as an "associate nurse" in selected instances. Since the first edition was published in 1974,

many nurses have implemented primary nurs- ing and have conducted research studies on primary nursing. The authors have incorpo- rated findings from those studies and com- pared them to their previous studies. In particu- lar, this comparison was added to the chapters discussing effects of primary nursing on pa- tients, nursing personnel, and other hospital personnel and systems.

Although primary nursing as described in this book is an ideal situation, the authors de- scribe modifications used in various hospitals. But the ideal is still emphasized, with caution not to be satisfied with modifications, which are viewed as an interim phase. However, little encouragement is given to those who can only reach the interim phase no matter how well they may implement a system of nursing care delivery appropriate to their situation.

Chapter 6, which contains all new informa- tion, addresses the need for research in clini- cal nursing. Nursing administrators should take note of this chapter and be encouraged to implement or expand nursing research in their institutions.

This updated primary nursing handbook should be a valuable aid to all practicing nurses. The necessity for professional au- tonomy, accountability, and collaboration have been addressed, and practical guides to achieving them have been described. There is useful information in this book that can be applied by professional nurses in any general or specialty situation.

Mary F Welch, RN Phoenix, Ariz

Blades' Surgical Diseases of the Chest, 4th ed. Effler, Donald Brian, ed. C V Mosby Co., 11830 Westline Industrial Dr, St Louis, Mo 63141, 1978, 839 pp, $59.50

Blades' has been revised, and a review of this excellent text is long overdue. Contributions from 34 authors cover a wide range of surgical conditions of the chest, including congenital, acquired, and traumatic conditions in patients of all ages. Special emphasis is placed on myocardial revascularization, pacemaker im- plantation, the esophagus, pulmonary neo- plasms, and congenital heart disease.

Each chapter contains extensive refer- ences, which are grouped under topic head- ings. There is a good discussion of normal anatomy as well as abnormal conditions. I was pleased to find that the book's first chapter addresses the medical and ethical consid- erations of such topics as fee spliting, advertis- ing, "ghost" surgery, overcharging, and un- necessary surgery. As an OR nurse, I see many practices I question and was wondering whether surgeons question them also.

Blades' is an excellent reference for the heart team and for OR nurses who wish to expand their knowledge of the heart and chest. The chapters contain many photos, drawings, and x-rays illustrating both normal and abnor- mal conditions. The open heart team will find the discussions interesting and well refer- enced.

Marjorie Lang, RN Loveland. Colo

Young & Weller's Baby Surgery: Nursing Management and Care, 2nd ed. Young, Daniel G; Martin, Eleanor J. University Park Press, 233 E Redwood St, Baltimore, Md 21202, 1979, 160 pp, $16.50

This second edition of a popular book updates information concerning the management of in- fants with surgical disorders. Although some of the British terminology used may be unfamiliar to readers, the text is readable, interesting, and informative. The many diagrams and pic- tures, some in color, add much to the under- standing of material.

The introduction presents the newborn, who has had to adjust to many changes because of the birth process, and describes the care he requires. This care, of course, has to be mod- ified when abnormalities are present and surgery is required. The care and support of the parents in such situations is also of paramount importance. Two chapters provide general nursing care methods and resuscita- tion techniques.

The seven other sections cover particular systems. The systems described include the alimentary, genitourinary, central nervous, respiratory, cardiovascular, and musculo- skeletal systems. A final section describes con- ditions involving the skin and subcutaneous tissues and other conditions such as cleft lip

680 AORN Journal, March 1980, V o l 3 1 , No 4