Day Surgery. Principles and Nursing Practice
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* Claude Lemay

**DAY SURGERY. PRINCIPLES AND NURSING PRACTICE**. Edited by Heather Cahill and Ian Jackson. 238 pp. Illust. Baillière Tindall, London, UK; Harcourt Brace & Co. Canada, Ltd., Toronto. 1997. Can$44.95. ISBN 0-7020-2028-1

This book is divided into 13 chapters that cover all aspects of surgical nursing care. Although the authors have identified their book as a resource for day surgery, almost all the concepts described apply to any surgical patient.

The authors make a significant distinction between day surgery patients and inpatients, which I have not well understood and can only assume that major differences exist in the structure of the health care systems of the United Kingdom and Canada to explain the distinction. All aspects of patient care are described by the authors with the understanding that day surgery patients require a very different approach somehow defined as more complex and requiring more exquisite care. This distracts the reader experienced in surgical care in both day surgery and inpatient settings. The experienced reader knows that patient issues do not depend so much on the setting as the circumstances of the illness in the patient’s life.

A few statements warrant criticism: “Day Surgery is a more patient-oriented approach to care”; “Thankfully, Day Surgery nurses are not as obsessed with bladder-emptying as in-patient nurses”; “Day Surgery patients are considered to be the most anxious of all surgical patients.” These statements are debatable and certainly do not serve any purpose. On many occasions, it almost seems as if day surgery care and inpatient care are 2 different (if not opposing) components of the health care delivery structure. The last chapter further describes day surgery as a “specialty.”

In discussing the different roles of the nursing personnel, the authors advocate that scrub technicians assist surgeons, saying that “trained monkeys” could perform that role. The Association of Operating Room Nurses and Operating Room Nurses Association of Canada standards advocate, however, that nurses should scrub and circulate alternately to maintain good skills at all levels in the operating room and thus ensure optimal patient care. Because they obviously want to cover their topics well, the authors go from the most theoretical level (general theory on stress, nursing models) to the most specific (content of an emergency cart, description of electrocardiographic PQRST waves, normal values for a biochemistry profile). This manner of covering topics does not allow the development of any theoretical model at any satisfactory level and in fact limits the possibility of listing specific details in such a way that the book becomes a practical handbook.