Tag: United States

Weekend Writing Retreat for Nurses/NYC

Here is a terrific writing retreat geared for nurses. I took a writing workshop this past April with Joy Jacobson and Jim Stubenrauch (at U of Iowa’s Examined Life conference) and can attest to the fact that they are wonderfully supportive teachers.

From the Center for Health, Media & Policy at Hunter College (CHMP) HealthCetera blog:
Weekend Writing Retreat for Nurses
by Jim Stubenrauch
If you’re a nurse who writes or one who wants to write, please join us for Telling Stories, Discovering Voice: A Writing Weekend for Nurses, to be held July 19-21, 2013 in New York City. This is a chance for all nurses and nursing students to strengthen and expand their capacity to write in a variety of modes and genres, including personal essays, poetry, and fiction, as well as blog posts and articles on clinical and health policy topics. We’ll write together in a safe and supportive environment, share our writing aloud, offer encouragement and constructive feedback, and discuss the role of narrative in medicine and nursing. We’ll also examine the potential for using social media as a public-health tool.

The conference will be led by CHMP poet-in-residence Joy Jacobson and senior fellow Jim Stubenrauch. This special event is co-sponsored by the Center for Health, Media & Policy at Hunter College (CHMP) and the Hunter-Bellevue School of Nursing, and is offered as part of the CHMP’s program in Narrative Writing for Health Care Professionals. Participants will receive 17 continuing education units.

We’re very excited that Karen Roush, clinical managing editor of the American Journal of Nursing and the founder of The Scholar’s Voice, will be the keynote speaker. Karen has extensive experience as a writer, teacher, and nurse and has published books, scholarly articles, personal essays, and poetry.

The price for the conference (including continental breakfast and lunch each day) is $675 + $20 registration fee until July 1; $725 + $20 fee after July 1. Groups of six or more from one institution receive a discount price of $575/person. Students receive a 20% discount. Register for the event online at https://ceweb.hunter.cuny.edu/cers/CourseBrowse.aspx. (In the “Search Courses” window at the upper left, enter course code SEMTSDV.) Or call 212 650-3850.

Want to know more? Check out these two blog posts about last summer’s workshop: in the first, attendee Patricia Wagner Dodson, BSN, RN, MA, CCRN wrote that “in this workshop community of real nurses and real writers, a consensus seemed to emerge: the stories need to be told. The workshop was the beginning of the telling.” In the second, I shared some of my own impressions of the weekend, with excerpts from pieces written during and after the workshop by two other participants, Karen Hardin, MS, RN and Amy Dixon, BSN, RN.

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!

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.

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

By Lee Gutkind
$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.

 

Death, taxes, and childbirth!

Cover of "Gone with the Wind"
Cover of Gone with the Wind

“There’s never any convenient time for any of them.” Thus said Scarlett O’Hara in Margaret Mitchell‘s Gone with the Wind.

I have no advice to offer on either taxes or childbirth, although I have experienced both in my life. But I do have advice on death, specifically on the importance of having Living Wills/Advance Directives. I’ve written many blog posts related to this topic, about my frustrating encounters with the healthcare system misplacing/not honoring my elderly father’s Advance Directives.

“April 16 is National Healthcare Decisions Day, and I hope that you will take this time to discuss and document your healthcare wishes.  We all need to be prepared in the event of a health crisis, and having the talk is easier than most people think, but many of us need a little inspiration or a reminder to do it.  I hope that this message and National Healthcare Decisions Day are all you need for inspiration.  Please check out the short, but fantastic video at www.nhdd.org and then mark your calendar for April 16 to have the talk with your loved ones.  There are all sorts of free resources–including free advance directive forms for each of the 50 states–on the NHDD website: http://www.nhdd.org. Additionally, please help me spread the word with Twitter, Facebook, and LinkedIn. Advance care planning is something we ALL should do and encourage others to do, regardless of age or current health.  Discussing your wishes can be one of the most important gifts you ever give your loved ones.” (from Nathan Kottkamp, Chair of the National Healthcare Decisions Day initiative.”

Related to this topic, and especially relevant to nurses, is the excellent American Journal of Nursing short essay by Doug Olsen, “Issues Raised by Media Coverage of a Nurse Declining to do CPR.”In his essay, Olsen points out the ethical issues related to media people who sensationalized the case of the ‘nurse’ in a California assisted living facility who refused to do CPR on an elderly woman resident. But he also points out the willful lack of education of the general public (by the healthcare system) about the dangers of and limits to CPR, especially in elderly patients. This is something nurses and other healthcare professionals need to do a better job with.

So listen to Scarlett: do your taxes, attend to whatever childbirths you may encounter, and talk with your loved ones about their end of life wishes.

My Week As A Chavista

OLYMPUS DIGITAL CAMERAFormer Venezuelan President Hugo Chavez is having a state funeral today, being buried in the red beret and green army uniform he came into power with fourteen years ago. He won’t really be buried. Instead, his body will be “embalmed like Lenin” and displayed in a glass case for “eternity,” perhaps in his recently built New Museum of the Revolution, or in the new $60 million Mausoleum for Simon Bolivar.

The first time I visited Venezuela was in August 1999, during Chavez’s first year of presidency. He had publicly vowed to end poverty and homelessness—a laudable if impossible goal. I spent a month in Venezuela, first in the mega-city Caracas and then in the agricultural state of Yaracuy. It was there that I found myself wearing a red shirt and being interviewed on TV and by newspaper reporters about the situation of homeless youth in the U.S. I was asked to give a public talk on reproductive health of homeless young women at the local university. My talk was sponsored by the federal Ministry of Families social services agency. The shortened title of my talk became “Infancia Abandonada,” literally translated as abandoned children. There were about fifty people in attendance, with the front two rows occupied by the Venezuelan military in their red berets and gold braid and tassels. It was an interesting cross-cultural immersion experience. Even at the time I realized I was a political pawn in the grand chess game of inter-American relations. They wanted me to highlight how a rich (and arrogant) country like ours can have such a large homeless population, including abandoned children living on our nation’s streets.

The public health and nursing schools located in Yaracuy wanted to establish research ties through me with the university in the U.S. where I work. But since their university was state-run and Chavez became increasingly anti-U.S., those research ties had to be undone. I’ve returned to Venezuela twice since my first visit. On my most recent visit in 2010, it was a vastly different country: rolling electricity blackouts, water stoppages, food shortages and rationing of even basic staples like corneal, and major roads almost impassable by lack of maintenance. There was also a palpable level of anxiety and dis-ease among the Venezuelans, especially in Caracas but also noticeable in other areas of the country I visited. The only other country I have ever been in where I felt a similar level of dis-ease was in the military-run Burma/Myanmar. While poverty levels have reportedly been lowered during Chavez’s fourteen years in office, I was left wondering who exactly was measuring this and how they were measuring it. I was left wondering if there aren’t much worse things than poverty and homelessness….

Into the Sunset

dadatbeachIn October 2010 I first wrote about the journey of my elderly father through declining health and the healthcare maze. In my blog post titled A Practical Man and Modern Medicine this is how I started his/our story:

Today on the phone, my 87-year-old father asked me to be his patient advocate. He is facing tough health care decisions over the condition of his heart, and is scheduled for surgery in a week. He is a practical man, bright, charming, and articulate, with no cognitive deficits that I can detect. He told me where his Living Will and Advanced Directives are, where he wants his body donated for medical research, and what to do when his CD matures (he’ll be in surgery) so that he can roll it over to a money market account. He says he needs access to the money for his after-hospital care, in case he survives surgery. I am thinking about the health policy issues within all of this: 1) heart failure accounts for the largest portion of Medicare expenditures, 2) none of his doctors have talked with him about what all is involved with this surgery, or what quality and quantity of life he can hope for afterward, and 3) home care provided by family members is not well supported (financially and otherwise) in our country. As his daughter and as a family member embedded in the health care system, what do I do with this information?

Almost three years later I still don’t know what to do with this information. I have discovered the healthcare system to be even more bewildering and capricious than I had imagined. I last wrote about my father this past fall in the post Transitions (October 22, 2012), when I was back in Virginia helping him survive the rough crossings between four different health care settings in six weeks—the last one being the calmest and sanest of all—home hospice. My father was weak, oxygen-dependent, and had advanced wasting from end-stage congestive heart failure. His cardiologist didn’t expect him to live much past Christmas. The day after hospice started my father used his walker to get from his hospital bed in the living room to the studio in the back of the house. Once there he strapped himself into his recumbent exercise bicycle and started “getting back into shape again.” We all thought he was nuts, but decided if he wanted to die while riding his bike off into the sunset of the studio that was his choice.

Since then he has confounded his cardiologists who say that by all objective measures my father should be so physically disabled as to be bed bound. Instead, he once again ‘graduated’ out of home hospice and as I write this he is riding his ‘real’ bicycle off into the ‘real’ sunset on a beach in Florida to meet up with friends for Happy Hour, sans alcohol for my teetotaler father. The photo to prove it was taken by my niece who is his caregiver for a few weeks.

Clearly my father’s story is not over, even though he has finished writing his memoir in barely decipherable handwriting on ten legal pads, which are in the mail to me. My father wants me to transcribe them and make into a book. “After all, this whole memoir business was your idea,” he said to me. He wants to proofread the final draft to make sure I didn’t change any of his words.

Last fall I wrote an essay titled Home Death about my experiences with the healthcare system, as I tried to uphold my role as health care advocate and proxy for my father. It was published recently in Johns Hopkins Public Health: The Magazine of the Johns Hopkins Bloomberg School of Public Health, Special Issue 2013. You can read it here.

Head, shoulders, (teeth), and toes….

Dentistry logo
Dentistry logo (Photo credit: Wikipedia)

Of all parts of the human body, only feet and teeth have their own separate health care providers. Feet have podiatrists (although they also have orthopedists/medical specialists). Teeth have dentists and only dentists—there are no medical specialty fields that deal with teeth. Oral surgeons may do some crossover work in medicine, but in the U.S. at least they are still considered dentists. As we all know from living in/with our own bodies, feet and teeth have a lot to do with our overall health. I’ll deal with feet in some future posts, but today I want to take a closer look at teeth and oral health.

First of all, why are dentistry and medicine so separate? That seems to stem from a historical artifact, having to do with the history of Western Medicine, the separation of physicians (higher class) from surgeons (lower class, tied to trades). Surgeons—including ones who did crude dentistry—tended to be barbers, blacksmiths, and silversmiths. Supposedly Paul Revere, our Colonial patriot and silversmith also dabbled in dentistry. Revere developed the field of forensic dental science. The father of dentistry is considered to be the 17th Century Frenchman Pierre Fauchard. He encouraged the gargling of human urine as prevention of dental carries. I assume this was before the concept of minty fresh was popularized.

The continued separation of dentistry and medicine is problematic on many levels. It explains why we have separate medical and dental health insurance industries in our country. It explains why dental insurance and dental care are so expensive, and why dental care is viewed as a luxury item available mainly to the rich. It explains why the American Dental Association is engaged in a turf war trying to block the development and expansion of so-called dental mid-level providers (also called “supervised dental extenders” or “dental therapists.”). It explains why nursing and medical students get little to no education or training in oral health.

Dental problems lead not only to pain, infection (including fatal infection), and tooth loss, but they also contribute to the increased risk for serious medical conditions such as diabetes, heart disease, and poor birth outcomes. Poor people, persons of color, immigrants/refugees, and people living in rural areas of our country have a higher burden of dental problems and less access to dental care. In 2009 (latest available stats I could find) there were 830, 590 emergency room visits in our country specifically for dental problems; this was a 16% increase from 2006. The overwhelming majority of dentists in our country are located in affluent suburbs, and most refuse to treat Medicaid patients. The Healthy People 2020 report includes oral health as a leading indicator of U.S. population health, the first time oral health has been included in our national health guidelines.

The ACA has included children’s dental care as an essential health benefit, but worrisome loopholes in the proposed implementation of the law have developed. As currently worded, dental care would be ‘essential’ as long as dental coverage is offered as an ‘add on,’ meaning that parents could opt out of dental care without being assigned penalties. There is also concern that individual and small group markets under ACA don’t have to cover adult dental coverage. (see: “Gaps in health law dental coverage” by Paige Winfield Cunningham, 2/15/13, Politco).

Some of my nursing students have asked me about their potential ability to get more involved in oral health/dental primary care, over and above the usual dental hygiene/ oral health literacy they know they can do. This will vary by state professions licensing/regulatory laws, but in Washington State nurses can and do provide community-based fluoride varnish services for high-risk children and adults:

“Medical personnel working under the delegation of a licensed physician with documentation of completion of a training program on fluoride varnish are also qualified to apply fluoride varnish in health settings.” (source: Washington State Department of Health website, “Fluorides and Fluoridation.”)

Additional resource:

Dental Crisis in America: The Need to Fix Access. U.S. Senate Report. Senator

Bernard Sanders/Committee on Health, Education, Labor and Pensions. Subcommittee on Primary Health and Aging. February 29, 2012.

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

 

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 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.