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quite sophisticated psychological research into smokers. Some of their findings represent the most detailed data we have about the psychology of smoking. "By the 1980s, the tobacco industry had an increasingly nuanced understanding that individual psychological makeup, mental and emotional processes, and external stress all played a role in smok- ing behaviors…their awareness of the complex issues for smokers far outpaced that of psychiatrists of that time," writes Hirshbein. The 1988 surgeon general's report on nicotine addiction changed our understanding of smoking and shifted the focus starting in the 1990s from "tolerance to treatment." Whereas mental health providers previously viewed cigarettes as a potential treatment ally for the mentally ill, now it was something to stop. "Power dynamics around smoking are now characterized by providers encouraging (or nagging) mentally ill smokers to quit," writes Hirshbein. "The use of cigarettes has been something to further set apart the mentally ill from treatment teams. And many current experts insist that providers have an obligation to use their power to push for smoking cessation, regardless of the consequences." While she acknowledges that the "seismic shift" against smoking has been one of the huge tri- umphs of public health in this country, she questions just how nec- essary it is to continue to push mentally ill people to quit smoking when they may be facing much bigger and more immediate unad- dressed mental health problems. Today, Hirshbein writes that mentally ill smokers seem caught in a lose-lose situation between two large for-profit market forces that both stand to make money off of them: the tobacco companies that want them to keep smoking, and the pharmaceutical industry that wants to sell them drugs to help them quit. There is no clear answer as to whether the healthcare system should force mentally ill smokers to quit, according to Hirshbein, but what she says is important is to honor the dignity of the patient and take his or her perspectives and priorities into account. "And In her book, The Nurses, author alexandra robbins notes, "we rely on nurses to be our healers, our heroes, to comfort us, to soothe our hurts and salve our psyches. But how often do we pause to wonder who takes care of the nurses?" sadly, robbins, whose investigative skills are in evidence throughout this book, did not apply them to answering her own question. if she had looked a little deeper, she would have found nurses around the united states collectively demanding better treat- ment for themselves and their patients. it's called union organizing and it's absolutely and inexplicably missing from this book. as a result, the book's depiction of hospital nurses as helpless in the face of workplace abuse is so lopsided, it might as well be titled, the Victims. robbins wrote The Nurses after a year of shadowing four er nurses working at hospitals within a 50-mile radius of a major american city, as different from one another, "as fairy- tale sisters." robbins doesn't give the hospitals' real names but nurses and others who read this book might be tempted to guess their identities based on the descriptions of their organizational cultures and other characteristics. robbins also seems to be suggesting that within a 50-mile radius of every major american city, you will probably find the range of hospital environments explored here. you will also discover, as she did, that while some hospital work environments are harsher than others, registered nurses face similar challenges in all of them. the hospitals described in The Nurses are like characters in and of themselves, each with its own personality. Pines Memorial Hospital was independently owned until recently, when it was gobbled up by a corporation. serving an affluent population of academics and retirees, the Pines er has 60,000 visits per year, many victims of major-impact car accidents on the nearby highway. south general Hospital, designated a level 1 trauma center, serves the most indigent areas of the city and has 95,000 er visits a year. in contrast, white-pillared, brick academy Hospital is located on an elite university campus surrounded by million-dollar homes and has 45,000 annual visits to the er. Completing the quartet is Citycenter Medical, a teaching hospital in a dense urban area, serving low-income, uninsured patients with a poorly man- aged er handling 85,000 visits per year. stylistically, the book is a bit of a mashup comprising reportorial segments on contemporary nursing themes and narrative sections, replete with dialogue, multiple characters, and plot lines featuring four emergency department rns: sam, a young recent nursing grad; lara, in recovery from a drug addiction she acquired stealing meds from her job; and experienced rns juliette and Molly, one working as a full-time employee and the other working on a per diem basis at sever- al of the hospitals in the area. unfortunately, the transitions between the book's narrative and non-narrative elements are awkward, making it a confus- ing read. sandwiched between sections underscoring nurses' professional skill and dedication, the gossipy narrative profiles depict nurses as petty and immature. Chapter after chapter describes the abuse heaped on nurses and the consequences: burnout, bullying, Ptsd, compassion fatigue, second-victim syndrome, and even suicide. all the stereotypes we're accus- tomed to in the media are here, including nurse as hero, mar- tyr, bully, sex object, and drug addict. as a reader, i came away believing that robbins really does care about nurses and wants readers to care about them too, it's just that she (and/or her publisher) wants to sell books first and foremost. they're betting sensationalism and melodrama will help in this regard. Hence the tag line: a year of secrets, drama, and miracles with the heroes of the hospital. THE NURSES: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital By alexandra robbins workman Publishing Company, 2015 18 n a t i o n a l n u r s e w w w . n a t i o n a l n u r s e s u n i t e d . o r g j u ly | a u g u s t 2 0 1 5