Customer Reviews

Critical Care: A New Nurse Faces Death, Life, and Everything in Between

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Countless books, movies and television dramas have been devoted to the lives of doctors, but what about those unsung heroes: nurses? Nurses provide the vast majority of patient care: from administering treatment to monitoring vitals to cleaning up accidents to counseling patients and patient advocacy. Still little is known about the professional lives of these vital medical providers.

Stepping into this void is nurse-author Theresa Brown in Critical Care who documents her first year as a R.N. in the oncology ward of a large teaching hospital. Brown, a former Tufts University English professor, is better equipped than most to share the real day to day lives of modern nurses. Brown explains her mid-life career change from the ivy walls of academia to the stressed halls of the nursing floor as a choice for a more chaotic, but meaningful professional life.

Critical Care is a beautifully written insider's account of what really happens at a present-day hospital. And the truth is somewhere between the gloried angels of Marcus Welby and the pill-popping antics of Nurse Jackie. Some nurses pull rank and wield authority like a weapon. Some nurses help their colleagues and bond over cups of coffee. Some physicians expect to be treated like demi-gods. Some physicians treat the nurses and their patients with respect. Some patients and their families harangue their caregivers. Some patients praise their nurses as "angels." Every story is, however, compelling.

As Brown confesses:

Anyone hearing a true nursing story will not want to believe it. The level of vulnerability, dependence, and fear experienced by patients in the hospital remains far outside the realm of normal, everyday life, and none of us want to imagine ourselves in that position. But people find themselves there, regardless, and they find nurses there too. Doctors don't do poop; they're concerned with other things. That's OK, but it's a difference between the two jobs. Probably they don't do Bibles either. But nurses have to get to the heart of the matter, whatever that may be.

Getting to the heart of the matter - whether it is finding a Bible for a patient or listening to a few Bruce Springsteen songs with a patient - is what Critical Care does best!



Publisher: HarperStudio (June 1, 2010), 208 pages.
Advance Review Copy Provided Courtesy of the Publisher.

Theresa Brown has made a mid-life career change, trading in her job as an English professor in order to begin anew in nursing. "I liked teaching, and at times I found in enjoyable enough, but I never felt passionately about it, for better or for worse," says Brown of her previous career, and given the serviceable but bland prose in which she tells her story one is well able to believe that English was never her passion.

Brown is extremely enthusiastic about her new job, and she is proud of what she does. Perhaps a little too proud. Her descriptions of grateful patients and her own tenacious, mongoose-like determination to do absolutely anything for them may give more modest readers a twinge of displaced embarrassment. Throughout the book she shares a number of patient stories with accompanying philosophizing. The stories of suffering oncology patients are inherently touching; her philosophy is of the Chicken Soup for the Soul variety, certainly deeply felt but nothing out of the common way.

The book, despite being written by a medical professional, is sprinkled with inaccurate statements and downright false medical information. According to Brown, cholera causes lethal dehydration that "only IV fluids can control". In reality, literally millions of lives have been saved with oral rehydration therapy as a treatment for cholera. She says, with "100 percent certainty", that no doctor in the United States ever collects feces for occult blood sampling. This actually happens quite regularly during rectal exams in family practice, and in many other circumstances. These may seem like minor quibbles but one does not like to see this type of factual error, especially as Brown heavily emphasizes the importance of patient education.

The best part of the book, by far, is the chapter entitled "A Day on the Wards". Brown really captures the reality of a day of nursing, making this chapter a great read for people considering a nursing career or for those who are interested in learning more about medicine in practice. Overall, the book is perhaps best for those that are very new to the world of medicine. Those who have read medical memoirs or been heavily involved in health care as patients or medical professionals may not find much that is novel here. However, one thing is very clear; Theresa Brown is no doubt an excellent and dedicated nurse.

My favorite books, whether novels or memoirs, are those that allow me to connect with the narrator, that speak with a distinctive voice, that offer a deeper understanding of our human condition, and that leave me feeling enriched by the encounter. This beautifully written book delivered on all fronts. I follow the author's columns on The Well (The New York Times's online health feature), so I was eager to read her in a more expanded format. I'm so glad I did. The whole book is an excellent read. The book gives us a fascinating view into Theresa Brown's introductory year as an oncology nurse, complete with unexpected professional and personal challenges that she handles with thoughtfulness and wit. I especially liked the way the chapter "A Day on the Floor" powerfully and effectively brings home the multi-layered experience of nursing, even to readers (like me) whose only medical experience has been as an occasional patient. I found myself reading many passages aloud to my husband. This is one of those books you want to share with your friends for purely selfish reasons, just so you can have the opportunity to discuss it together.

CRITICAL CARE: A NEW NURSE FACES DEATH, LIFE, AND EVERYTHING IN BETWEEN by Theresa Brown is a short book with a deceptive simplicity. First, two disclosures that color my perceptions: 1) I have been a RN since 1979; earned a master's degree in nursing in 1996 and am in advanced nursing practice, as a nurse practitioner. 2) I love my profession.

With a straightforward clear-eyed realism, Brown explains via personal anecdotes what nurses do, and why we do it. Just as importantly, she talks about fear, death, joy, relationships, anxiety, and being human. Brown was able to convey the complex competing and conflicting demands of hospital floor nursing, as well as touching upon several common ethical and professional issues that bedevil health care. I have no doubt she could have discussed those issues in far more detail - but that would have been beyond the scope or intent of this memoir.

Brown did an excellent job of laying out her insecurities and intimidation - universal feelings during the earliest years of a nursing career - and how she found her own voice on behalf of her patients and herself. This memoir is written in an accessible style that those not in health care will have no difficulty understanding - yet her experiences rang so true, honestly, and eloquently that I read it cover-to-cover. I look forward to reading more from Nurse Brown, as she has much to say - and I enjoy how she says it. Highly recommended.

~Sharon

Advance Review Copy Provided Courtesy of the Publisher.

In Theresa Brown's "Critical Care," she recounts her mid-life move from academia to an oncology ward. Brown, who holds a Ph.D. in English from the University of Chicago and taught writing at Tufts University, retrained and became a registered nurse who works with cancer patients in a Pittsburgh hospital. Brown admits, "I don't think even I fully understood my career change," but "nursing just felt right." She relishes the opportunity to reach out to patients who are frightened, confused, and vulnerable. Even when she doesn't have a comforting message to impart, she tries to convey that "whatever happens, I am here with you."

Many books have been written by doctors and nurses about why they chose their profession, what their training was like, the memorable patients whom they met, and the ways in which medicine changed them. This work covers the same territory. In clear and lucid prose, Brown explains how having her three children changed her outlook on life. She wanted to do a job that combined "technical skill and knowledge with love." So Brown gave up summers off for the "messy and stressful" work of a floor nurse specializing in medical oncology.

The author invites us along on a typical work day during which she deals with anxious men and women, some of whom are in great pain. Her patients suffer from a variety of symptoms such as incontinence, nausea, bleeding, lack of mobility, and an inability to breathe properly. Brown must endure long shifts during which tremendous demands are made on her time. She is expected to handle complicated orders, correctly dispense a variety of medications (including chemo), interact with colleagues effectively, record meticulous notes, and communicate with her patients' relatives. Inevitably, some individuals in her care do not make it. Although many would cower before such challenges, Brown finds her work exhilarating and fulfilling.

"Critical Care" will be of interest to readers who want to know about the nuts and bolts of patient care as well as "the human side of nursing." Although it is depressing to read about so many sick people who are afflicted with a variety of cancers, this straightforward and lucid work of non-fiction cannot help but increase our admiration for the men and women who selflessly dedicate their lives to soothing and healing. Theresa Brown says: "At times this caring will ask so much of you that being devoted to the job is the only thing that will enable you to keep doing it."

Theresa Brown brings us right into the hospital room with a remarkable first hand account of the dramas and tragedies that happen in hospitals every day. So well written and absolutely fascinating! Her book shines a bright light on health care as it is today -- the methods, the problems (the cure is often worse than the disease), and the personal struggles behind the scenes. A very enlightening primer on oncology care and life as a nurse, one that will hook you!

This is the well-written and gripping story of the author's first year in her new career as a nurse on an oncology hospital floor. Brown came to nursing after leaving the fairly pampered life of an English professor, and I found myself admiring her courage in making such a drastic career change. I've read a lot of medical memoirs written from the perspectives of doctors and patients; this is the first nurse's memoir I've read. I found myself appreciating the nursing perspective a great deal; as Brown makes abundantly clear, the vast majority of hands-on patient care in hospitals is delivered by nurses, not M.D.s, most of whom in Brown's book remain rather shadowy figures that she is always having to track down to obtain permission to do what she already knows is right for her patients.

Because Brown works on an oncology unit, there are not a lot of cheery stories of miraculous recoveries to be found in the pages of this memoir. Many of her patients will and do ultimately relapse; some of them die during the year that this book covers. Brown makes an excellent case for the need to improve how the medical establishment deals with patients and families on end-of-life issues. Probably the most emotionally powerful sections of the book are those involving Brown's feelings of helplessness as it becomes clear that a patient is very near the end of life and the difficulties inherent in talking with the patient and family members about their preferences for aggressive treatment at this stage. If you have not had such conversations regarding DNR orders and health proxies with your loved ones before reading this book, you'll definitely be inspired to do so after.

Equally powerful and illuminating are the sections of the book where Brown describes how she is able to cope with the knowledge that so many of her patients will not get better and in fact will die prematurely: She focuses on the moment and the fact that, while she and medicine may not be able to save a particular patient's life, she CAN work to make this a better day for them right now--and maybe that's enough.

Brown doesn't mince words when it comes to describing some of the less pleasant aspects of nursing (I had no idea that doctors would even contemplate performing a poop transplant [!!], as they considered in one example of intractable diarrhea). While that sort of detail made it clear to me that I would never be cut out to be a nurse myself, simply reading about Brown's matter-of-fact acceptance that taking care of sick people will involve messy stuff like blood and poop--and that it is no big deal at all for her and her colleagues--will probably make any future hospital stays I endure a lot less embarrassing for me.

Brown also does a good job of explaining just what it is that nurses do all day and why they may not be available to answer your every push of the call button within 60 seconds. It's exhausting, physically demanding work, and anybody who anticipates being in a hospital at any point of their lives (which, face it, is just about all of us) should be eternally grateful that there are dedicated professionals like Brown who are willing to endure the stress and burn-out of nursing because they care about people.

One of the sections of the book that resonated the most with me was the epilogue, where Brown talks about the lesson that SHE has learned from her patients: Life is fragile. We are every one of us vulnerable, and every day is a wonderful gift. She relates the anecdote of her husband indulging a mid-life impulse to buy the grand piano he had long dreamed of, a decision that brought him "a joy like nothing else in his life." She ends her book with words that we would all do well to heed: "People say, why wait? But really they should say, don't wait. Listen when you can, tell the people in your life you love them, and buy the piano."

As a soon to be nursing student, I was interested in what info this book could provide me re the day to day, on the job life of a nurse. It was helpful in that regard. Not extremely well written and at times I found the author a little whiny, but worth a quick read for the non-TV/hollywood description of the actual duties of a floor nurse.

This book had great potential--there were moments were it shined, but they were few. You would expect a former English prof to be a brilliant writer, right? Not necessarily, especially if they studied literature rather than creative writing; even still, it's a talent, and not everyone has it (some "writers" included!). I wish she explained more about her decision to leave academia. I myself left a career of teaching English at a university, so I was very curious about this. However, she barely mentions it. Also, disappointing cliché descriptions and adages show up throughout the book. At times the narrative fell into nursing jargon and technicalities which would be interesting if they were offset by more quality reflection. Still, the book is a fast read, and for medical junkies like me, contains items of interest.

Warning: if you or someone you love have or have had leukemia, do NOT read it: the amount of death from leukemia treatment complications will unsettle you. I definitely won't be recommending this to my friend who is a leukemia survivor of three years. She doesn't need that weight on her mind.

Theresa Brown's book "Critical Care" has been excerpted in the New York Times Health and Wellness section, which is where I first read about the book. Brown, a college-English-professor-turned-oncology-nurse, combines her two areas of expertise in a book about her first year as a nurse. She's an excellent writer with an interesting story to tell.

As another reviewer here noted, nurses are the unsung heroes of the medical world. They do the grunt work, the unceasing care of patients, and are often the first, and last, contact a patient has with a hospital. Brown, because she works in the oncology department at a Pittsburgh-area hospital, has seen, and participated in, the ups and downs of cancer treatment. What doesn't kill cancer patients often ends up saving them, or at least putting them into remission, but the effects of chemotherapy are often as bad as the disease itself. How many cancer patients ask themselves in the midst of horrifying treatment if the possible cure is worth the agonies of the treatment?

Brown does not make any statements about the worthiness of treatment, she assumes her readers would be able enough to make a decision if faced with a cancer diagnosis.

Brown also writes about the personal toll cancer treatment and possible death of patients have on the nursing/doctor staff. Some medical staff are able to distance themselves from the pain they see around them, while others can't. Brown writes that identifying with her patients - showing her "human side" - was a good method she chose to use when dealing with treating cancer patients.

Theresa Brown's book seems to be an honest appraisal of her first year in nursing. She's a very good writer and her story, while often offering a discouraging look at cancer treatment and care, is well worth reading.