Just A Nurse

Cherry Ames
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This is the title of a poem/bookmark/recruitment campaign by Suzanne Gordon, the friend of nursing journalist who has spent over two decades documenting nursing in articles, books, plays—and bookmarks. Her “Just A Nurse” poem ends with: “I’m just central to providing the real bottom line in health care. Don’t you want to be ‘just a nurse’ too?” (wait—did she intend a pun on a bum of ‘bottom line’?) Ms. Gordon explains on her website that she was inspired to write “Just A Nurse” in response to her, “…sense of frustration and even outrage (at) the persistent devaluation of nursing.” She goes on to explain that in her decades of interviewing nurses, she heard too many of them describe themselves as ‘just a nurse’—or ‘elite’ nurses (nurse practitioners/nurse academics/nurse researchers) refer to themselves as ‘not just a nurse.’

I have been trying to catch up on the nursing literary canon—a part of literature I have purposefully avoided for many years. The loose can(n)on would seem to begin with Genesis: Florence Nightingale’s Notes on Nursing—to which I would add the far jauntier/better read by the Jamaican nurse Mary Seacole’s Wonderful Adventures of Mrs. Seacole in Many Lands (1857). It then continues in semi-chronological order through Louisa May Alcott, Walt Whitman, Lillian Wald—then to the Cherry Ames series of Post-WWII era (written by a social worker/haven’t read any of these)—to the bra-burning era/ journalists (and not nurses) Barbara Ehrenreich and Deirdre English’s Witches, Midwives and Nurses: A History of Women Healers (The Feminist Press, 1973)—up to the Modern Era of Sally Tisdale, Courtney Davis, Theresa Brown and—my current ‘modern’ favorite—Mary Jane Nealon. And then there are the writings of Suzanne Gordon—again, a journalist/not a nurse, but she writes almost exclusively about nurses and nursing.

I first read Gordon’s Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care (Cornell University Press) when it was first published in 2005. I bought it with the thought of using it for teaching health policy to nursing students. It was too depressing to use for teaching soon-to-be nurses. Plus it struck me as “raging insatiably” (Homer, by way of Lytton Strachey’s description of Florence Nightingale), and for a long time I was convinced it was written by a disgruntled nurse. The book’s unfortunate cover photo of a female nurse in blue scrubs sitting alone, crumpled up and crying, reinforced my largely negative perception of the book—and prejudiced me against the author. Not fair, since I know that authors often have no control over their book’s cover illustration.

But in a recent burst of renewed enthusiasm for nursing literature/non-academic writing by, about and for nurses, I bought and read other books by Gordon. One is her ‘classic’ Life Support: Three Nurses on the Front Lines (originally published 1997 Little Brown & Co/Cornell edition, 2007). The book focuses on hospital nurses and health care through Boston’s Beth Israel Hospital, but does include a geriatric nurse practitioner working through their Home Care Department. This was my favorite nurse story since I got my start in nursing by being a home health aid in Boston’s neighborhoods. The 2007 edition of the book includes an afterword that describes changes that occurred since the book’s first publication—mainly that Beth Israel (high value on nursing) merged with Deaconess Medical Center (high value on medicine) and nursing lost out. Joyce Cliffords, Chief of Nursing at Beth Israel had been a champion of primary care nursing as a model of safe, effective hospital nursing care. But she and primary care nursing were pushed out in the merger. (Cliffords recently died of heart failure at the age of 76  NYT obit ). In many ways I found the Preface, the Afterword and the final chapters of the book the most informative, because they included more self-reflective writing—such as Gordon’s description of the origins of her personal interest/investment in nursing, as well as her assessment of the shortfalls of our health care system.

The other recent book I read, which was edited by Suzanne Gordon, is When Chicken Soup Isn’t Enough: Stories of Nurses Standing Up for Themselves, Their Patients, and Their Profession (Cornell University Press, 2010).  Gordon says that she edited this book in reaction to the Chicken Soup for the Nurses’ Soul-type of books that play into the nurses as angels clichéd metaphor. She wanted to edit a book of nurses’ writing about the realities of nursing advocacy—advocacy as defined in a variety of forms, settings and from a variety of countries. Most of the (very short—too short—Chicken Soup dice and stir short—Reader’s indigestion short) writings have a happy ending: nurse victorious over the evils of the health care system. But Gordon also includes a final section “Still Fighting” which includes “stories of defeats or of constant battling, not of victories” (p 227). She states that people tried to dissuade her from including this section—that it was too much of a downer—but that she insisted it was a part of the true picture of nursing advocacy. The short (did I mention too short?) essays in this final section are some of the most powerful in the entire book.

Suzanne Gordon is a friend of nursing journalist, as Barbara Ehrenreich puts it—she is a journalist who is a nursing advocate—I would add she is almost a crusader for nursing. But as I read more of Gordon’ writing, including her blog entries (such as her recent tirade against Gawande, “Atul Gawande Does It Again” 10-31-11), I keep thinking that she is not what I consider a ‘true friend/a critical best friend.’. Besides pointing out that nurses are too self-deprecating, dissembling, unwilling to ‘leak to the media,’ Gordon doesn’t do much meaningful critique of nursing. Perhaps she is reticent to turn the mirror on nursing since she is not herself a nurse? I would find this sort of writing more useful.

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