Dear Lit Loves,
While I'm patiently waiting to hear from literary agents and publishers, I'm continuing to read widely in my preferred genre of memoir. Last week I read Critical Care: A New Nurse Faces Death, Life, and Everything in Between by Theresa Brown. I really like to read about all things medical as I've had a vast amount of experience with the medical industry over the course of not only my life, but the lives of my immediate family. This book was a very fine read about a woman who was once an English professor at Tufts University when one day she decided she wasn't doing what she wanted to do with her life. Happens to quite a few of us. She decided to return to school to become a nurse and this book chronicles her first year of nursing on an oncology ward.
One of the first nurse responsibilities Ms. Brown chronicled was when to call a "Condition A". A "Condition A" means a patient has crashed or arrested. I had always assumed it was the physician that made this call, but no, nurses make the call especially if you are in house at the hospital and not arriving via ambulance. When a nurse makes this kind of call, it basically means all hands on deck; we've got a patient in serious distress and on the verge of death. In this particular case Ms. Brown encounters a woman who had been admitted after a CT scan showed profuse amounts of lung disease and the patient was having trouble breathing. When her heart rate went to 160 beats per minute the all hands on deck mode went into effect whereby adenosine, a medication to regulate heart arrhythmias, was administered. This caused the patient to experience a kind of shock, but it also stabilized and returned to a regular heart rate. Two weeks later Nurse Brown returns to see this patient once again on her rotation, but the woman is near death. Her body remains, but she is unaware. She was having such a difficult time breathing that she was experiencing air hunger where the patient is grasping physically for air. The family of the patient asks Nurse Brown to assemble a priest to administer last rites. Later, after family members have expresses a desire for the patient to no longer suffer, Nurse Brown removes the breathing mask and gives the patient morphine. The patient passes. This is Nurse Brown's first experience with patient death and she learns that she must call the funeral home and the funeral home prefers to pick up patients with no family members present.
It was also interesting to me to read about a nurse's first year experience on an oncology ward for cancer patients as I've spent much time on one. My dad has anaplastic large cell lymphoma that has relapsed twice and he's also had a stem cell transplant. Additionally, my mom has endured breast cancer. And my dad and I have both been treated for skin cancer. An oncology floor is challenging, but it's not without its victories as when Nurse Brown stands up to a pre-op nurse in order to make sure one of her sickest cancer patients gets his Hickman catheter so he can begin receiving his chemo treatment. Cancer doesn't take a vacation and the longer a patient has to wait for catheters to be embedded in the body, the more time the cancer has to spread. Nurse Brown thinks like this and she wasn't scared to stand her ground against another more experienced nurse in another busy department of her hospital.
And nurses are also the folks who have to deliver news of death to a family member. This happens when a patient assigned to Nurse Brown is sent down to the basement area of the hospital for a radiation treatment. His wife chose that time to go to lunch or run an errand. Later, Nurse Brown receives a call from radiation informing her that her patient down in radiation has coded and since he has no "do not resuscitate" papers, the medical team is continually trying to revive him. Nurse Brown has to be the one to give this news to the patient's wife upon her return, but the wife must go down to radiation and give the crash team permission to stop trying to revive her husband. And only then can the medical team pronounce the patient dead. My advice: Have the living will done, get the healthcare power of attorney form completed and signed by a notary, and don't make your family have to make these kind of awful decisions when something dire happens to you.
And who even knew that bullying exists even among the nurses at a hospital. Sure enough, Nurse Brown experiences brushes with nurses who critique her patient notes and those that just plain want to point out her shortcomings in front of all the people on the oncology floor. This made me furious because honestly, there's no time for this type of juvenile behavior on an oncology ward. So I was glad to learn that Nurse Brown moved to an adjacent oncology floor where stem cell transplants and bone marrow transplants take place. There's no shouting at staff, no staff belittling one another, and better still, the oncology staff works as a team and takes up for one another. This is as it should be.
I thoroughly enjoyed this book, learned quite a few things in the process, and overall felt satisfied I had come away from the book knowing more than when I first read the back copy. It's excellent and you should read it. Until next time,
Grace
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