The Shift

Starred review from July 27, 2015
Books about nurses abound, but this meticulous, absorbing shift-in-the-life account of one nurse’s day on a cancer ward stands out for its honesty, clarity, and heart. Brown, a former Tufts University English teacher who later became a nurse, juggles the fears, hopes, and realities of a 12-hour shift in a typical urban hospital with remarkable insight and unflagging care. “To be in the eternal present of illness and unease, never knowing the future,” a weary Brown writes at the end of her long day, “it’s where my patients live so I, ever hopeful, live there with them.” Brown’s shift on one cold November day is focused on four patients. Dorothy, whose leukemia is in remission, is waiting to go home. Sheila’s excruciating abdominal pain turns into a life-threatening surgical emergency. Richard will get a drug that will help his body kill its cancer cells—unless the drug kills him first. Candace, enduring a long hospital stay for an intravenous infusion of her own cancer-free cells (an autologous transplant), says it “feels like an emotional chess game.” Brown notes that “an oncology nurse’s favorite words to a patient are ‘I hope I never see you here again.’” Her memoir is a must-read for nurses or anyone close to one.

July 1, 2015

In this title, readers experience a typical workday through the narrative of hospital oncology nurse Brown. During the course of her 12-hour shift, Brown cares for four patients, each with their own needs and distinct personalities. She faces many challenges, but through them all demonstrates dedication to patient care. Often ignoring her appetite, Brown places the demands of her job first. Forced to give attention to requisite record keeping and other paperwork, the author feels that more time could be spent with patients. Another daily stress factor is an antiquated hierarchy that persists among medical professionals. And based on Brown's experience, it seems that the prevailing attitude, especially in cancer treatment, should be one of solidarity. Brown's background as a university English professor is evident in her prose. Readers will relate to her description of her coworkers, learn medical vernacular, and connect with patients on an emotional level. VERDICT This book can be enjoyed by all readers. Nursing students and professionals will appreciate the humor and will understand the situations involved.--Chad Clark, Nederland, TX

Copyright 2015 Library Journal, LLC Used with permission.

July 15, 2015
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.

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September 1, 2015
In this day-in-the-life memoir, Brown, a 45-year-old R.N. with a PhD in English, recreates one 12-hour shift she spent caring for cancer patients. As she notes in a disclaimer, she has changed details and characters to conceal the identities of coworkers and patients, and she uses dialogue reproduced to the best of my memory. She explains a bit too many hospital acronyms, misses the chance to share helpful information, and her literary education can be a blessing and a curse. It pays off with some lovely phrases, such as chemotherapy, like surgery, always comes with Faustian trade-offs. Some readers may find her allusions, preference for poetic language, and self-presentation off-putting, while others will enjoy her perspective and heightened form of expression. At its best, Brown's memoir increases empathy for nurses, who work hard and often must care for difficult patients and cope with a caste system that gives them less respect than MDs. This account also raises important ethical questions, such as just how fully informative healthcare workers should be when the prognosis isn't good.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)