Book review: 'The Shift' puts you in a nurse's shoes for 12 hours
September 22, 2015 12:00 AM
Theresa Brown, author of "The Shift."
"The Shift" by Theresa Brown.
By Virginia Linn / Pittsburgh Post-Gazette
U.S. medical schools typically send out books to their incoming first-year class to give students a glimpse of the profession they’re about to embark upon.
Rush Medical College in Chicago, for example, mailed to its class of 2019 “The Immortal Life of Henrietta Lacks,” the true story of a poor black woman whose cells — taken without her knowledge in 1951 — have been used to develop everything from the polio vaccine to gene mapping.
By Theresa Brown, RN Algonquin Books ($24.95).
University of Pittsburgh Medical School for several years has mailed out Atul Gawande’s “Complications: A Surgeon’s Notes on an Imperfect Science” for an illuminating look at the life of a surgeon.
There’s now a new book to add to this list: Theresa Brown’s “The Shift,” released today, which should be required reading for all incoming medical and nursing students — or anyone who is a patient or visitor in a hospital.
A clinical nurse who lives in Point Breeze, Ms. Brown takes readers through a typical 12-hour day on a local oncology ward.
Through her clear and compelling narrative, readers gain a new appreciation of what is involved with being a nurse on the front lines of modern health care and the colossal responsibility they have in caring for very sick patients during these highly regulated, complicated and confounding times.
This is the second book about nursing by Ms. Brown, 50, a former English professor at Tufts University, who quit teaching mid-career to become a nurse.
She became a popular contributor to The New York Times “Well” blog and is now a columnist on its opinion pages, lending an eloquent voice from the medical community. Ms. Brown, a mother of three children, also lectures around the country about the challenges of the nursing profession.
She recounted many experiences in her 2010 book, "Critical Care.”
In “The Shift,” she begins her day with a two-mile bike ride to work before sunrise on a brisk November day. “Biking to the hospital gives me an unexpected patina of toughness, which matters in health care,” she writes. “Hospitals are filled with caring staff, but resilience and determination are prized as high as empathy.”
From the moment she clocks in at 7:03 a.m., her day will be a whirlwind of tough decisions, tense moments, fear, doubt, heartache, compassion and joy.
She receives papers on the patients she’ll care for that day: Richard is a lymphoma patient in his late 70s to whom she’ll have to administer a risky treatment that could cure him — or kill him. Dorothy, 57, is a cheerful woman with a candy dish in her room who’s nearing the end of her six-week stay for leukemia treatments. There’s also Sheila, in her mid-40s, who came in with a blood clotting disorder.
It seems like a manageable load until Ms. Brown is notified that Candace will also be one of her patients. Candace is what’s known as a PITA — Pain in the Ass — because of her frequent demands that keep nurses as busy as two normal patients. (She brings her own supply of disinfecting wipes and has a rotating set of family and friends who help sanitize her room.)
Dorothy gets the good news in the morning that she’s well enough to go home. She alerts her husband to get her ready, and then ... waits. Waits for the papers to be signed. Waits for the discharge instructions to be administered. Waits until Ms. Brown can break away from the demands of her other patients. The nurse must give Richard the risky drug that requires close monitoring. Another nurse’s patient crashes. Then Sheila is suddenly found to have a lethal condition that turns into what Ms. Brown calls a “slow-motion medical emergency.”
It would have been easy for Ms. Brown to overdramatize her experiences in “The Shift,” or bore readers with medicalspeak. But her story is riveting in the exacting way she recounts the way her day unfolds.
After reading this book, hospital patients and visitors may no longer wonder: Why is it taking so long to be discharged? Why doesn’t the nurse come instantly when I call? How is a nurse so busy with just four patients?
“A shift lasts 12 hours,” she writes. “Twelve hours of holding a few lives in my hands, trying to make order out of the chaos of bodies and disease, working within a health care system that sometimes forgets it exists to serve human beings rather than bureaucrats or businessmen.”
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