Code Green

Beth Israel was an international benchmark hospital which many saw as setting the nursing standards to be achieved elsewhere. This account of its recent history carries important messages about the domination of economics over the need for nursing care, the fragility of even the best nursing leadership during amalgamations, and the ease with which a reputation can be lost.

-- Tom Keighley * Nursing Management *

Hospital restructuring has fundamentally changed nurses' work and the very meaning of nursing. It has overlooked the therapeutic value of the nurse-patient relationship and the importance of 'knowing the patient.' Is it any wonder, then, that so many nurses are leaving the profession because of frustration and disillusionment? In the end, this hurts nurses as well as patients, physicians, and hospitals. Weinberg concludes that when designers draw up cost-effective plans for hospital restructuring, they must thoughtfully include nurses in their planning. The author is to be congratulated on bringing this important topic into view.

-- Barbara Mann Wall * Health Affairs *

Hospitals frequently devise a system of color codes to convey a message to their personnel succinctly and exclusively. Weinberg chooses 'code green' to refer to the financial crisis that hospitals are facing today, the ensuing trend to merge hospitals, and its implications for the nursing profession.... This thought-provoking book gives a uniquely personal perspective. It is suitable for specialized healthcare collections in academic, larger public, and medical libraries.

* Library Journal *

In this thorough investigation into how the nursing profession has changed radically over the last decade, Weinberg cites hospital consolidation and 1997's Balanced Budget Act, which brought cuts to Medicare payments and severely affected hospitals' bottom line, as keys to the problem. The Brandeis University research associate uses the merger of Boston's prestigious Beth Israel Hospital with New England Deaconess as an example of how fiscal problems and consolidation are responsible for the growing shortage of nurses and rampant dissatisfaction in the field.... Weinberg's analysis will be important to medical professionals and hospital administrators.

* Publishers Weekly *

The author scrutinizes how and why hospitals, in the era of profit-driven health care, routinely exploit qualities such as empathy, dedication, and professionalism in nurses. Using human science research, she illustrates how nurses really are 'ripe for exploitation,' in part because we internalize responsibility for patient care, patient safety and the caring-healing process.

-- Virginia Gillispie * Denver's Nursing Star *

Weinberg provides an incredible account of her observations of the state of nursing at the newly merged Beth Israel-Deaconess Medical Center. Her goal was 'to find out why the nurses are crying.' Each chapter thoroughly examines current issues faced by the professional nursing staff as seen through their eyes. These issues are similar to those faced by nurses nationally as financial goals take precedence to quality patient care.... An excellent account of challenges faced by nurses today. Summing Up: Essential.

* Choice *

Weinberg's book is a powerful description of the issues facing both nurses and hospitals at a time when the entire health care industry is concerned with a growing shortage of nurses. Her portrayal of the impediments faced by nurses in their efforts to continue to provide quality patient care are well-documented, and, in many instances, frightening. The book makes clear nurses' contributions to patient safety and quality-even if the nurses themselves were unable to do so.

-- Barbara A. Mark, Ph.D., RN, A * Journal of the American Medical Associati