THE SHIFT

A registered nurse recounts a typical shift.

Brown (Critical Care: A New Nurse Faces Death, Life, and Everything in Between, 2010), who contributes a column to the New York Times opinion page, delivers a vivid depiction of a clinical nurse's standard 12-hour shift on a hospital cancer ward. While some of her colleagues take a dispassionate, "just the facts, ma'am" approach to their work, the author takes great care in describing this particular shift. She shows superhuman forbearance of her patients' quirks and the immense demands on her limited time, and she explains that the constant requests by patients are usually defense mechanisms to combat their vulnerability and lack of control over their particular maladies. Throughout the book, Brown doesn’t provide wasted or unnecessary details. She is thorough, yet her prose moves swiftly, often reflecting the rapid pace of her shift. She effectively conveys the great burden—and uncertainty—of the critical decision-making doctors require of her and how she sometimes, agonizingly, second-guesses herself. Readers will share Brown's frustration when she laments how constant "CYA [cover-your-ass] charting" (the procedural entering of all the minutiae of patients' developments every time they are seen) takes nurses away from talking, and listening, to their critically ill patients. "Patient care…is heart and soul,” writes the author, “but these days, charting pulls nurses away from the bedside more and more….I do understand why such thoroughness matters legally, but I sometimes wonder if sadists designed our [computer charting] software. It should not be easier to order a sweatshirt from Lands End than to chart on my patients, but it is.” Throughout this engrossing book, Brown demonstrates that while nurses can appear even-tempered and certain in their decisions, they are usually harried and always working feverishly.

An empathetic and absorbing narrative as riveting as a TV drama.