Working: Nurses Talk About What They Do All Day and How They Feel About It

76/366: working (?)
76/366: working (?) (Photo credit: Tim McFarlane)

Like Lance Armstrong, I am ready to speak candidly. But mine is not a confession that I need to make at the feet of Oprah Winfrey. No, I haven’t been doping.  Rather, it is that I have yet to meet a book on nursing that I like.

It isn’t for lack of trying. I’ve kept an open mind. I’ve read (OK, I’ve attempted to read) many contemporary books on nursing. I’m not talking about nursing textbooks, which I mostly boycott altogether. I’m talking about books that deal with ‘real life’ working nurses. These books typically fall into one of two categories. The first and most common category is the Hallmark-Moment-obnoxious-musical-card sort of book. When you open the front covers of these books, the heavenly host of white angels of mercy start singing the BeatlesI Want to Hold Your Hand. The other category is the angry, burned out, nurses as the most oppressed group in the world. An example in this category is Suzanne Gordon’s Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes and Medical Hubris Undermine Nurses and Patient Care (Cornell U. Press, 2005).

Imagine my excitement when I encountered the new book on nurses: Carolyn JonesThe American Nurse Project. On first pass The American Nurse Project book looked fresh and inclusive. But then I realized it is a coffee table book and I began to be suspicious. Most nursing coffee table books involve Hallmark Moments. Still, I suspended judgment and read through the book, which includes beautiful black and white photo portraits of 75 nurses, alongside synopses of personal interviews Ms. Jones had with these nurses (in nine states plus the District of Columbia). But something didn’t sit right with me. For one thing, all of the nurses’ supposed “words” were upbeat and uncritical of anything except nebulous ‘health systems’ or ‘poverty’ sorts of issues. In her book introduction, Ms. Jones states that she wanted to do something to “honor nurses” and to “give nurses a voice.” (Nurses have a voice, thank you.) She stated that “…nurses don’t complain much!” along with, “I do believe that they (nurses) are a special breed—some combination of innate compassion and learned behavior.”  (I’m with Kate Winslet here when she recently commented about the theme song to Titanic—hearing it results in internal eye-rolling and nausea). These are not the ‘real’ nurses’ voices that I hear.

As I dug deeper, I discovered the book was commissioned by Fresenius Kabi, USA, a large multinational for-profit company selling infusion therapy for care of “critically and chronically ill patients, both inpatient and outpatient.” Some of the Kabi leaders met with Ms. Jones to pick out nursing topics of interest to them (inpatient critical care, hospice/home health care, returning wounded war Veterans primarily—all heavy consumers of infusion therapy) and then contacted the agencies in the U.S. primarily responsible for this care. They asked them to nominate nurses who “could best represent their institution.” It all makes so much sense now…

Oddly enough, I recently stumbled across a book that at least includes authentic (and non-nauseating) interviews with ‘real nurses.’ It isn’t exactly a current book, and it doesn’t focus on nurses. It is Studs Terkel’s now classic book Working: People Talk About What They Do All Day and How They Feel About It (Avon Books, 1972). He purposefully excluded interviews with doctors and lawyers and writers, pointing out that they already had ample avenues for talking about their work. Instead, he interviewed a wide range of workers, from firefighters and farmers to prostitutes and used car salesmen. The nurses appear toward the end of the book, in a section called “Cradle to Grave.” This section includes interviews with a baby nurse, a practical nurse in an ‘Old People’s Home,’ a teacher, an occupational therapist, a patients’ representative (aka: hospital bill collector), and a gravedigger. Good company. We need someone to channel Studs Terkel and write a book on the real work of real nurses.

3 thoughts on “Working: Nurses Talk About What They Do All Day and How They Feel About It

  1. This is Carolyn Jones and I’m the author of The American Nurse. First of all, thanks for reading the book and writing about it. This is the 4th book I’ve done and it’s true that all of the work that I do is pretty “upbeat.” I was motivated to celebrate nurses and tell their stories because of my own personal encounter with a nurse. It’s been my way in all of my books to celebrate the best in people. My first book was about people living positively with AIDS, so being upbeat is in my DNA.

    On another note, you’re absolutely right – of course nurses have a voice. But I wish that we, as patients, could learn to listen to what nurses know about end-of-life and preventive practices. I want to make that voice louder.

    I do want to clarify one thing. Fresenius Kabi USA was the sponsor for the project in the same way that a company might be a sponsor for a PBS program. They had no editorial input other than to tell me the different kinds of nursing in a general way. There was no conversation regarding who uses what treatment, and to this day I don’t have a clue. The producer on the project, Lisa Frank and I were completely on our own in terms of finding nurses that would shine a light on topics that resonate with everyone. Those topics were driven by the work we do together at the 100 People Foundation, not Fresenius Kabi. FK never got involved in the process other than at the beginning to send us on our way, and the end to see what subjects we had chosen to celebrate. Lisa Frank directly contacted the organizations that we were interested in. The editorial control was completely in my camp – which is the only way I work. So… fair enough if you don’t think I captured the right stories, but it was my doing and not anyone else’s.

    I’m with you on the Titanic theme so I would hate to think that I’m contributing to that pool of work! It was my desire to be authentic and tell the stories as I heard them. We’re working on a documentary film now following six of the nurses that we met. I hope you’ll see it.
    Carolyn Jones

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    1. Hi Ms. Jones,
      Thank you for your thoughtful response and for the points of clarification as to your process for the book. Not sure if you read my previous blog post “Nursing Out of the Closet” (12-6-12), but in that one I gave a positive shout-out to your book’s inclusion of Nathan Levitt and his work on transgender/sexual minority health issues.
      And–your book has a prominent spot on the coffee table in our University of Washington School of Nursing main lobby–so thank you for doing this project.
      ~Josephine Ensign

      Like

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