The Shift

The Shift

YA nonfiction
"...There won't be any floating once I hit the hospital floor.
I'll have drugs to deliver, intravenous lines to tend, symptoms to
assess, patients in need of comfort, doctors who will be interested in
what I have to say and others who won't, and my fellow RNs, who with a
combination of snark, humor, technical skill, and clinical smarts,
work, like me, to put our shoulders to the rock that is modern health
care and every day push it up the hill."
For reasons I will explian later,every library should have two
copies of Theresa Brown, RN's The Shift. Brown, a nurse and former
college English professor takes the reader along on a twelve hour
shift at the hospital oncology ward she works at. In addition to the
actions that take place, we are privy to her thoughts and feelings.
We also get to know the patients she cares for and their families
intimately.
For that reason alone, the book would be a fascinating read. It
is so much more. In a seamless blend of narrative and theme, Brown
brings up a number of issues that should have us very concerned about
21st century American health care.
One concern Brown brings up that I regularly see played out in
the state and local section of the Bangor Daily News is the tendency
to cut down on the number of nurses on a shift to reduce labor costs.
"...The more patients an individual nurse cares for, the smaller the
amount of TLC per patient. More significantly, research on staffing
levels has above a certain number (the number itself depends on the
patient population and how sick the patients are,) the larger the
liklihood a patient will die who wouldn't have otherwise. In other
words, nurse-to-patient ratios aren't just about patients feeling
cared for; they're also about fragile people staying alive."
Another peril Brown describes quite eloquently is one many of us
have at least heard about. The hectic, pressured, intense schedule
considered normal for health care professionals may not do them or
their patients any favors. "When doctors and nurses train, the idea
is to push through exhaustion, ignore it, transcend it, but only the
rarest of us can really do that without drugs to help, and no one,
even with chemical stimulants, can do it forever. Humans need sleep
as much as we need food and water, and when we don't get enough our
minds fray at the edges."
And there are plenty more areas of needed awareness.
Libraries will put The Shift in the YA section since teens
constitute the target audience. It's perfect for them, especially for
any youngsters interested in going into nursing. However it is an
equally good read for not so young adults. Although an increasing
number of us raid the YA fiction section, "reading down" in nonfiction
still carries somewhat of a stigma.
Many of the books penned for adults that seek to raise a let the
buyer beware awareness in regard to the modern American health care
system are written by doctors. While doctors know whereof they speak,
they often are clueless when it comes to adressing people without
medical degrees. Their works can range from over most of our heads to
snarky and condescending. Brown delivers the perfect blend of
pertinent information interspersed with fascinating narrative.
Readers, you would do well to at least skim The Shift even if
you have to cross over to the YA section. (Libraries put a second
copy in your adult wing). While most of us will never become health
care professionals, as Brown reminds us, very few, if any, of us will
get throughout life without at least now and then being hospital
patients. Her message is particularly pertinent since this is
National Patient Safety Awareness Week. In a fine op ed piece
appearing in the March 17, 2006 Bangor News (I highly encourage anyone
out of the area to read the whole thing on the Internet) RN and
patient safety advocate Kathy Day informs us that preventable health
harm is beat out only by heart disease and cancer as leading causes of
death. She leaves us with the vivid image that the population of the
whole state of Maine is equal to three years of health care
mortality. And then there are the legions who are permanently
disabled and often lose everything. She includes in her piece this
inspiring paragraph:
"Must we accept that healthcare can be a crapshot? Absolutely
not. We need to hold the health care industry, providers and
caregivers accountable for this harm and for making necessary
improvements. We pay for and deserve safe, high quality care when we
are sick or injured. We need to protect ourselves and our loved ones
from avoidable harm that can lead to disability, death and financial
devastation. Zero harm is the only acceptable goal."
On a personal note, I had a point at which my bitchiness and the
timely intervention of a nurse saved my life. I had given birth to my
first child by emergency c section. I was experiencing symptoms I
considered red flags. I mentioned them to the doctor leading the
rounds entourage. He just said "It's your imagination," and made a
dismissive quip to his followers about first-time mothers. At that
point a hospital acquired infection was wreaking havoc on my surgery
stressed body. Luckily I was stubborn enough to override him and
ring my nurse. She listened, took vitals, and set things in motion to
get me on intravenous antibiotics. I was in that hospital nine days.
My day of discharge a social worker said I had almost died. If I'd
accepted that doctor's opinion I'd have most likely left the hospital
in a body bag instead of the mandatory wheelchair.
A great big shout out goes out to Brown and Day for their education
and advocacy and to nurses around the world. Nurses, in my book, are
rock stars. I try to share my story with as many of then as I can in
thanks for the so far over a quarter of a century of very good life
one of their number gave me. Treat the nurses in your life like the
superheroes they are.
Julia Emily Hathaway


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