It is a refreshing change to read a book on the nursing profession that highlights the successes of nurses and their broad contribution to the health of Canadians. Picard states that his book attempts "to give nurses more visibility-and a voice in Canada". Let's hope this book serves as an eye opener to all who read it and as a catalyst for action.

I had the privilege of meeting with Picard in Halifax at a breakfast meeting with some of the members of ACEN at their annual meeting a few years ago. He is an accomplished journalist and even in beginning his research for the book clearly indicated his respect and support for the nursing profession. He has travelled widely across Canada to interview numerous nurses in a variety of fields of practice providing a rich source of material about the profession.

The book begins with a profile of Helen Mussallem who he describes as a "nursing pioneer", and who led the way in upgrading the education of nurses and contributed to the growth of nursing as a profession. As executive director of the Canadian Nurses Association Mussallem was also active in shaping the health care system of Canada.

The next eight parts of the book take us on a journey through the life cycle of man. Part One-The Early Years describes the nurses role from labour and delivery through to early childhood. The many facets of that experience are portrayed by interviews with nurses in hospital settings, as flight nurses and in health promotion. Part Two-Childhood to Adolescence begins with the school nurse, through nursing the more acute childhood diseases of cancer and cystic fibrosis, to the telemedicine nurse. Part Three-Growing into Adulthood focuses on the teen-age years and associate problems. Nursing roles in health promotion, university clinics, abortion clinics and a trauma centre are described.

Part Four-The Adult Years is on health issues common to the 30's, 40's and 50's population. Acute areas such as emergency and burn nursing are covered, as well as the nurses role in dealing with adult chronic health problems and health prevention programs. Part Five-Mental Health runs the gamut from addiction to mental illness. The social and economic implications of mental illness and addiction are highlighted and the chapter describes the active roles nurses take in dealing with such concerns across the country. Their perseverance and courage is outstanding.

Part Six-The Not-Quite Golden Years covers the big three causes of illness and death in the population over 45 - cardiovascular disease, cancer and respiratory disease. Nursing care in hospitals, home care and community health are described in dealing with the ravages of these diseases. Part Seven-The Final Years, the fast-growing population of seniors over-75 and over-85. Prevention, supportive care, longterm care and palliative care are features of this lifespan and nurses play an active role in each sector.

Lastly, Part Eight-Nursing and Beyond recognizes the Canadian nursing leaders in national and international nursing. He explores the great need for nursing leadership in the professional, social, economic and political arenas. Picard's interviews feature what drives nursing leaders to strive to maintain and enhance the nursing profession and provide leadership country-wide.

What is fascinating about the book is the descriptions of the many entrepreneurial and leadership roles undertaken by nurses across the spectrum of nursing. Advanced education and specialization have broadened the nursing role and help to display the many talents, skills and plain guts that nurses have. I highly recommend this book as it is an exceptional read for all in the nursing profession, the public and politicians. Students will find it an exploration of the history of nursing, as well as direction for the future.

"Critical Care: Canadian Nurses Speaking for Change", by Andre Picard.

ISBN 0-00-255726-6.
HarperCollinsPublishers,

A Phyllis Bruce Book

264 pages. $30.00.

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