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American Nursing:  A History

American Nursing: A History
Philip A. Kalisch
Philadelphia: Lippincott Williams & Wilkins, 2004
RT4 .K34 2004

The U.S. health care system is in a time of great change. Increasingly broader health concerns are influencing how nurses are educated and practice. Since publication of the 3rd edition back in 1995, few subjects have generated more interest, more debate, or more activity than our nation's health and health care delivery system. The nation has seen its health bills consume 14 percent of the gross national product, or one seventh of the economy, on an annualized basis, at the amount of $1 trillion, 400 billion. However, there are interesting paradoxes:

  • Most Americans have access to unparalleled, state-of-the-art health care and are satisfied with the treatment and nursing care they receive.
  • People from all over the world come to the United States in search of the most advanced medical procedures and technologies.
  • Our nursing and medical education systems produce the finest nurses, physicians, and scientists.
  • The United States is the world's recognized leader in biomedical and nursing research. For example, we have made remarkable progress toward unlocking the mysteries of the human genome.

At the same time, however, 40 million Americans do not have adequate health insurance. Our morbidity and mortality rates do not compare favorably to countries that expend half the amount on health care that the United States does. We have seen the reemergence of preventable diseases such as polio and measles, the continuatiuon of devastating but preventable disabilities caused by various carcinogenic substances, lead poisenings, the return of tuberculosis, and an explosion of sexually transmitted diseases. In addition, we percieve new threats of the results of bioterrorism and the use of biological weapons of war.

Consumers are understandably confused or ambivalent: thankful for but expecting and demanding that high-technology subspecialty care be available when they need it, yet concerned about their ability to afford and obtain general care that attends to their health as well as their diseases. In addition, the quality of delivery of health care in all settings is increasingly compromised by an inadequate number of registered nurses along with an aging nursing force that is significantly dissatisfied with the working conditions and compensations available.

Solving today's health care and nursing problems is tied closely to a comprehension of the past performance of the health care industry and the nursing profession. The purpose of this book is to place nursing's past in a broader social, cultural, and economic context.

Quoted from preface.