MAY IWS, VOL 61, NO 5
in acute care facilities and strati- fied by zip code. From this pool of 1,000 nurses, 42% returned ques- tionnaires. yielding 41 9 usable responses. To compare question- naire responses of nurses in a sin- gle acute care setting to the responses of the state-wide sani- ple, the researchers sent question- naires 10 staff nurses working in a single acute care facility; 40% of these nurses responded, yielding a comparison sample of 159 nurses. The two groups of nurses were similar in all characteristics except tenure in their present positions and education levels. The nurses in the single-facility comparison sample had been employed at their facility slightly longer, and a greater percentage of the single- facility sample nurses had bac- calaureate education than did those in the statewide sample. The statewide sample included nurses working in all major specialty areas. with 50% of this group working in medical/surgical or intensive care units.
The researchers used the seven-point Likert-type Organiza- tional Commitment Scale, devel- oped by two organizational hehav- ior scientists, to measure expressed commitment along three dimensions or subscales: moral, calculative, and alienative. The researchers defined nioral commitment as an intensely posi- tive affective response based on internalization of organizational goals and values. Calculative commitment is a less intense form of attachment that is hased on sat- isfaction with the personal rewards and benefits of working for an organization. Alienative commitment is an intensely nega- tive attachment characterized by a negative attitude but a strong desire to remain with the organiza-
tion. The Organizational Commit- ment Scale has been determined to be a valid. reliable tool for classi- fying the nature of an individuals commitment to an organization.
The researchers analyzed the data by ohtaining mean scores for each of the three subscales. Moral commitment scores for both the statewide group (mean [MI = 4.76, standard deviation [SD] = 1.17) anti the single-facility group (M=4.96.SD= 1.17)werehigh- er than the groups mean scores for calculative iind alienative com- mitment. The researchers also cat- egorized individual nurses strength of commitment scores on each of the three suhscales. The researchers classified scores lower than 3.99 a s low for that commit- ment type, and they eliminated neutral scores (ic, 4.00 to 4.99). Scores in the range of five to seven points indicated the pre- dominant commitmcnt type, which was moral commitment for both the statewide and single- fricility groups. Calculative com- mitment scores were lower, with alienative commitment scores being the lowest.
Perioperative nursing impllca- tions. It is not evident how many of the subjects were perioperative nurses; therefore, the results may not be generalizable to periopera- tive nursing managers. The major- ity of nurses in this study felt a strongly positive attachment to their organizations, based on their internalization of organizational goals and values. Nurse managers should acknowledge the great psy- chological investment that these employees make in their jobs and recognize that sudden changes in organizational goals and values can be upsetting to them. Nurses with nioral commitment to their organizations need to have mean-
ingful input into the change process to sustain their high com- mitment levels.
The calculative type of coni- mitment, which was found in less than 20% of this sample ofnurses, requires a different type of man- igcment approach. This type of commitment is based primarily on responses to the exchange of ser- vices and rewards between the individual and the organization. Nurses with this type of conimit- ment tend to focus more on their personal objectives than on orga- nizational goals. For thesc nurses, managers need to focus on reward systems, such as merit-based wage increases and promotions based on performance.
Nurses with alienative commit- mcnt to their organizations would like to leave, but they feel trapped in their jobs. With the current decrease in job mobility for peri- operative nurses, the number of nurses with this commitment type is likely to increase. The manage- ment challenge is to recognize thesc individuals and control any disruptive behavior they may exhibit so that other staff mem- bers morale of can be maintained.
KATHLEEN B. GABERSON RN, PHD
NURSING RESEARCH COMMITTEE
SPANISH FOR HEALTH CARE PROFESSIONALS By Willirrm C. Warivy 1994,273pp $1 I .95 paperhack
o learn a new language, noth- ing bcats spending a few T weeks in a foreign country. If
such a trip is not possible, this pocket-sized book is ;I fine alter- native for health care personnel
MAY 19%. VOL 61. NO S
who want to learn Spanish. The book consists of a self-study pro- gram for medical, nursing, and ancillary health care providers who have no knowledge of Span- ish. The reader can slowly build strength in terminology while pro- gressing through chapters on top- ics such as trauma, gynecology, and radiological examinations. Other chapters cover anatomical terminology and descriptive phrases such as, Dont worry, and Open your mouth. Special sections address phrases specific to children and the elderly. Providers will be pleased by the short but detailed section on insur- ance tenninology.
Word pronunciation is spelled out phonetically. There is an ade- quate bilingual dictionary in the back that, unfortunately for peri- operative nurses, contains almost no surgery-related terms. A notable feature of the book is the presentation of three case studies, each with a different interview scenario. The simulated interviews provide a framework in which ear- lier vocabulary and grammar are woven together, effectively illus- trating the nurse/patient exchange.
The author intends for the book to be a user-friendly, on-the-spot resource manual, but it does not quite succeed in this effort. Because of the self-study struc- ture, readers will find the book to be more effective as a teaching tool that is studied prior to its application in the patient care set- ting. Another shortcoming is that the medical terminology covered is too brief and superficial to facil- itate communication with profes- sional colleagues in other coun- tries. Perioperative nurses will, however, find this book an excel- lent resource when they begin learning Spanish, as the intended
outcome is the ability to interface effectively with monolingual Spanish-speaking patients in the United States.
This book is available from Barrons Educational Series, Inc, PO Box 8040, 250 Wireless Blvd, Hauppage, NY 11788.
RUTH ELLEN LAHDE RN, BA, CNOR
STAFF NURSE STANFORD (CALIF) UNIVERSITY HOSPITAL
PERIOPERA TI VE NURSING HANDBOOK By Mark L. Phippen, Maiyann Pupcmirr. Wells 1995,345 p p $21.95 paperback
he Periol,erative Nursing Handbook is a compact refer- T ence book that details nursing
diagnoses, laboratory tests, periop- erative patient assessments, surgi- cal hand scrubs, and more. There are five sections in the book, and the last section contains informa- tion regarding the registered nurse first assistant competencies.
This book would be useful for new personnel in the OR and pre- ceptors and as an everyday refer- ence book for experienced periop- erative nurses. It is small enough to put in a pocket and use as a fre- quent reference.
Many tables describe normal and abnormal physical character- istics. The book also discusses documentation and communica- tion procedures, instrumentation and sterile supplies, medication and solution administration, surgi- cal patient monitoring, patient positioning, and culture and speci- men handling.
This comprehensive book cov- ers every aspect of the OR and the penoperative patient. I highly rec- ommend it. It is available from W.
B. Saunders Co, The Curtis Cen- ter, Independence Square W, Philadelphia, PA 19 106-3399.
PEARL M. TORRESYAP RN, CNOR
ORTHOPEDIC CHARGE NURSE VETERANS AFFAIRS MEDICAL CENTER
NURSE- PH YSlClA N COLLABORATION: CARE OF ADULTS AND THE ELDERLY Edited by Eugenia L . Siegler. Fay W . Whitney 1994? 243 p p $35.95 hardcover
p he editors of this book are a nurse and physician in collab- 1 orative practice. They intend
the book to be used to teach med- ical and nursing undergraduates and advanced practice nursing stu- dents. The book also is intended to foster interest in nurse/physician practice models as a method of delivering care. Research in col- laborative practice models is encouraged for people who are setting up their own nurse/physi- cian practices. I believe the authors accomplished their desired goals for this book.
Collaborative practice in a vari- ety of settings, including tradition- al (eg, home care) and nontradi- tional (eg, intensive care unit) set- tings, is explored. The use of case studies to illustrate the practice models adds depth and interest to the book. Not all the case studies have successful outcomes, howev- er, and this allows readers to learn from the authors unsuccessful experiences. The experiences of other nurse/physician teams and collaborative practice models are presented as well. There is discus- sion about barriers to collaborative practice (ie, social, economic, interpersonal) and suggestions
885 AORN JOURNAL