In celebration of my blog’s new focus, I would like to repost a review of the book that instantly convinced me to become an ICU nurse. When I had my interview for the ICU, I wasn’t ashamed to say that I wanted to work there because of Tilda Shalof’s book. Have a read, the book review says it all!
When I first read Tilda Shalof’s book, “A Nurse’s Story: Life, Death, and In-Between in an Intensive Care Unit” three years ago, it changed the course of my entire nursing career.
When I began work on my Bachelor’s degree in Nursing, I was dead set on becoming an Emergency Room nurse. My vision was completely tunneled, and no other alternative was acceptable. When I wrote a paper in my first of four years entitled “Why I Became a Nurse,” I wrote that I became a nurse because I loved the television show ER and I wanted to be just like the nurses I saw on TV. This reason was partially in defiance of what I felt was an essay topic suitable for a grade three class, and partly because I wanted to be unique. I was quite aware that what they were looking for were stories of being “called” to the profession.
However, in Tilda Shalof’s book, I found a new hero (sorry Carol Hathoway)! The author takes our hand and pulls us, with eye’s wide open, into the world of the ICU. When I first read the book, I had minimal real-life hospital experience. I had only spent about eighty hours on a medical unit giving bed baths and helping patients to the bathroom. At the time, the ICU was a completely mysterious and inaccessible place (and to a large extent, still is). There were no television shows that focused around the lives of the doctors and nurses that inhabited their halls, and I knew that my education would not include any critical care experience.
Thanks to Shalof’s accounts, I discovered that the ICU was a completely unique experience in nursing. Instead of many patients, the nurse has one patient that they focus on completely throughout the day. Shalof describes in much detail the many focused tasks that ICU nurses are continually performing: all the tubes that must be checked, the monitors that must be monitored, and the constant assessing and adjusting of treatments.
But as nurses know, the direct patient care is only the tip of the iceberg. Shalof shows us the true behind the scenes workings of the ICU: constant debates with doctors, the nursing of families, the education of new nurses, the chaos of being charge nurse. She also reaches into the depths of a nurse’s soul to expose the emotional vulnerabilities in caring for extremely sick patients, as well as the fear that comes with the possibility of making a mistake at any time.
Fortunately (and this is my favorite part of the book), Shalof completes her portrait of the ICU with descriptions and dialogs of the nurses and doctors that surround her. Each of them with a unique personality that shows differing opinions and complementary strengths. These characters are her support group and remind me (and will remind any nurse) of those that surround them in their own jobs.
Shalof does not shy away from any topic. From discussion of adoring some patients while disliking others, and certain “shitty” nursing tasks, to a mother’s possible indiscretions with her mentally handicapped Son. These stories serve as the backbone for her larger discussion of nursing as a profession.
When I first read this book I was focused on the fascinating stories and tasks performed in the ICU. But on more recent readings, I realized that the true story is the angst that the author is feeling throughout her career. She discusses foremost the fine balancing act nurses must walk between emotional connection and disconnection with each patient. This constant struggle causes turmoil and (I would say) neurosis within nurses.
Another reoccurring theme is that of how much treatment is too much. Shalof vividly describes stories in which families and doctors go too far to keep patients alive, instead of allowing them to die peacefully. The characters in the book all add their opinions to this ongoing debate that does not have a concrete solution. From this debate comes one of my favorite mottos that I have taken to heart, “We can withdraw treatment, but we never withdraw care.”
The moments that connect with me the most are her brief, yet poignant descriptions of floor nurses. Shalof describes the absolute chaos she and her patients feel when they are transferred out of the ICU with 1:1 nursing care to the floor where nurses may have up to eight patients. As a floor nurse, I can see the shock this causes a patient, and the difficulty they and their families have when being transferred. I have often witnessed their anxiety when a nurse is not present at all times. In fact, we jokingly refer to it as ICUitis, and is usually diagnosed during a night shift when the patient starts hitting the call bell every two minutes for the smallest of reasons.
Now, I said that this book changed the course of my entire career, and that is true. The moment I finished this book in my first year of nursing school, I abandoned all plans to become an ER nurse, firmly aware that I wanted to work in the ICU. I have read this book again and again and I continue to come to the same conclusion. In fact, I have just recently been accepted the Critical Care certificate program and will begin the theoretical portions this fall.
So, I tip my hat to Tilda Shalof (and all of “Laura’s Line”) who has inspired me in my career and my nursing care. Shalof has since written a book entitled “The Making of a Nurse” that describes her life outside of the ICU and how it affected her career. I recommend both books with all my heart, which is why they have a permanent home on my blog (look to your left). There is not one single nurse that would not benefit from a read of this extraordinary realistic account of ICU nursing. I only hope somebody, someday writes a similar account of nursing from the perspective of a medical-surgical nurse.
The biggest reward of writing this review was hearing from Tilda Shalof herself! I was absolutely awed when the following comment appeared on my blog:
I love the the feeling that my career is blossoming and my life is going somewhere…
