Theresa Brown is trying something new.
The local nurse and author is currently on a regional book tour for The Shift: One Nurse, Twelve Hours, Four Patients’ Lives (Algonquin Press Chapel Hill), her new memoir that takes place over one 12-hour shift in an oncology ward.
Unlike her previous book, Critical Care: A New Nurse Faces Death, Life, and Everything in Between, which covered her first year as a nurse, The Shift focuses on her patients.
“I didn’t want [The Shift] to be about ‘I am Theresa Brown, Super Nurse,’ but about the richness of [patients’] stories,” says Brown.
Brown was formerly an English professor at Tufts University. She moved to Pittsburgh in 2005, when her husband took a teaching job at the University of Pittsburgh. She used the opportunity to make a career change, completing Pitt’s one-year accelerated nursing program and becoming an RN at a local hospital. (For privacy reasons, she declines to name the hospitals she’s worked.) And she began chronicling her experiences in an opinion column in The New York Times.
Brown, who now lives in Point Breeze with her husband and three kids, structured The Shift to give it a novelistic arc. She used two stories that occurred over one real-life shift, about “Sheila,” a patient she assumed was OK but wasn’t, and “Mr. Hampton,” a patient she worried about who turned out to be fine. She pulled the stories about “Candace,” the difficult patient, and the elderly “Dorothy” from memories of past shifts. (All the patients were given pseudonyms.)
With The Shift, which the Wall Street Journal called “an engrossing human drama,” Brown pushed herself to write about her patients more empathetically. She doesn’t shy from noting how difficult patients like Candace, who insisted on scrubbing her hospital room with Lysol wipes, could make her job. But she also offers insight into their thought processes, reminding us — and herself — how uncomfortable the patients must be, away from home and dealing with debilitating diseases.
Brown came to a troubling realization: Hospitals are not good for patients.
In The Shift, we see how patients’ sleep is disrupted when Brown must perform tests or retrieve blood work, and the difficulty she has giving individual attention to all four people under her care.
“Hospital administrators with their eyes on the bottom line seem to think that nurses can stretch infinitely, like rubber bands,” Brown writes in The Shift. But “the more patients an individual nurse cares for, the smaller the amount of TLC per patient.”
In hospitals, Brown says, patients are subject to hospital workers’ schedules. She points to lab work: Patients are awoken at 4 or 5 a.m. for blood draws, so that the results are ready when doctors make their rounds at 10 a.m.
“We set things up to work for us,” Brown says.
Overall, The Shift is less an indictment of hospitals and more a celebration of the tenacity of nurses and patients living under stressful circumstances. Brown writes fondly of her coworkers, who are overworked and often go uncompensated for lunch breaks they never take.
Nonetheless, last year, Brown tried something else new professionally. She left her job as a hospital nurse and switched to home-based care, working with a single patient in his or her own home.
“It’s been eye-opening,” Brown says. “People in their homes have more privacy and dignity.”
It’s a sentiment echoed by Doug Weaver, “Ray” in the The Shift. Weaver was diagnosed with acute myeloid leukemia in 2009, and has become a friend of Brown’s. He speaks highly of Brown and the other nurses who tended to him during his hospital stay, but he much preferred the home-based care he received after a bone-marrow transplant. “I didn’t feel like I was being treated like a number,” he says.
Brown’s Times column covered previously unexplored issues like doctor-nurse bullying, and larger ones like health-care reform, earning her an invitation to the White House in 2009 to meet President Obama and attend an event in support of the Affordable Care Act. However, she plans to continue writing about nursing and health care, and will chronicle her experiences with home-based care.
In The Shift, she advocates for issues that directly affect nurses, like less charting; “alternates” who would allow them to take breaks; and more people helping to transport patients.
“It takes a lot of people to work with ailing human bodies,” Brown says.
But along with that stress, Brown illustrates the camaraderie between nurses, who pitch in to help each other whenever they can. As she declares in The Shift, “This is nurse’s work, and it’s a privilege to do it.”