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A Nurse's Story: Life, Death and In-Between in an Intensive Care Unit ペーパーバック – 2005/2/22
英語版
Tilda Shalof
(著)
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購入オプションとあわせ買い
The team of nurses that Tilda Shalof found herself working with in the intensive care unit (ICU) of a big-city hospital was known as “Laura’s Line.” They were a bit wild: smart, funny, disrespectful of authority, but also caring and incredibly committed to their jobs. Laura set the tone with her quick remarks. Frances, from Newfoundland, was famous for her improvised recipes. Justine, the union rep, wore t-shirts emblazoned with defiant slogans, like “Nurses Care But It’s Not in the Budget.” Shalof was the one who had been to university. The others accused her of being “sooo sensitive.”
They depended upon one another. Working in the ICU was both emotionally grueling and physically exhausting. Many patients, quite simply, were dying, and the staff strove mightily to prolong their lives. With their skill, dedication, and the resources of modern science, they sometimes were almost too successful. Doctors and nurses alike wondered if what they did for terminally-ill patients was not, in some cases, too extreme. A number of patients were admitted when it was too late even for heroic measures. A boy struck down by a cerebral aneurysm in the middle of a little-league hockey game. A woman rescued – too late – from a burning house. It all took its toll on the staff.
And yet, on good days, they thrived on what they did. Shalof describes a colleague who is managing a “crashing” patient: “I looked at her. Nicky was flushed with excitement. She was doing five different things at the same time, planning ahead for another five. She was totally focused, in her element, in control, completely at home with the chaos. There was a huge smile on her face. Nurses like to fix things. If they can.”
Shalof, a veteran ICU nurse, reveals what it is really like to work behind the closed hospital curtains. The drama, the sardonic humour, the grinding workload, the cheerful camaraderie, the big issues and the small, all are brought vividly to life in this remarkable book.
They depended upon one another. Working in the ICU was both emotionally grueling and physically exhausting. Many patients, quite simply, were dying, and the staff strove mightily to prolong their lives. With their skill, dedication, and the resources of modern science, they sometimes were almost too successful. Doctors and nurses alike wondered if what they did for terminally-ill patients was not, in some cases, too extreme. A number of patients were admitted when it was too late even for heroic measures. A boy struck down by a cerebral aneurysm in the middle of a little-league hockey game. A woman rescued – too late – from a burning house. It all took its toll on the staff.
And yet, on good days, they thrived on what they did. Shalof describes a colleague who is managing a “crashing” patient: “I looked at her. Nicky was flushed with excitement. She was doing five different things at the same time, planning ahead for another five. She was totally focused, in her element, in control, completely at home with the chaos. There was a huge smile on her face. Nurses like to fix things. If they can.”
Shalof, a veteran ICU nurse, reveals what it is really like to work behind the closed hospital curtains. The drama, the sardonic humour, the grinding workload, the cheerful camaraderie, the big issues and the small, all are brought vividly to life in this remarkable book.
- 本の長さ368ページ
- 言語英語
- 出版社McClelland & Stewart
- 発売日2005/2/22
- 寸法15.29 x 2.41 x 22.86 cm
- ISBN-100771080875
- ISBN-13978-0771080876
商品の説明
レビュー
“Tilda Shalof’s A Nurse’s Story is the first time the work of nurses has been documented in print in Canada in such an honest, no-holds-barred account. . . . Shalof has seen it all, and writes about it, too.”
—Calgary Herald
“But her book isn’t a doom-and-gloom account of overworked nurses. Interspersed with tales of tragedy are accounts of the funny, often bizarre events that transpire on an ICU.”
—Canadian Press
“A compelling book laced with humour.”
–Times & Transcript
“There are genuinely heart-rending, disturbing and thought-provoking stories to be found in the pages of A Nurse’s Story. If this book doesn’t give you pause, you’re made of stone.”
–Edmonton Journal
“In a post-SARS world where nurses are finally being recognized for the heroes they always were, A Nurse’s Story is the best-seller no one can put down.”
–The Gazette (Montreal)
“This is a difficult book. Its content is difficult. Its tone is difficult. But it is also difficult to put down, so compelling and beautifully written are these stores. . . . Shalof’s stories are naked and vulnerable. Nothing is held back in her portrayals of her most memorable experiences from the early ‘80s to the SARS crisis. . . . Shalof’s colleagues point out during one of their ongoing discussions about the value of their work, that eventually everyone needs a nurse. And for that reason alone, A Nurse’s Story would worth reading, in order to understand where it is most of us will end up sooner or later, what it is that might be visited upon us and just who it is that will be looking after us. . . . A Nurse’s Story helps us understand where it is most of us will end up sooner or later.”
–Winnipeg Free Press
“Readers may approach this book with the hope of reading dramatic tales such as those seen on television shows such as ER. While such readers are not likely to be disappointed, they are likely to discover more than they had hoped. . . . By turns sad, funny and touching, the author has done an admirable job of providing an insightful look into the real world of an ICU.”
–Brandon This Week
“A cracking good read. . . . Despite the overt moralizing, this is undoubtedly a strong memoir. I hope it’s not the only story Shalof has to tell.”
–Quill & Quire
—Calgary Herald
“But her book isn’t a doom-and-gloom account of overworked nurses. Interspersed with tales of tragedy are accounts of the funny, often bizarre events that transpire on an ICU.”
—Canadian Press
“A compelling book laced with humour.”
–Times & Transcript
“There are genuinely heart-rending, disturbing and thought-provoking stories to be found in the pages of A Nurse’s Story. If this book doesn’t give you pause, you’re made of stone.”
–Edmonton Journal
“In a post-SARS world where nurses are finally being recognized for the heroes they always were, A Nurse’s Story is the best-seller no one can put down.”
–The Gazette (Montreal)
“This is a difficult book. Its content is difficult. Its tone is difficult. But it is also difficult to put down, so compelling and beautifully written are these stores. . . . Shalof’s stories are naked and vulnerable. Nothing is held back in her portrayals of her most memorable experiences from the early ‘80s to the SARS crisis. . . . Shalof’s colleagues point out during one of their ongoing discussions about the value of their work, that eventually everyone needs a nurse. And for that reason alone, A Nurse’s Story would worth reading, in order to understand where it is most of us will end up sooner or later, what it is that might be visited upon us and just who it is that will be looking after us. . . . A Nurse’s Story helps us understand where it is most of us will end up sooner or later.”
–Winnipeg Free Press
“Readers may approach this book with the hope of reading dramatic tales such as those seen on television shows such as ER. While such readers are not likely to be disappointed, they are likely to discover more than they had hoped. . . . By turns sad, funny and touching, the author has done an admirable job of providing an insightful look into the real world of an ICU.”
–Brandon This Week
“A cracking good read. . . . Despite the overt moralizing, this is undoubtedly a strong memoir. I hope it’s not the only story Shalof has to tell.”
–Quill & Quire
抜粋
It’s night shift. I jot down a series of numbers onto my patient’s twenty-four-hour flow sheet and then prepare to read them out loud to the medical resident who is standing with me at the patient’s bedside, waiting to hear them.
“Everything is out of whack,” I say: “7.26, 68, 76, 14.”
That’s a losing lottery ticket. No one can survive such a deranged acid-base balance, sky-high carbon dioxide levels, and plummeting oxygenation and bicarbonate ions.
“Those numbers are not compatible with life,” the resident says.
“Not life on this planet, anyway,” says Lynne, the nurse who’s kneeling by the door, packing up her knapsack, getting ready to leave. She was on the day shift and is the only one in the room who’s smiling: she’s going home. “I’m outta here. I’m going home to have sex with my husband.” Lynne has finished giving me report on Mr. DeWitt, all the facts and the numbers, what’s high, what’s low, what’s rising, and what’s falling. Now it’s up to me to carry on throughout the night.
“Have fun,” I say as I’m thinking about something else. “You know what, Lynne? I think we should call a family meeting. Does his wife know how bad the situation is? Has anyone told her? I’m going to call her. I think she needs to come in.”
“She just went home,” says Lynne. “She’s been here all day and was exhausted when she left. What makes you think he might not make it through the night? He’s been spiralling downward for weeks. You could probably get him through the night.”
Together we stand there, Lynne just outside the door, me just inside, surveying the body of the middle-aged man stretched out in the bed, surrounded by machines and monitors, tubes and wires, bags and drains that expose all the secret fluids of the body.
“I see your point, though,” Lynne said. “When you take a minute to step back and really look at it all, you do start to wonder sometimes. But do you really think it’s going to be tonight?”
“I have a feeling.” I have learned to trust my feelings.
I consult with the medical resident and together we decide that I should call Mrs. DeWitt and ask her to come in. I tell her that unfortunately, her husband is not doing well. His blood pressure is very low, I say. It is dropping, I add, as gently as possible. He is on powerful intravenous medications for his blood pressure, inotropes we call them, but we have had to add another drug because of the serious heart irregularities that he developed today. Another problem is that his urine output is dropping off. Perhaps she would like to return to the hospital and we can talk about it further? Is there someone who could drive her?
*****
“FAMILY MEETING” is the term we use to gather all the people closest to the patient to provide them with an update on the patient’s condition. Sometimes we call a family meeting to discuss the death and how we will let it happen. A family meeting is rarely called if the patient is improving.
We convene in a shabby, cramped room called the “quiet room.” It is a tiny room with buzzing fluorescent lights, no windows — I would never take anyone in there if they suffered from claustrophobia. It has the feel of a bunker in a war zone, but aesthetics aside, it seems to be the only room in this huge, bustling, overcrowded, downtown hospital that could be made available for this purpose. The quiet room! It is probably the most disquieting place in the whole hospital. Bombs are detonated in here.
We turn our attention to Mrs. DeWitt. She is the one who knows Edgar DeWitt best. She is the person who will speak on his behalf, as he is no longer conscious and cannot tell us himself what he wants us to do. She perches on the chair, frail, but tensed up. She knows why we’re gathered here.
“What would Mr. DeWitt have wanted?” the doctor asks his wife.
“To live! That’s what he would have wanted.” She sobs into her hands.
Of course. Isn’t it obvious? Isn’t that what anyone would want?
“We understand,” the doctor says, “but, given his deteriorating condition and his irreversible medical problems, if we continue with the life-support measures that we have in place, we are merely prolonging the inevitable.”
I watch Mrs. DeWitt and I can see that in her panicked state, she finds comfort in the simple fact that the doctor is talking, because all the time the doctor is talking, her husband is still alive.
“We do not believe that we can reverse his medical problems. Perhaps the time has come, that we should very gently, slowly, when you are ready, of course, remove the ventilator, all the life supports, and let nature take its course?”
She sits weeping into the cave of her two hands. I offer her a new box of tissues and pull out the first one to get it started.
“Did you ever discuss this situation with him?” I press gently. “Do you think he would want all this to be done?” My words are like sticks, poking at a fire, making it flare.
“Who would want all this done?” she asks.
The doctor and I smile at her response, so true and honest.
“I don’t know what to do,” Mrs. DeWitt says. “Whenever we had a big decision to make, Ed and I always made it together.”
“There’s no need to decide anything this minute,” I say, “but his condition is very critical. Anything could happen tonight.”
Whatever happens, it will be a long night for all of us.
The family meeting is over and we return to Mr. DeWitt’s room.
Frances peeks her head in the door and whispers, “Do you want to order in food, Tilda?”
“Everything is out of whack,” I say: “7.26, 68, 76, 14.”
That’s a losing lottery ticket. No one can survive such a deranged acid-base balance, sky-high carbon dioxide levels, and plummeting oxygenation and bicarbonate ions.
“Those numbers are not compatible with life,” the resident says.
“Not life on this planet, anyway,” says Lynne, the nurse who’s kneeling by the door, packing up her knapsack, getting ready to leave. She was on the day shift and is the only one in the room who’s smiling: she’s going home. “I’m outta here. I’m going home to have sex with my husband.” Lynne has finished giving me report on Mr. DeWitt, all the facts and the numbers, what’s high, what’s low, what’s rising, and what’s falling. Now it’s up to me to carry on throughout the night.
“Have fun,” I say as I’m thinking about something else. “You know what, Lynne? I think we should call a family meeting. Does his wife know how bad the situation is? Has anyone told her? I’m going to call her. I think she needs to come in.”
“She just went home,” says Lynne. “She’s been here all day and was exhausted when she left. What makes you think he might not make it through the night? He’s been spiralling downward for weeks. You could probably get him through the night.”
Together we stand there, Lynne just outside the door, me just inside, surveying the body of the middle-aged man stretched out in the bed, surrounded by machines and monitors, tubes and wires, bags and drains that expose all the secret fluids of the body.
“I see your point, though,” Lynne said. “When you take a minute to step back and really look at it all, you do start to wonder sometimes. But do you really think it’s going to be tonight?”
“I have a feeling.” I have learned to trust my feelings.
I consult with the medical resident and together we decide that I should call Mrs. DeWitt and ask her to come in. I tell her that unfortunately, her husband is not doing well. His blood pressure is very low, I say. It is dropping, I add, as gently as possible. He is on powerful intravenous medications for his blood pressure, inotropes we call them, but we have had to add another drug because of the serious heart irregularities that he developed today. Another problem is that his urine output is dropping off. Perhaps she would like to return to the hospital and we can talk about it further? Is there someone who could drive her?
*****
“FAMILY MEETING” is the term we use to gather all the people closest to the patient to provide them with an update on the patient’s condition. Sometimes we call a family meeting to discuss the death and how we will let it happen. A family meeting is rarely called if the patient is improving.
We convene in a shabby, cramped room called the “quiet room.” It is a tiny room with buzzing fluorescent lights, no windows — I would never take anyone in there if they suffered from claustrophobia. It has the feel of a bunker in a war zone, but aesthetics aside, it seems to be the only room in this huge, bustling, overcrowded, downtown hospital that could be made available for this purpose. The quiet room! It is probably the most disquieting place in the whole hospital. Bombs are detonated in here.
We turn our attention to Mrs. DeWitt. She is the one who knows Edgar DeWitt best. She is the person who will speak on his behalf, as he is no longer conscious and cannot tell us himself what he wants us to do. She perches on the chair, frail, but tensed up. She knows why we’re gathered here.
“What would Mr. DeWitt have wanted?” the doctor asks his wife.
“To live! That’s what he would have wanted.” She sobs into her hands.
Of course. Isn’t it obvious? Isn’t that what anyone would want?
“We understand,” the doctor says, “but, given his deteriorating condition and his irreversible medical problems, if we continue with the life-support measures that we have in place, we are merely prolonging the inevitable.”
I watch Mrs. DeWitt and I can see that in her panicked state, she finds comfort in the simple fact that the doctor is talking, because all the time the doctor is talking, her husband is still alive.
“We do not believe that we can reverse his medical problems. Perhaps the time has come, that we should very gently, slowly, when you are ready, of course, remove the ventilator, all the life supports, and let nature take its course?”
She sits weeping into the cave of her two hands. I offer her a new box of tissues and pull out the first one to get it started.
“Did you ever discuss this situation with him?” I press gently. “Do you think he would want all this to be done?” My words are like sticks, poking at a fire, making it flare.
“Who would want all this done?” she asks.
The doctor and I smile at her response, so true and honest.
“I don’t know what to do,” Mrs. DeWitt says. “Whenever we had a big decision to make, Ed and I always made it together.”
“There’s no need to decide anything this minute,” I say, “but his condition is very critical. Anything could happen tonight.”
Whatever happens, it will be a long night for all of us.
The family meeting is over and we return to Mr. DeWitt’s room.
Frances peeks her head in the door and whispers, “Do you want to order in food, Tilda?”
著者について
TILDA SHALOF, RN, BScN, CNCC (C), has been a staff nurse in the Medical-Surgical Intensive Care Unit at Toronto General Hospital for over twenty years. She is the author of five books about her experiences in nursing, including A Nurse’s Story, The Making of a Nurse, and Camp Nurse, and the editor of a collection of nurse's stories, Lives in the Balance. She is an outspoken patient advocate, passionate nurse leader, public speaker, and media commentator. She lives in Toronto with her husband and their two sons.
登録情報
- 出版社 : McClelland & Stewart (2005/2/22)
- 発売日 : 2005/2/22
- 言語 : 英語
- ペーパーバック : 368ページ
- ISBN-10 : 0771080875
- ISBN-13 : 978-0771080876
- 寸法 : 15.29 x 2.41 x 22.86 cm
- カスタマーレビュー:
著者について
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他の国からのトップレビュー
Laila silva nesbitt
5つ星のうち5.0
Best book really good writing
2023年4月3日にカナダでレビュー済みAmazonで購入
Best book for all nurses
Kimber Scott
5つ星のうち5.0
A Real Nurse's Nurse
2010年12月20日にアメリカ合衆国でレビュー済みAmazonで購入
With less than a year working on a grueling medical/surgical unit and with aspirations of becoming a critical care nurse, Shalof's book lays out for me in black and white what we go through at the bedside and beyond. She has become the mentor I've yet to find and she makes me proud to be a nurse.
The book is riveting and well written and I know everyone in it - even though I practice in the Southwest United States and she in Ontario. We all know all of these patients and their families and we all have our own lives and our own families to deal with. Shalof shares herself in an unimaginably honest way and she opens the doors to the nursing field's triumphs, frustrations, political absurdities, and the educational disparities found within. She's taught me a lot with this book and has validated many of my own feelings as a new nurse.
I sped through this book and am now reading her next book, "The Making of a Nurse," where she delves more deeply into her own personal life, her nursing stint in Israel, and on through her registry jobs and back to the ICU. All of it incredibly honest, however, I wish she would have, or could have, maybe mentioned some of her early nursing mistakes - she must have made some. I can understand why in the litigious society we live in and I'm sure she doesn't want to scare patients, but it would be helpful for those of us who are still wet behind the ears to know how a real nurse handled real mistakes and how she overcame them, learned from them, and went on to become the seemingly great nurse she is.
Five Stars - Well Deserved!
The book is riveting and well written and I know everyone in it - even though I practice in the Southwest United States and she in Ontario. We all know all of these patients and their families and we all have our own lives and our own families to deal with. Shalof shares herself in an unimaginably honest way and she opens the doors to the nursing field's triumphs, frustrations, political absurdities, and the educational disparities found within. She's taught me a lot with this book and has validated many of my own feelings as a new nurse.
I sped through this book and am now reading her next book, "The Making of a Nurse," where she delves more deeply into her own personal life, her nursing stint in Israel, and on through her registry jobs and back to the ICU. All of it incredibly honest, however, I wish she would have, or could have, maybe mentioned some of her early nursing mistakes - she must have made some. I can understand why in the litigious society we live in and I'm sure she doesn't want to scare patients, but it would be helpful for those of us who are still wet behind the ears to know how a real nurse handled real mistakes and how she overcame them, learned from them, and went on to become the seemingly great nurse she is.
Five Stars - Well Deserved!
Judy Walshe
5つ星のうち5.0
Thought Provoking
2015年8月23日にオーストラリアでレビュー済みAmazonで購入
So real! The push to do everything to prevent death occurring. Health concerns and safety being overlooked in favour of the mighty dollar. Well written and thought provoking.
Damaskcat
5つ星のうち5.0
Harrowing and thought provoking
2011年2月15日に英国でレビュー済みAmazonで購入
I find books written by members of the medical professions absolutely fascinating reading and this is one of the best in my opinion. The author spent many years working in Intensive Care Units in hospitals in Canada and she recounts her experiences in this book.
There are tragic cases and cases with happy outcomes. There are incidents which will make you laugh and incidents which will make you cry and many will stay with you long after you have finished reading the book. This is medicine at the frontiers of knowledge. The question of when it is better to let nature take its course is always hovering there is the room with the nurses and their seriously ill patients.
Technology can do marvellous things in modern medicine. People can be kept alive for very much longer than they've ever been before and can recover from illnesses which would have been an automatic death sentence even in recent years. But having the ability to do something does not mean we should always use that ability. Families do not always see it like that and demand the very best of treatment for their loved ones when perhaps it would be more compassionate to let them go.
This book makes the reader confront some very difficult and unpleasant problems and I would recommend it to anyone - in good health or not - because these issues need to be considered by all of us at some time in our lives. This is not a comfortable book to read but it is very worthwhile reading.
There are tragic cases and cases with happy outcomes. There are incidents which will make you laugh and incidents which will make you cry and many will stay with you long after you have finished reading the book. This is medicine at the frontiers of knowledge. The question of when it is better to let nature take its course is always hovering there is the room with the nurses and their seriously ill patients.
Technology can do marvellous things in modern medicine. People can be kept alive for very much longer than they've ever been before and can recover from illnesses which would have been an automatic death sentence even in recent years. But having the ability to do something does not mean we should always use that ability. Families do not always see it like that and demand the very best of treatment for their loved ones when perhaps it would be more compassionate to let them go.
This book makes the reader confront some very difficult and unpleasant problems and I would recommend it to anyone - in good health or not - because these issues need to be considered by all of us at some time in our lives. This is not a comfortable book to read but it is very worthwhile reading.
Al Har
5つ星のうち5.0
great memoir
2022年3月30日にカナダでレビュー済みAmazonで購入
really well written. Canadian content. mix of all the feels. humour is nice woven through.