The Shift: One Nurse, Twelve Hours, Four Patients Lives

Nursing Book Club

The Shift: One Nurse, Twelve Hours, Four Patients Lives

By Theresa Brown, RN, BSN, Ph.D. (Algonquin Books, 2015
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Reviewed By Christine Contillo, RN, BSN, PHN

Author Theresa Brown, RN, BSN, Ph.D., found nursing as a second career after teaching college English. She’s one of those rare people who seems to do many things well. In her latest book, The Shift: One Nurse, Twelve Hours, Four Patients’ Lives, we see that it’s not without considerable effort — in fact, this high degree of multi-tasking comes at great cost to her.

New Grad Anxiety

In The Shift, Brown shares just one day on a medical oncology unit at a busy medical center in Pittsburgh. For that unit, her four patients on that shift are probably ordinary, but to me, they seemed frightfully fragile, receiving infusions of toxic medications and suffering decreased cognitive abilities. Some of the patients also have more “normal” personality problems that make medication administration and frequent assessment difficult, if not nearly impossible.

At one point, the author notes that many RNs don’t make it through a full year at this job. I must admit to being one of those. Working on a busy med-surg unit at an inner-city public hospital with the conflicting demands of multiple patients was exhausting. As soon as possible, I transferred to the one-on-one care of labor and delivery.

Reading this book brought back all the anxiety associated with that first job. I was immersed again in that world and had to frequently put the book down and walk away, as I felt my pulse increase just thinking about it. Brown captures the shift and all it entails very well.

We will all be able to identify with the author and we’ve all had patients like these. The Shift gives us an opportunity to reflect back on our own accomplishments: what they might mean to others and the toll they’ve taken on us. For anyone unfamiliar with the nature and difficulty of nursing, both physical and emotional, Brown packs it all on.

Administrators, Take Note

Brown, who is a columnist for the New York Times as well as the American Journal of Nursing, writes as much for the general public unfamiliar with nursing as she does for nurse readers who share her point of view.

She brings a unique personal perspective to American healthcare as it now exists, including all the complexities already obvious to us, but not yet to the business people behind the scene at larger hospitals.

My greatest wish would be for every hospital policy maker to have this as required reading. Administrators seem willfully ignorant of the human side of medical needs. After reading this book, they’d no longer have any doubts about appropriate salary, nurse ratios or the benefit to patients. Nurses? They’re priceless.   

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