional has blurred the traditional distinction between physicians and nurses. Nurse practitioners argue that they combine both the traditionally male health care delivery of the M.D. and the traditionally female caring attention of the R.N. In her previous work Sue Fisher has analyzed the difficulties that women patients have in getting doctors to listen to their medical concerns. Now she asks whether women fare any better with nurse practitioners.
Nursing Wounds takes us into the examining rooms of nurse practitioners and doctors to listen to how health care professionals and women patients communicate. The nurse practitioners, unlike the doctors, go beyond the medical problem to ask about the social context of the patients' lives. In these exchanges the doctors insist on reinforcing both their professional status and dominant cultural assumptions about women. While the nurse practitioners sometimes do this, they also distance themselves from their professional identities, respond to their patients woman to woman, and undermine traditional understandings about gender arrangements.These differences have important consequences for the delivery of health care.
This compelling and complex analysis employs a range of theoretical perspectives--from sociolinguistic to postmodern and materialist. Fisher concludes by urging a health care policy that capitalizes on the special strengths of nurse practitioners as providers of primary care who pay real attention to what their patients are saying and who support an alternative, even oppositional, understanding of women's lives.
摘要
The rise of the nurse practitioner as a new kind of health care professional has blurred the traditional distinction between physicians and nurses. Nurse practitioners argue that they combine both the traditionally male health care delivery of the M.D. and the traditionally female caring attention of the R.N. In her previous work Sue Fisher has analyzed the difficulties that women patients have in getting doctors to listen to their medical concerns. Now she asks whether women fare any better with nurse practitioners.
Nursing Wounds takes us into the examining rooms of nurse practitioners and doctors to listen to how health care professionals and women patients communicate. The nurse practitioners, unlike the doctors, go beyond the medical problem to ask about the social context of the patients' lives. In these exchanges the doctors insist on reinforcing both their professional status and dominant cultural assumptions about women. While the nurse practitioners sometimes do this, they also distance themselves from their professional identities, respond to their patients woman to woman, and undermine traditional understandings about gender arrangements.These differences have important consequences for the delivery of health care.
This compelling and complex analysis employs a range of theoretical perspectives--from sociolinguistic to postmodern and materialist. Fisher concludes by urging a health care policy that capitalizes on the special strengths of nurse practitioners as providers of primary care who pay real attention to what their patients are saying and who support an alternative, even oppositional, understanding of women's lives.
评论 (2)
Choice 评论
Fisher analyzed physicians' and nurse practitioners' encounters with female patients to compare how the providers gave care. A nurse-practitioner friend of the author had asserted that nurse practitioners address both physical and psychosocial problems (caring), while physicians deal only with physical problems (curing). Fisher concluded that major differences do exist in how the two providers talk with patients, and how they interpret the needs of women. Physicians had the patient undress first and stood looking down at the patient as the interview began. The nurse practitioner first talked with the patient dressed, both sitting face to face. Physicians conveyed to patients that they are not competent; nurses conveyed that women patients are competent, in their lives and in the encounter. These differences can influence whether, e.g., patients comply with prescribed regimens. However, both providers limited topics for discussion, albeit differently. Approaches show how best to interact with patients to assure maintenance of self-worth and greater compliance for recovery. The epilogue includes important implications for health policy. Highly recommended for providers at all levels, graduate faculty, and medical and nursing students. Upper-division undergraduate through professional.
Choice 评论
Fisher analyzed physicians' and nurse practitioners' encounters with female patients to compare how the providers gave care. A nurse-practitioner friend of the author had asserted that nurse practitioners address both physical and psychosocial problems (caring), while physicians deal only with physical problems (curing). Fisher concluded that major differences do exist in how the two providers talk with patients, and how they interpret the needs of women. Physicians had the patient undress first and stood looking down at the patient as the interview began. The nurse practitioner first talked with the patient dressed, both sitting face to face. Physicians conveyed to patients that they are not competent; nurses conveyed that women patients are competent, in their lives and in the encounter. These differences can influence whether, e.g., patients comply with prescribed regimens. However, both providers limited topics for discussion, albeit differently. Approaches show how best to interact with patients to assure maintenance of self-worth and greater compliance for recovery. The epilogue includes important implications for health policy. Highly recommended for providers at all levels, graduate faculty, and medical and nursing students. Upper-division undergraduate through professional.