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 different patients (she was working in a stem cell transplant unit at the time); completes admissions and discharges; and communicates with families, colleagues, and administrators.

This book brought back vivid memories of what my own clinical days were like—intense, exhausting, and often frustrating, but mostly satisfying, because of the work, the patients, the colleagues.

While I hope nurses will read this book, especially staff nurses who will probably recognize Brown’s story as akin to their own, here’s who I think should be required to read it:

  • Hospital administrators and board members. Brown highlights the demands of managing the changing needs of four patients and shows how even one patient with a real or potential crisis can disrupt and delay care to others (and what might that do to HCAHPS scores?). On such days a nurse might work a 12-hour shift without a single break. And many nurses have six to eight patients, compounding the issues and the stress (and what might that do to the risk for errors?). Perhaps this book will help hospital administrators and board members to better appreciate all that goes into good nursing and give them another reason to invest in appropriate staffing.
  • Medical students, residents—heck, all physicians. Many think they know what nurses do because they’ve worked alongside nurses, but they only see us performing clinical care and coordinating patient care. They often don’t “get” the thinking that underlies our actions. Perhaps this book will help them better appreciate the intellectual and organizational skills nurses use. Brown asks little of her physician colleagues: “Listen to me as a colleague and consider carefully what I tell you about your patient.” Most nurses would probably agree with that, though I’d add, “Answer my page when I call, because I only call if I really need something.”

I hope the general public reads this book, too. It’s time for consumers to see past the traditional stereotype in which nurses are only physicians’ helpers, and see instead the essential role that nurses play in ensuring quality and safety in health care.

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Editor-in-chief, AJN


  1. […] Working a Shift with Theresa Brown gets at what my friend Marianna Crane and I aimed to do when we wrote our nursing memoirs. To show not only what nurses do, but how they think. What goes into their decision-making to choose nursing as a profession, their clinical specialty (child health, adult health, mental health, and more), their role (bedside nurse, teacher, nurse practitioner, administrator, researcher and more), and then what is required of them as they fulfill their roles. […]

  2. Lois Roelofs July 20, 2015 at 8:33 pm
  3. Carol Loves to Travel July 20, 2015 at 1:46 pm

    Looks like an interesting read. It would be wonderful if the daily life of a shift nurse was able to be shared in an educational and informative manner. So many of the “reality” shows have twisted the public’s idea of what we do on a daily basis. I work on a neuro/trauma/ortho acute care unit and we have 6 patients every day.

  4. Joanne Disch July 20, 2015 at 12:55 pm

    Just as Shawn Kennedy rarely writes book reviews, I rarely write blogs – but I am making an exception here because I think she makes a persuasive case for reading the book – and for sharing it with others who would benefit from reading it.

Comments are moderated before approval, but always welcome.