Interviews
Exclusive Barnes & Noble.com interview with Sandra M. Nettina
Barnes & Noble.com: The Lippincott Manual, as it is commonly known in the nursing community, has been a mainstay in the nursing curriculum for many years. Why do you think it continues to be the bestselling nursing text throughout the U.S.?
Sandra M. Nettina: The Lippincott Manual of Nursing Practice established itself as the bible of nursing practice some 25 years ago when original authors, Lillian Brunner and Doris Suddarth, saw the need for a practice manual aside from their Textbook of Medical Surgical Nursing. It has been serving the needs of nursing students and practicing nurses ever since. I think it meets the needs of so many nurses because it contains medical-surgical, pediatric, maternal-child, and psychiatric nursing practice information all in one text. It is written in a concise yet comprehensive outline format for quick and easy use. It is well indexed and cross-referenced, and it is written for the student as well as the practicing nurse.
B&N.com: This new seventh edition adds many changes, including more coverage of home care, the problems of infants, genetics, and standards and legal issues of care. Can you give us an idea of why some or all of these changes were considered?
SN:
I have made significant additions and changes to The Lippincott Manual, Seventh Edition based on the evolution of nursing and health care. I have added more home care information because the age-old tradition of nurses caring for people wherever they need it has again focused on the home. I did not want the book to reflect only nursing care given in the acute care setting of the hospital. Slightly different techniques that may be used in the home, long-term care setting, clinic, office setting, school, or street are provided wherever applicable.
A chapter on genetics was added because of the medical knowledge we are gaining that genetics is the basis of many health problems. Current research has clinical implications for expanded screening, new diagnostic tests, new treatments, and possible prevention. Genetic counseling is becoming a new nursing specialty.
Although The Lippincott Manual has always been written to imply the standard of care in nursing, I felt some fundamentals should be explained in an early chapter to heighten the nurse's awareness of legal and ethical issues. In addition, standard of care boxes are placed throughout the book to call attention to the nursing assessment and interventions that would be expected for certain acute conditions. Although the practice of nursing is not always black-and-white, following certain fundamentals can help the nurse meet the applicable standard of care and reduce the risk of litigation. After my name became associated with The Lippincott Manual, Sixth Edition, I was surprised to start getting calls from hospital policy committees, attorneys, and others interested in getting an opinion about standard of care, policies, and procedures. Although it was not designed specifically as such, it seems The Lippincott Manual is being used as an authoritative source for the nursing standard of care.
A section on "Problems of Infants" was added to fill a gap. It was a chapter in the fifth edition, but was taken out of the sixth edition because it was lengthy and perhaps too specialized. The most important content was integrated into the pediatric section. I responded to readers, however, who said they wanted it back. We compromised for the seventh edition and came up with the basics to help the maternal-child nurse working in the nursery or with infants on a pediatric unit.
B&N.com: Herbal and complementary therapies are also new to this edition. With a standard text now incorporating complementary medical therapies, do you see this as confirming the acceptance of these therapies in the medical community? What has influenced the medical community to accept herbal and complementary therapies in the last few years?
SN: By adding complementary and alternative therapies to The Lippincott Manual, I absolutely see it as confirming their acceptance. Little by little, over the past five to ten years, complementary medicine has become more mainstream. I saw this first in the literature, then in clinical practice. I also became more aware of the large role that nurses play in providing these therapies -- from healing touch to aromatherapy -- as I accessed the literature and the Internet for information.
I feel that the change in the medical community to accept these things was brought on by consumer demand. High-tech, low-touch treatments were not meeting the consumers' needs. They desire more options, and they want to help themselves. Consumers would take their business elsewhere if the medical community did not respond. Fortunately, I think nurses are open to learning new (or ancient) ways to help their patients.
B&N.com: How long have you been an editor for The Lippincott Manual? What are the challenges in updating such a large text? Any anecdotes you'd care to share?
SN: I edited The Lippincott Manual in 1996 and 2001. That means I started the 1996 edition in 1994, so it has been a big part of my life since then. Both editions proved to need extensive revision and updating, especially in diagnostic testing and treatment. There have also been several totally new conditions to add each edition. Even though it takes over a year to rewrite and edit the book, my contributors, reviewers, and I watch closely for new developments that we can incorporate right up to press time. For example, changes in the CPR guidelines were proposed in August 2000. I began searching for a full text of the changes that I could incorporate into sections of the book but found out that changes were not yet being implemented into clinical practice. The book was literally on the printing press when I had to make a decision on what to update. Fortunately, I was able to add some information and a web site resource for CPR where readers could go to learn more as the guidelines are implemented.
B&N.com: Do you have a special field of interest in nursing? If so, can you describe what you are currently doing?
SN: I really love many areas of nursing and health care. I worked a lot in medical ICU settings early in my career, and in primary care of adults and the elderly for the past 14 years. I am currently a nurse practitioner in an outpatient setting, but I also do some work in long-term care facilities and home care. Working in primary care has allowed me to broaden my focus of health care and dabble in all body systems and a variety of settings.
B&N.com: What are the most interesting questions that are currently being asked about the future of nursing, its curriculum, and/or its practice?
SN: I think one of the most interesting questions that is being asked about nursing today is about the role of the nurse in the health care system. The role is certainly evolving with fewer nurses at the bedside, a growing number of advanced practice nurses, an expanding scope of practice, and more consideration of direct reimbursement for nurses. Much of the role is shaped by economics in the health care system, yet nursing itself will continue to shape its own destiny. I believe that independence for nurses will increase, although the practice of health care will remain collaborative. The skills of a variety of players are needed for the most effective team.
B&N.com: Can you tell us about your background? How and why did you get into nursing?
SN: I am an R.N. diploma grad from 1978. I learned the fundamentals of nursing and the wonderful tradition of caring from the faculty and staff at Sisters of Charity Hospital in Buffalo, New York. I think I went into nursing because I loved science and was a good people person. Although I loved my first couple of staff nursing jobs, I knew I would move on. I received my B.S.N. from Marymount University in 1982 and M.S.N. from the University of Pennsylvania in 1986.
The degree from Penn seemed to open many doors for me. By that time, I had also matured and gained enough experience in bedside nursing to do anything. I worked as a freelance clinical editor in the mid '80s for Springhouse Publishing, then made contacts at Lippincott Publishing. My first nurse practitioner job after graduating from Penn was in the E.R. at Temple University Hospital, then I moved to student health at LaSalle University before moving to Maryland. I have been truly blessed with opportunities in publishing, teaching, and legal consulting, as well as clinical practice in the last decade. I am currently seeing patients as a nurse practitioner in a doctor's office two days a week; serving as an adjunct faculty member for George Mason University in Fairfax, Virginia, and George Washington University in Washington, D.C.; and working at home a couple days a week on a new Internet nursing journal project and various editing and writing projects. I love my multidimensional career.
B&N.com: Would you care to share with us your thoughts on any books you have read recently, whether for work or pleasure? Are there any other books you would like to recommend to nursing students and/or instructors?
SN: When I need to go beyond The Lippincott Manual for more background information, I use Brunner and Suddarth's Textbook of Medical-Surgical Nursing and Pillitteri's Maternal Child Health Nursing. In my nurse practitioner role, I consult Bates' Guide to Physical Examination and History Taking; Primary Care Medicine by Goroll, May, and Mulley; and Adult Primary Care by Horan and Meredith. I love to look for resources on the Internet, but the search can be time consuming. I usually start with Medscape.com, which contains Medscape Nursing and CBS Healthwatch.
For fun, I would rather be outside raking leaves, cleaning up brush, cutting the grass, or walking the dog. I do read for fun with my kids, usually adventure books they pick out. In my next life, I would like to become more holistic, study philosophies, and write something purely inspirational.
