Working a Shift with Theresa Brown

bookBy Maureen Shawn Kennedy, AJN editor-in-chief

Many of you may be familiar with Theresa Brown, nurse and author of Critical Care: A New Nurse Faces Death, Life, and Everything in Between, as well as a blogger for the New York Times. Brown also writes a quarterly column for AJN called What I’m Reading (her latest column, which will be free until August 15, is in the July issue). Her new book, The Shift: One Nurse, Twelve Hours, Four Patients Lives, will come out in September, and I was able to read a prepublication copy. (You can pre-order it.)

I don’t usually write book reviews. I think of most books like food: what one person finds delicious may be less savory to another. But I’m making an exception because this book is an accurate and well-written portrayal of nursing (at last!).

Anyone who wants to know what it’s like to be a nurse in a hospital today should read this book. Patients, families, and non-nurse colleagues tend to see nurses as ever-present yet often in the background, quietly moving from room to room, attending to patients, and distributing medications or charting at computers. But what they don’t understand about what nurses do is what Brown so deftly describes—the cognitive multitasking and constant reordering of priorities that occur in the course of one shift as Brown manages the needs of four very […]

End-of-Life Discussions and the Uneasy Role of Nurses

Amanda Anderson, BSN, RN, CCRN, is a critical care nurse in New York City and enrolled in the Hunter-Bellevue School of Nursing/Baruch College of Public Affairs dual master’s degree program in nursing administration and public administration. She is currently doing a graduate placement at AJN two days a week, working on a variety of projects. Her personal blog is called This Nurse Wonders.

Evelyn Simak/ via Wikimedia Commons Evelyn Simak/ via Wikimedia Commons

Nurse and writer Theresa Brown wrote a piece for this past Sunday’s New York Times on the dilemmas physicians face when their patients want to stop aggressive treatment (the latest installment of Brown’s quarterly column, What I’m Reading, is in the September issue of AJN [paywall]).

Brown’s Times column talks about physicians who have trouble letting patients go and instead push for more unnecessary and often unwanted treatment. She describes a case in which—after palliative care has been decided upon by the patient’s family members, the palliative care team, and even the heartbroken oncologist—the patient’s primary care physician intervenes and pushes for still more futile treatment. (Much of the article delves into the broader issue of palliative care and the benefits it has for patients in many stages of chronic illness.)

Have you ever […]

The Perception Treadmill: Has Nursing’s Status Really Gone Anywhere?

a Treadmill

By Margaret Gallagher, BSN, RN. Margaret is a cardiovascular nurse currently working in Georgia. Her last post for this blog was “Return on Investment: A Mother Makes Her Wishes Clear.”

Usually, it’s nice to share stories among friends you haven’t worked with in a while. However, I haven’t been able to let go of one such recent conversation.*

“You want to know what really burns me?” asked Lisa, a long-time nurse, as I sipped my coffee. “The rumors had been going around for a while that the residents get an incentive if the patients’ coag levels stay within therapeutic range. You know that John and I go way back; I decided to just flat out ask him.”

I listened attentively, expecting that Lisa and John’s friendship wouldn’t keep the attending MD from laughing her out of the ICU for this one.

Lisa glowed like an electric oven coil. “John told me it was true, and with a straight face! How dare they! All the residents do is click on ‘heparin protocol’ in the computer when the patient’s admitted. We draw the labs, follow the protocols, and titrate the drip around the clock until the patient is transferred, but they get the bonus. Does that stink or what?”

I couldn’t help but think back to my very first code. It was three states away and nearly three decades ago. For those who’ve never worked in a teaching […]

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