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A Nurse's Story
Cover of A Nurse's Story
A Nurse's Story
Borrow Borrow
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.
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.
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Excerpts-
  • From the book 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...
About the Author-
  • 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.
Reviews-
  • The Calgary Herald

    "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."

  • Canadian Press "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."
  • Times & Transcript "A compelling book laced with humour."
  • Edmonton Journal "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."
  • Montreal Gazette "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."
  • Winnipeg Free Press "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."
  • Brandon This Week "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."
  • Quill & Quire "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."
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