Approaching Death

Check out Kimberly Condon’s essay “Approaching Death” (from the anthology I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind, In Fact Books 2013) reprinted today in Slate. In the Slate version the full title includes “A nurse goes from the ER to hospice, and changes the way she thinks about life and its end.”

Congratulations Kim!

Shocking News: Nurses Can (and do) Read and Write

Who would have thought the world would come to this? A world in which there are IMG_1009so many nurses who are not only reading real books, but also writing real books, or essays, or poems, or short stories—so many nurses with the audacity (and ability) to obtain writing credentials, MFAs, writing certificates, and bona fide publications in non-nursing literary magazines and anthologies for God’s sake! Shocking indeed.

That was one of the main takeaway messages I got this week from listening to a podcast interview with Lee Gutkind on RN.FM radio. Lee Gutkind is the founder and editor of the literary magazine Creative Nonfiction; he is also the editor of the recently published anthology I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind (In Fact Books, 2013).

In the radio interview, Gutkind states that the anthology was something he had wanted to do for a long time. Whenever he pitched the book idea to publishers they rejected it, saying it was a bad idea because nurses don’t write and nurses don’t read. So with the support of the Jewish Healthcare Foundation he published it himself under the new imprint of the Creative Nonfiction Foundation. Gutkind admits that he was surprised by the volume of submissions to the anthology, that the submissions “were so much better than we expected,” and “how many had writing degrees, writing experiences, as well as being nurses—it was encouraging to us.”  

The book was first released in early April, quickly sold out, and is now into its third printing. (Amazon says it is out of stock/due in 1-3 months but they should have it in stock much sooner than that. Elliott Bay Book Company has the book in stock and can ship it to you. They hosted our reading of the book this week/is what photo is of). Jane Gross, in her May 20th NYT book review Semi-invisible’ Sources of Strength, wrote of the anthology:

It is beautifully wrought, but more significantly a reminder that these “semi-invisible” people, as Lee Gutkind calls them in this new book, are now the “indispensable and anchoring element of our health care system.”

I would argue that nurses always have been the ‘indispensable and anchoring element in our health care system’ and that most laypersons have long recognized this fact. Perhaps what is different now is that people higher up in the rigid health care system hierarchy are being forced to recognize this. The forces contributing to this shift are fascinating and complex, but have to include the growing proportion of BSN prepared nurses in our country’s workforce. Both Jane Gross and Canadian nurse author Tilda Shalof (whose essay Ms. Gross quotes from) are dating themselves by focusing on the outdated rift between diploma/Associate’s degree (ADN) and four-year university-educated nurses in tertiary care settings. Ladies: in the U.S. that battle is over. As the authors of the Institute of Medicine’s 2010 The Future of Nursing: Leading Change, Advancing Health report states:

The formal education associated with obtaining the BSN is desirable for a variety of reasons, including ensuring that the next generation of nurses will master more than basic knowledge of patient care, providing a stronger foundation for the expansion of nursing science, and imparting the tools nurses need to be effective change agents and to adapt to evolving models of care. (p. 4-9)

Currently, 50% of the U.S. nursing workforce are BSN prepared; the Future of Nursing report has set the goal to increase that to 80% by 2020. What a BSN education includes that an ADN education does not, are grounding in liberal arts (including literature and writing), leadership development, and public health/health policy competencies (more complex systems-level thinking)—all essential ingredients for more nurses to be readers, writers, and change agents in our health care system.

Something that I found disturbing in the radio interview and discussion was how much the two nurse radio hosts stayed stuck in the tiresome tropes of  “nurses as an oppressed profession,” (and specifically that they are oppressed by physicians) and that nurses “empower patients.” “Empowering” someone else is a slippery slope ethically and even practically, and nurses are not the only members of the healthcare team to advocate for patients. As to nurses being oppressed—oppression is understood to mean the unjust or cruel exercise of power. Yes, there are still ‘unjust cultures’ within hospitals that negatively impact nurses (as in the case of Kim Hiatt here in Seattle), but to extrapolate that to the statement that all nurses are oppressed is not only incorrect, it is unhelpful. Unhelpful to the image of nursing and unhelpful to the improvement of our health care system.

 

One of the radio hosts recommended that Gutkind offer a nurse writer conference—as a way to bring nurse writers together, to foster a community of nurse writers. Gutkind replied by encouraging listeners to e-mail him if they are interested in such a conference (information@creativenonfiction.org or under ‘contact form’ at www.Leegutkind.com).

Elliott Bay Book Company ‘Becoming a Nurse’ Event/June 11th, 7pm

The following is from the Elliott Bay Book Company (Seattle) Events page for June. I believe I have Karen Maeda Allman, bookseller and director of Author Events at EBB to thank for the kind description. As a writer who uses their bookstore as a gathering space, she is referring to the fact that I am part of Waverly Fitzgerald’s monthly Shipping Group at the EBB cafe. Thank you Waverly and all my fella’ Shippers for all the support over the years!

I want to add that we may (hopefully) be joined on June 11th by Nina Gaby, psych nurse practitioner, visual artist, and writer from the Boston area. Her essay “Careening Toward Reunion” in the Becoming a Nurse anthology is quite dogeared in my personal copy. I seriously want to meet her… If you are in the Seattle area on June 11th, please come join us for some nurse power time at Elliott Bay.

JOSEPHINE ENSIGN, EDDIE LUEKEN & KARLA THELLEN

Start: 06/11/2013 7:00 pm

It’s a particular pleasure for us when writers who use our bookstore as a gathering space have new work to celebrate, as will happen a few times this spring and summer. Tonight, Josephine Ensign, who has contributed so much to our community as a nurse and teacher of the next generation of nurses, appears with colleague Eddie Lueken and Karla Thellen for a group reading from their new anthology, I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse (edited by Lee Gutkind, InFact Books). Nurses are the backbone of the healthcare system and these stories reveal something of the experiences of nurses at all stages of their careers. Here is illuminating reading for those aspiring to join the profession as well as for those who benefit from their work.

$15.95

ISBN-13: 9781937163129
Availability: On Our Shelves Now
Published: In Fact Books, 3/2013


Location:
The Elliott Bay Book Company
1521 Tenth Avenue
Seattle, WA 98122
United States

Becoming a Nurse: The Events

becominganurseThis week Jane Gross in the NYT wrote a nice review of the new book I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse, edited by Lee Gutkind (In Fact Books, 2013). The title of the book review is  ‘Semi-invisible’ Sources of Strength, referring to the fact that nurses are often the un-sung, un-heard, un-seen cast members in the grand drama that is modern medicine. Semi-invisible sources of strength: I suppose then that nurses are to health care what the backbone is to the human body? Lumpy and bumpy, semi-visible through the skin, at times painful? OK, I’ll stop with the analogy.

In the days following the NYT book review, True Stories of Becoming a Nurse quickly became one of their top sellers. In the past day it has been in the top 20 on Amazon. Fascinating to see the book filed under “healing,” “spirituality,” and “personal transformation,” as if it belongs in Whole Foods next to the crystals and incense and socks made of recycled bamboo. Thanks Jane Gross for writing the review and thanks NYT for including it. That Ms. Gross focused her review on the old old and seriously tiresome rift between diploma-trained and university-educated nurses in tertiary care settings is unfortunate—but understandable given that she was writing the review as a testament to her diploma-trained RN mother. I get it; I’ll move on to more important topics.

Our University of Washington (with support from 4Culture)-sponsored Becoming a Nurse book launch on April 18th at Suzzallo Library in Seattle was a great success. We had a total of five nurse author panelists who read from their anthology essays. Many, many thanks to the four panelists (Kim Condon, Eddie Leuken, Lori Mulvihill, and Karla Theilen) who paid their own way out here to attend the event. I only had to ride my bike two miles in the rain to get to the event—several of the other panelists flew in from across the country). Many, many thanks as well to the mighty team of UW Health Science librarians (Tania Bardyn, Lisa Oberg, Joanne Rich, and Janet Schnall) for organizing, hosting, and recording the event. The video recording of the readings is here . Note that the audio quality is much better than the video but you can see our general shapes as we read!. You can’t see the wonderful audience but they packed the room—standing room only. Thanks all you supportive audience members!

In case you missed the UW Suzzallo Library Becoming a Nurse event, we will have another Becoming a Nurse reading next month (Tuesday June 11th, 7pm) at Elliott Bay Book Company in Seattle. I will be reading along with Eddie Leuken and Karla Theilen). All three of us will read excerpts from our anthology essays, as well as new work.

This Friday (May 24th) at 6:30pm I’ll be reading at the Northwest Folk Life Festival in Seattle as part of the 2013 Jack Straw Writers Program. (6:30-7:30pm SIFF Cinema/Narrative Stage). Kathleen Flenniken, poet laureate of Washington State will be the host/KUOW sponsors the event. I’ll be reading from new work from my collection of poetry and prose I’m working on called Soul Stories: the stories feet can tell about the journey of homelessness. In the essay I’ll read I ask myself (and partially answer) the questions: why am I drawn to the suffering of others? Why have I spent the past thirty years working as a nurse with homeless and marginalized people? Wouldn’t I be happier if I was drawn to work as a shoe buyer for Saks Fifth Avenue? Questions I am sure many nurses and others in helping professions ask themselves.

 ___________________________________________________

The following is the press release for the book.

I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse
Edited by Lee Gutkind
Featuring new work by Theresa Brown, Tilda Shalof, and others.

 

As editor Lee Gutkind points out in the introduction to I Wasn’t Strong Like This When I Started Out, “there are over 2.7 million working RNs in the United States (not to mention our many LPNs and LVNs), compared to about 690,000 physicians and surgeons. There are more nurses in the United States than engineers … or accountants and auditors … And, yet, many of us take the work these men and women do for granted.”

 

This collection of true narratives captures the dynamism and diversity of nurses, who provide the vital first line of patient care. Here, nurses remember their first “sticks,” first births, and first deaths, and reflect on what gets them through long demanding shifts, and keeps them in the profession. The stories reveal many voices from nurses at different stages of their careers: One nurse-in-training longs to be trusted with more “important” procedures, while another questions her ability to care for nursing home residents. An efficient young emergency room nurse finds his life and career irrevocably changed by a car accident. A nurse practitioner wonders whether she has violated professional boundaries in her care for a homeless man with AIDS, and a home care case manager is the sole attendee at a funeral for one of her patients. What connects these stories is the passion and strength of the writers, who struggle against burnout and bureaucracy to serve their patients with skill, empathy, and strength.
Pub. Date: March 2013, ISBN: 978-0-393-07156-6, 5 ½ x 8 ¼, Trade Paper, 278 pages,
$15.95, Distributed by Publishers Group West

 

Lee Gutkind has explored the world of medicine, technology and science through writing for more than 25 years. He is the author of 15 books, including Many Sleepless Nights: The World of Organ Transplantation, and the editor of five anthologies about health and medicine, including At the End of Life: True Stories About How We Die.

In Fact Books is a new imprint founded and edited by Lee Gutkind, editor and founder of Creative Nonfiction. In Fact Books titles help create an understanding of our world through thoughtful, engaging narratives on a wide variety of topics and real-life experiences. All titles are distributed by Publishers Group West. For more information, please visit http://www.infactbooks.com.
For interview requests and other media related questions, please contact:
Hattie Fletcher at fletcher@creativenonfiction.org or (412) 688-0304.

 

Becoming A Nurse: Nurse Writer Panel Discussion

You are all invited/open to the public:

Becoming a Nurse

Nurse Writer Panel Discussion and Reading

Thursday April 18th 6-8:30pm

Suzzallo Library Smith Room

6-6:30 Light Refreshments

6:30-8:30 Panel Discussion, Reading, and Book Signing

I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse

Edited by Lee Gutkind

In Truth Press. Pub. Date: April 2, 2013

This collection of true narratives captures the dynamism and diversity of nurses, who provide the vital first line of patient care. Here, nurses remember their first “sticks,” first births, and first deaths, and reflect on what gets them through long demanding shifts, and keeps them in the profession. The stories reveal many voices from nurses at different stages of their careers: One nurse-in training longs to be trusted with more “important” procedures, while another questions her ability to care for nursing home residents. An efficient young emergency room nurse finds his life and career irrevocably changed by a car accident. A nurse practitioner wonders whether she has violated professional boundaries in her care for a homeless man with AIDS, and a home care case manager is the sole attendee at a funeral for one of her patients. What connects these stories is the passion and strength of the writers, who struggle against burnout and bureaucracy to serve their patients with skill, empathy, and strength.

Panel will include an interview with Theresa Brown who writes for the NYT Well Blog. Participants include Josephine Ensign, DrPH, Associate Professor, Department of Psychosocial and Community Health, whose essay Next of Kin appears in the anthology.

This project was supported, in part, by an award from 4Culture  4culture_color

University of Washington Health Science Library   logo-hsl-admin-color-printer

I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse

smith

For those of you in the Seattle area who are interested in narrative advocacy from a nursing perspective, save the evening of Thursday April 18th, 2013 . I’m working with Lisa Oberg and Joanne Rich of the University of Washington Health Sciences library to host a nurse writer panel discussion and reading 6-8:30 pm at Suzzallo library, in the Smith Room (photo is of the Smith Room/ free and open to the public). I’ll be there along with some other author/contributors to the anthology True Stories of Becoming a Nurse (see below for information).

The following is the press release for the book.

I Wasn’t Strong Like This When I Started Out:
True Stories of Becoming a Nurse
Edited by Lee Gutkind
Featuring new work by Theresa Brown, Tilda Shalof, and others.

As editor Lee Gutkind points out in the introduction to I Wasn’t
Strong Like This When I Started Out, “there are over 2.7 million
working RNs in the United States (not to mention our many LPNs
and LVNs), compared to about 690,000 physicians and surgeons.
There are more nurses in the United States than engineers … or
accountants and auditors … And, yet, many of us take the work
these men and women do for granted.”

This collection of true narratives captures the dynamism and
diversity of nurses, who provide the vital first line of patient care.
Here, nurses remember their first “sticks,” first births, and first
deaths, and reflect on what gets them through long demanding
shifts, and keeps them in the profession. The stories reveal many
voices from nurses at different stages of their careers: One nurse-in-training
longs to be trusted with more “important” procedures, while another questions her ability to care for nursing home residents. An efficient young emergency room nurse finds his life and career irrevocably changed by a car accident. A nurse practitioner wonders whether she has violated professional boundaries in her care for a homeless man with AIDS, and a home care case manager is the sole attendee at a funeral for one of her patients. What connects these stories is the passion and strength of the writers, who struggle against burnout and bureaucracy to serve their patients with skill, empathy, and strength.
Pub. Date: March 2013, ISBN: 978-0-393-07156-6, 5 ½ x 8 ¼, Trade Paper, 278 pages,
$15.95, Distributed by Publishers Group West

Lee Gutkind has explored the world of medicine, technology and science through writing for more than 25 years. He is the author of 15 books, including Many Sleepless Nights: The World of Organ Transplantation, and the editor of five anthologies about health and medicine, including At the End of Life: True Stories About How We Die.
In Fact Books is a new imprint founded and edited by Lee Gutkind, editor and founder of Creative Nonfiction. In Fact Books titles help create an understanding of our world through thoughtful, engaging narratives on a wide variety of topics and real-life experiences. All titles are distributed by Publishers Group West. For more information, please visit http://www.infactbooks.com.
For interview requests and other media related questions, please contact:
Hattie Fletcher at fletcher@creativenonfiction.org or (412) 688-0304.
Early Praise:

A startling collection of stories from the bedside.
—Paul Austin, author of Something for the Pain: Compassion and Burnout in the ER

The elephant in the living room of healthcare is that providers care deeply about and are affected by the people they tend. The best ones are, anyway. In I Wasn’t Strong Like this When I Started Out, nurses recall pivotal moments with patients and families that changed them from onlookers to active
participants in the art of healing. This excellent collection chronicles those experiences in funny, eloquent, and often piercing essays. It should be required reading for anyone beginning a career in healthcare—nurses and physicians alike. —Margaret Overton, MD, author of Good in a Crisis

Within these pages, we learn what it is like to protect a dying patient from a futile procedure, to smooth a newborn’s wrinkled brow for a postmortem photo, to work in a foreign country where medical equipment is improvised from household supplies. These stories teach us the essence of nursing—that even when cure is not possible, comfort is. —Catherine Musemeche, MD, surgeon and author

The nurses in this collection bear witness to life, death, suffering, joy—the many aspects of humanity itself. These are no saccharine tales of self-sacrifice, of stereotypical Florence Nightingale-like ladies with lamps. The men and women in this collection tell stories that cut to the bone, exposing their profession’s deep emotional, intellectual, physical, and spiritual trials. Yet, in those struggles emerges great beauty and human connection. This collection exposes not only the strong, beating heart of nursing, but its brain, muscle, sinew and nerve endings—alive, pulsating, raw, real.
—Sayantani DasGupta, MD, MPH, co-editor, Stories of Illness and Healing: Women Write Their Bodies

An honest and compassionate collection of life in nursing. In voices of novices and veterans in the field, it’s an intimate portrayal of how growth is a two way street. Whether listening, touching or just remembering, when you do anything you can to help your patient, your life is also shaped in the process. They are not just lessons, but gifts, that transcend any hierarchy in medicine.
—Gulchin A. Ergun, MD, Clinical Service Chief, Gastroenterology

Like most physicians, I have a long list of nurses who have mentored me, influencing my practice of medicine in the way they live their lives and care for their patients. This book is a testament to those wise nursing colleagues–and to the paths that have brought them their wisdom.
—Marion Bishop, MD, PhD, Emergency Medicine physician and essayist

With tenderness, honesty, humor, and some anger, the authors of these engaging essays draw us into the complex beauty of nursing from an exhilarating variety of perspectives. This welcome, eye-opening collection should be required reading for every medical student and apprentice hospital administrator.
—Margaret Mohrmann, MD, PhD, University of Virginia

In these powerful narratives, twenty-one nurses unfold what it means to practice their profession: what they are thinking and feeling when they care for patients and when they go home, how they came to choose this difficult and rewarding career, their satisfactions and frustrations, their triumphs and traumas. Moreover: they write exceedingly well.
—Charles Bardes, MD, author of Pale Faces: The Masks of Anemia and Essential Skills in Clinical Medicine

Poignant recollections from often ignored voices in medicine. These wonderful stories resound with truth. —Sandeep Jauhar, author of Intern: A Doctor’s Initiation

Note: My essay “Next of Kin” is included in this anthology. I am the “nurse practitioner wonders whether she has violated professional boundaries in her care for a homeless man with AIDS” included in the book blurb above.

In order to complete the sites visits and other research necessary for writing my essay, I received a 2011 Individual Artist Award from 4Culture. Therefore, this project was supported, in part, by an award from 4Culture; thank you 4Culture.4culture_color

 

Boundaries in the Age of Public Confession

Ephesus Ampitheater
Ephesus Ampitheater (Photo credit: The Brit_2)

I’ve been following the fallout from Liza Long’s controversial blog post “I am Adam Lanza’s mother: it’s time to talk about mental illness” (first posted on Boise State University’s The Blue Review blog 12-14-12, then re-posted on Ms. Long’s personal blog The Anarchist Soccer Mom, then re-posted on Huffington Post from whence it ‘went viral’ and landed Ms. Long interviews on NBC’s Today Show, ABC news and CNN).

In “I am Adam Lanza’s mother,” Ms. Long writes candidly about her struggles as a single mom with her 13-year-old son (one of four children) who (she claims) has angry, violent outbursts, and for which she recently had him involuntarily placed in an inpatient psychiatric facility. She says she changed her son’s name for the blog post, but she includes a photograph of him (looking perfectly angelic gazing at a butterfly perched on his hand). Many people have questioned the ethical and legal issues of her writing such things about her child in a public way. (For an interesting critique of Ms. Long’s post, see “Don’t compare your son to Adam Lanza” by Hanna Rosin, Slate, 12-17-12).

The urge to tell our stories (and those of our loved ones) must go back to the campfire stories our ancestors told while cooking Bison or whatever was for dinner. It seems locked within our DNA. But this is more than just telling true—or true-ish—stories; it is private confessional stories taken into the public realm Why do we do this?

Call it a different version of the ‘Oprah Effect.’ Like the tragedies in public amphitheaters of Ancient Greece, we live in an age of the spectacle of public confession, in TV talk and reality shows, internet chat rooms, blogs and other evolving media sources, and in books. Whether this is a good or a bad thing, or a combination (likely) for individuals, families, communities, and our society is a matter of debate. Do we confess to gain a sense of catharsis, or as an attention-getting device to say “look world: I exist! I may be weird, but I exist!”  Do we confess out of hope for fame and fortune? For the vicarious pleasure we get out of viewing train wrecks of people who are worse off than we are? (Schadenfreude is part of the human psyche). But why is this public confession a particularly American thing to do? Sure, people in other countries like Britain and Australia excel at this, but here in the U.S. we seem to take it to ever-greater extremes. Reflecting back on the similarities to the tragedies of Ancient Greece, is it part of our version of democracy?

These are questions I have asked myself throughout the process of writing narrative nonfiction (essays, a book, this blog), as a way of informing and forming the content of my writing. I began this blog several years ago with a post about my struggles helping my elderly father navigate the confusing healthcare system after his diagnosis with advanced congestive heart failure. I asked my father for his permission before I wrote/published about his illness, but I haven’t had him read and approve every blog post or published essay since then.

Writing true stories about anyone but oneself is fraught with ethical challenges. That doesn’t mean it shouldn’t be done. Personal ‘true’ stories have a power not found in fiction. Like with all power, comes responsibility. As Lee Gutkind and the contributing writers of Keep it Real (WW Norton, 2008) state, “… writers have an ethical responsibility to consider the ways in which their stories may continue to affect their subject’s lives, even long after publication.”