’This has to be on the reading list for medical and nursing students. ’
Title: Ending Medical Reversal
Authors: Vinayak K Prasad and Adam S Cifu
Publisher: Johns Hopkins University Press, 2015
Reviewer: Jane Brown, quality governance manager, Clinical Support Worcester Acute NHS Trust
What was it like?
This is essentially a huge request for evidence based medicine by the authors. As a nurse I am aware through literature that practices are still undertaken that are futile for patients. We are aware that practices and medications are fashionable then go out of fashion depending on “research” at the time. From my experience of a relative an oncologist who was unaware of their past medical history bombarded them with a first dose of chemotherapy that resulted in an admission to A&E in per arrest. Some may argue this was a chance to give them more time – but at what cost.
Point to be aware of is that, not everything the medical profession does is not all bad practice; some of the book may well be anecdotal. Sometimes practitioners have to act on the recommendations at that time and hindsight is a great thing.
What were the highlights?
The authors investigate where something went wrong and how this occurred suggesting where things could be carried out differently. Research at that time may not have had good or reasonable sample sizes the study may have had flaws. One has to appreciate drug companies are involved in treatments too.
We have seen so often reversal practices to prolong life in patients, when we look back on the research it was flawed.
Morbidity and mortality rates are an aspect the medical profession continually look at but there are so many strands to this.
Strengths & Weaknesses:
The authors give good arguments and back up there hypothesis with research and reference their material well. The book is written in a reader friendly manner in that the public will understand what is written and not just the nursing and medical profession.
The reader must ensure that they do not stop a treatment because they have read this book. This must be looked into and involve good practice and leadership skills. There is no harm in consulting senior colleagues – more harm to patients if this is ignored.
Who should read it?
This has to be on the reading list for medical and nursing students. This for the reader is an aspect of care that cannot be ignored and for the health care profession to keep striving for evidence based practice and not the old adage “we have always done it this way”.
ending medical reversal