A Final Arc of Sky, Memoir of a Critical Care Nurse

Nursing Book Club

A Final Arc of Sky, Memoir of a Critical Care Nurse

By Jennifer Culkin (Beacon Press, 2009)
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Reviewed By Elizabeth Hanink, RN, PHN, BSN

After a long day at work, you might not find the prospect of a book on nursing that appealing. After all, that’s what you do all day. In this case, make an exception. Jennifer Culkin writes so truly about our profession, and with such passion, that it’s hard to put her book down. Instead of the mushy glorification of patient care and the edgy cynicism of an old veteran, she offers a glimpse into the world of a highly skilled specialty where nurses do their very best while acknowledging, as only true professionals can, that not everyone is going to live. How poignant it is, trying against all odds, yet knowing you probably won’t succeed.

Culkin worked as a critical care and emergency flight nurse. Some of her stories will leave you in stitches; some will break your heart. She has an uncanny ability to paint the foibles of people while still depicting them with tenderness and respect. Her breadth of experience, from tiny neonates to critically injured adults, provides a wealth of anecdotes together with an appreciation for the vast array of skills necessary in this type of nursing.

And, like all nurses, Culkin doesn’t work in a vacuum. She has a family, troublesome at times, but also the source of many of her great strengths. The frustration of coping with frail parents who refuse her advice is palpable. So is her pain when they begin the inevitable deterioration that chronic illness brings. Her willingness to reveal her deep struggles with the people closest to her gives depth and authenticity to this memoir and enables her to capture the irony of facing the same decisions you have watched patients make. Despite all our experience, nurses probably handle lingering illness and death within their families much like everyone else: with confusion and doubt.

To balance a pressure-packed career with a stressful family life is enough. But Culkin has the added burden of multiple sclerosis. For a long time she was able to avoid a definitive diagnosis; MS, with its copycat symptoms and waxing and waning nature, lends itself to evasions of the truth. Eventually though, even as stalwart a character as she had to acknowledge that doing your very best won’t always work.

In 2005, she was forced to give up nursing, at least at the bedside. However, in a fundamental way she is still a nurse. Now her readers benefit from her expertise. Very few writers of our profession write about debilitating fatigue and guilt-inducing burnout as well as Culkin. Thirty years is a long time to give so completely and on so many fronts, and her segue into writing with such truth is a wonderful way to extend her career and continue to serve the nursing profession. 

Elizabeth Hanink, RN, PHN, BSN, is a freelance writer with extensive hospital and community-based nursing experience.

This article is from workingnurse.com.

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