I was always a reader. The days of the Scholastic book fair during elementary school were among my favorites. Although it doesn’t appear in my CV, my first job was working in the school store. With every shift I worked, the smell of blank sheets of paper, the thrill of a pencil awaiting to be sharpened to that perfect point, or the ballpoint and ink pens in a rainbow of colors stole my hard-earned quarters.
‘Is it on the NCLEX?’
But reading novels during nursing school was just plain hard. There were competing priorities, a brain brimming with vital information, and sheer exhaustion at the end of the day. Assigned readings presented an overwhelming amount of contextual information. And then there was the constant attention to evidence, protocols, and clinical practice guidelines. The “need to know” information took priority; the sheer pleasure of losing oneself in a story—whether novel or memoir—was lost.
During my senior year, in an advanced illness course, my professors assigned a novel-style memoir, Bed Number Ten by Sue Baier. To this day, I can remember the reactions to the assignment: “A book? Who has time for that?” “Are we going to be tested on this book?”
Or, most importantly: “Is it on the NCLEX?”
The influence of a patient’s story on a nurse’s perspective.
After our initial resistance, my fellow nursing students and I began to embrace this assignment, not just through reading this moving patient memoir of an 11-month hospitalization with Guillain Barre syndrome (and the sometimes callous treatment the temporarily paralyzed author received from doctors and nurses), but through our shared experience with the book, inside and outside of the classroom.
As a student preparing for a nursing career, I found it less threatening to receive the disturbing truth of this story through reading words on a page than it might have been to hear it face to face. Baier’s words never left me—I credit her compelling and honest story as a contributing factor as to why I am a critical care nurse today.
Introducing a ‘critical care book club.’
As Sarah McNicol and Liz Brewster (and many others) have observed, stories can develop empathy in a reader, lead to moments of catharsis, and assist the listener or reader in gaining personal insight. While the exchange of stories, whether formal or informal, has long played a role in nursing practice, of late it has become increasingly a matter of interest in health care and beyond with the proliferation of excellent patient, provider, and family narratives.
With such observations in mind, we introduced a ‘critical care book club’ into a team-taught course aimed at reinforcing skills and critical care nursing concepts to senior nursing students. Narrative critical care is an evolving branch of storytelling specifically focusing on listening to the perspective of the critically ill person in order to improve their care.
At the start of the semester, the students were randomly assigned into ‘critical care book clubs’ of 15 to 20, each with a memoir-style reading assignment. Books were written by a critical care practitioner or by a patient who had experienced a critical illness. Books were assigned in increments of pages or chapters over the course of the semester, and students engaged in casual, interactive online discussions facilitated by the course instructor with thought prompts.
The online discussion forum provided students with a safe and familiar medium to electronically interact with classmates. In fact, students ended up discussing the books with the course instructor inside and outside of class and sometimes expressed pleasure at returning to the next installment of a particular story and a particular narrative voice that had become familiar.
Words can describe.
Everyone has a story that deserves to be told. Storytelling is a priceless gift for listener and teller alike. In nursing, patients, providers, and families or caregivers are the talented authors. In times of high emotion, it’s common to say that “words can’t describe” an experience. But I would argue exactly the opposite. Words can describe; in fact, that is precisely their purpose. Words can express, command, forgive, or affirm, but most of all, words can heal. The reciprocal benefits of shared storytelling between those practicing written art and those practicing nursing art should be valued and embraced.
Examples of books used in the course’s critical care book club.
- Bed Number Ten – Sue Baier
- The Patient Experience – Brian Boyle
- In Shock – Rana Awdish
- The Call of Nursing – William Fitzpatrick
- Critical Care – Theresa Brown
By Susan Bartos, PhD, RN, CCRN, TNCC, assistant professor in the Egan School of Nursing and Health Studies at Fairfield University. She is currently pursuing an MFA with a concentration in fiction writing.
Susan,
I could not agree with you more! Use of the arts and humanities when working with nursing or medical students is such a lovely way to teach / discover empathy and develop insight. However, group reading and reflection upon works of memoir or fiction does not need to stop with program completion. I have been part of a Book Club in my OB nursing department for 3 years now. The group is made up mostly of RNs, with a few MDs as well. We read mostly non-hospital or medical-based books, yet, of course, the discussion often migrates to topics we face as health care providers every day – loss, joy, family, empowerment, disenfranchisement, etc. We recently read a fiction novel where the primary character has a falling out with a friend based on an action she thought was “the right thing to do” at the time. The friend was not only angry with her, but would simply not forgive her. We posed this question for discussion: “Has there ever been a time where you were truly sorry, but did not find or receive forgiveness?” One of our book club members shared that she would never forgive herself for allowing her 16 yr-old son to wear cheap plastic flip flops on the day he went fishing in a boat, slipped, fell and hit his head, and drowned. We all were struck dumb. This heartfelt, honest answer allowed us to listen to her story, feel her pain, and relive that moment and those days that followed. And of course no matter how much we said, “It’s not your fault…he was a teenager…it was an accident”, we also needed to witness that sometimes there is no forgiveness. Each book we have read has taken us on a wonderful, deep discussion. We are a better team of nurses and doctors because we take the time to discover ourselves in stories.
While in grad school for cardiovascular/physiological nursing I read Martha Lear’s wonderful book “Heart Sounds,” the story of, well, many things about love and life and marriage, but mostly seen through the lens of her physician husband’s long and ultimately fatal struggle with heart failure. (This was later made into a movie, “1984. New York urologist Harold Lear gets a taste of his own medicine when he suffers a heart attack and is confronted with a medical institution which doesn’t seem equipped to help. … Mary Tyler Moore, James Garner, Sam Wanamaker.”) At the time I was barely thirty, with a lot of open heart experience, including with untimely death, but not the kind of life experience that would have allowed me to be a better nurse to families. We had to present seminars on books we had read; many took texts or other refs, and this is the one I chose.
This book was one of the few I can think of that made me a better nurse, spouse, and person. If I could, I’d make it required reading for every nursing and medical student. I’m not even sure I still have a copy ::note to self, go get another:: because I’ve given away several over the years, but I can still remember sentences, descriptions, scenes with crystal clarity. This sort of storytelling stays with the reader….and can then spread, ripple-like, to far shores we can’t begin to see.