Have you looked into publishing it yourself? My husband just met a guy who self published a book he wrote. Do some research. Try lulu.com; outskirtpress.com/self-publishing; www.xlibris.com.

I don't know anything about it myself, but my husband just told me about his new friend this week and now that I've seen your post, I believe it's my job to share the information. I hope it helps - don't give up!

 have you submitted it to any of the publishers who have published other books about nursing?  those are the publishers who would know whether or not it would appeal to the market.

Do not stop with one publisher.  It may not be the type of thing they are looking for.  Remember, Burt Reynolds and Clint Eastwood were both told that they didn't have a chance in movies.  They did not give up.

If you know someone who is published, writing similar material as yours, ask them to critique it for you.  They may give you good pointers about how to wordsmith the document.  I was a Director at the FDA and later a pharm. company and I wrote lots of reports and papers.  But my brother is a published author and when I write something non-technical, I will pass it by him for a look and find out what his thoughts are about how I might be able to improve the copy.

Don't give up.  Just envision the guy at Penquin reading the reviews about your book after someone else publishes it.