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A review by christythelibrarian
The Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital by Alexandra Robbins
4.0
The Nurses is a deep-dive examination of what it is like to work in the nursing profession today. Robbins’ book follows four ER nurses through the events of one year. The names of the nurses and their hospitals have been changed to protect their identity, and of course the city where all of the nurses work is never named. One nurse battles the temptation to relapse into narcotics abuse after the death of her mother; another nurse is newly minted and trying to find her place; the other two nurses have their own personal and professional challenges. These four narratives are balanced with chapters containing well-researched discussion of the challenges facing nurses today.
As evident in The Nurses, Alexandra Robbins holds the nursing profession in high regard. She doesn’t gloss over issues such as the practice of more experienced nurses often “eating their young” or the fact that nurses aren’t immune to workplace cliques, but her main goal is to educate the public about nurses and to tell nurses’ stories. Robbins’ journalistic career has mostly been in the realm of education, but nurses kept asking her to tell their stories, and once she heard the stories, she was hooked, as she says in an interview on BookPage.
One of the main misconceptions about nursing is an old one: the idea of nurses as “hand-maidens” to the god-like doctor. The reality is that nurses are a vital part of the medical team treating the patient, and the “hand-maiden” paradigm is detrimental as it can lead to doctors discounting nurses’ wealth of knowledge, or even doctors mistreating nurses. And the blame for something going wrong disproportionately falls on the nurses.
I really appreciated the inclusion of the ER nurse who had a past narcotics addiction. Her story is not unusual; the nursing profession is vulnerable to addiction due to the stress and access to powerful drugs, though many institutions have put in protocols that have made it less easy to get the drugs without being noticed.
Another shocking aspect to the nursing profession is the frequent lack of a safety support structure to protect nurses against assault by patients, patients’ family members, and even other staff.
The Nurses also casts a critical eye on patient satisfaction surveys, a piece of the Affordable Care Act that can affect Medicare’s funding to hospitals. For example, “the survey doesn’t ask whether the hospital resolved or improved the patient’s medical issue, which one would hope would be the primary determinant of a patient’s satisfaction with the experience.” In early version of the survey, a comment section highlighted how erratic patients’ ideas of “satisfaction” can be, as some patients complained about things like a lack of Splenda, or a dying roommates’ noisy breathing. And of course, there are obvious shortcomings to such surveys: “Molly clocked out and stayed for two hours holding a dying man’s hand because he did not wish to die alone. He won’t be polled about his hospital experience.”
The last chapter of The Nurses is called “What You Can Do: Advice and Inspiration for the Public, Patients, Families, Nurses, Aspiring Nurses, Managers and others.” A few of the take-away points for Patients/Families:
– Appoint one family spokesperson.
– Ask questions – instead of “why” which can put staff in defensive, phrase it more like “help us to understand why he’s getting this medication”.
– Bring hand sanitizer and antibacterial wipes.
– “If you want to help the nurse, ask what you can do for the patient.” – family members can bathe patient, “brush their teeth, take them on walks, participate in therapies, and handle feeding”.
Not listed in this chapter, but something I gathered from the book overall, is to try and seek a hospital with a high patient-to-nurse ratio.
It’s funny, for all that this book highlighted the challenges and toughness of the nursing profession, it kind of does make you want to drop whatever profession you are in, and go become a nurse to care for people and save lives. And then, following on the heels of that thought, I admit to myself that I am probably not thick-skinned enough to succeed in that environment.
As evident in The Nurses, Alexandra Robbins holds the nursing profession in high regard. She doesn’t gloss over issues such as the practice of more experienced nurses often “eating their young” or the fact that nurses aren’t immune to workplace cliques, but her main goal is to educate the public about nurses and to tell nurses’ stories. Robbins’ journalistic career has mostly been in the realm of education, but nurses kept asking her to tell their stories, and once she heard the stories, she was hooked, as she says in an interview on BookPage.
One of the main misconceptions about nursing is an old one: the idea of nurses as “hand-maidens” to the god-like doctor. The reality is that nurses are a vital part of the medical team treating the patient, and the “hand-maiden” paradigm is detrimental as it can lead to doctors discounting nurses’ wealth of knowledge, or even doctors mistreating nurses. And the blame for something going wrong disproportionately falls on the nurses.
I really appreciated the inclusion of the ER nurse who had a past narcotics addiction. Her story is not unusual; the nursing profession is vulnerable to addiction due to the stress and access to powerful drugs, though many institutions have put in protocols that have made it less easy to get the drugs without being noticed.
Another shocking aspect to the nursing profession is the frequent lack of a safety support structure to protect nurses against assault by patients, patients’ family members, and even other staff.
The Nurses also casts a critical eye on patient satisfaction surveys, a piece of the Affordable Care Act that can affect Medicare’s funding to hospitals. For example, “the survey doesn’t ask whether the hospital resolved or improved the patient’s medical issue, which one would hope would be the primary determinant of a patient’s satisfaction with the experience.” In early version of the survey, a comment section highlighted how erratic patients’ ideas of “satisfaction” can be, as some patients complained about things like a lack of Splenda, or a dying roommates’ noisy breathing. And of course, there are obvious shortcomings to such surveys: “Molly clocked out and stayed for two hours holding a dying man’s hand because he did not wish to die alone. He won’t be polled about his hospital experience.”
The last chapter of The Nurses is called “What You Can Do: Advice and Inspiration for the Public, Patients, Families, Nurses, Aspiring Nurses, Managers and others.” A few of the take-away points for Patients/Families:
– Appoint one family spokesperson.
– Ask questions – instead of “why” which can put staff in defensive, phrase it more like “help us to understand why he’s getting this medication”.
– Bring hand sanitizer and antibacterial wipes.
– “If you want to help the nurse, ask what you can do for the patient.” – family members can bathe patient, “brush their teeth, take them on walks, participate in therapies, and handle feeding”.
Not listed in this chapter, but something I gathered from the book overall, is to try and seek a hospital with a high patient-to-nurse ratio.
It’s funny, for all that this book highlighted the challenges and toughness of the nursing profession, it kind of does make you want to drop whatever profession you are in, and go become a nurse to care for people and save lives. And then, following on the heels of that thought, I admit to myself that I am probably not thick-skinned enough to succeed in that environment.