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

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 Beatles’ I 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 Jones’ The 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.