Critical Care: A New Nurse Faces Death, Life, and Everything in Between

Critical Care: A New Nurse Faces Death, Life, and Everything in Between

by Theresa Brown


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"Doctors heal, or try to, but as nurses we step into the breach, figure out what needs to be done for any given patient today, on this shift, and then, with love and exasperation, do it as best as we can."—from Critical Care

"At my job, people die," writes Theresa Brown, capturing both the burden and the singular importance of her profession. Brown, a former English professor at Tufts University, chronicles here her first year as an R.N. in medical oncology. As she does so, Brown illuminates the unique role of nurses in health care, giving us a deeply moving portrait of the day-to-day work nurses do: caring for the person who is ill, not just the illness itself.

Critical Care takes us with Brown as she struggles to tend to her patients' needs, both physical (the rigors of chemotherapy) and emotional (their late-night fears). Along the way, we see the work nurses do to fight for their patients' dignity, in spite of punishing treatments and an often uncaring hospital bureaucracy. We also see how a twelve-hour day of caring for the seriously ill gives Brown herself a deeper appreciation of what it means to be alive. Ultimately, this is a book about embracing life, whether in times of sickness or health.

As she takes us into the place where patients and nurses meet, Brown shows us the power of human connection in the face of mortality. She does so with a keen sense of humor and remarkable powers of observation, making Critical Care a powerful contribution to the literature of medicine.

Product Details

ISBN-13: 9780061791550
Publisher: HarperCollins Publishers
Publication date: 06/01/2010
Pages: 189
Product dimensions: 5.60(w) x 8.30(h) x 0.90(d)

About the Author

Theresa Brown, R.N., lives and works in the Pittsburgh area. She received her B.S.N. from the University of Pittsburgh and, during what she calls her past life, a Ph.D. in English from the University of Chicago. Brown is a regular contributor to the New York Times blog "Well." Her essay "Perhaps Death Is Proud; More Reason to Savor Life" was included in The Best American Science Writing 2009 and The Best American Medical Writing 2009. Critical Care is her first book. She lives with her husband, Arthur Kosowsky, their three children, and their dog.

Table of Contents

Preface ix

Author's Note xv

1 Why the Professor Became a Nurse 1

2 Getting My Feet Wet 13

3 First Death 27

4 Benched 43

5 A Day on the Floor 61

6 Condition A 81

7 Openings 99

8 Doctors Don't Do Poop 113

9 Switch 129

10 Access 147

11 Poison 165

Epilogue 183

Acknowledgments 191

A Reader's Guide 195

Questions and Topics for Discussion for Nursing Students and Faculty 197

About the Author 201

What People are Saying About This

Julie Salamon

“If Theresa Brown tends her patients as well as she tells her story, they are lucky patients indeed. This absorbing dispatch from the front lines of medical care captures the daily travails and triumphs of nursing with humor, compassion, and sometimes terrifying immediacy.”

Pauline Chen

“A beautifully written account of a nurse’s first year on the wards, a medical memoir that combines lyricism and compassion with searing honesty and well-timed laugh-out-loud wit...I loved this book.”

Suzanne Gordon

“Brown shows us what it means to be a nurse and helps us understand that nurses need as much intensive care as their patients. Sometimes more!”

Elizabeth Cohen

“A must read for anyone who wants to understand healthcare. This extraordinary book will open your eyes to the reality of nursing. If you or your loved one ends up in the hospital, you’ll wish you had someone like Nurse Brown at your side.”

Richard M. Cohen

“Critical Care is a gift from an English-teacher-turned-nurse who writes from a deeply human context about her first year in a hospital oncology ward...A book of stirring stories about how we live, care for the sick and die.”

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Critical Care 3.8 out of 5 based on 0 ratings. 96 reviews.
LorraineNY More than 1 year ago
Everyone who ever questioned the value of the nursing profession should read this book. Theresa Brown offers insight into what a typical work day is for a nurse and how much nurses give of themselves to safely and effectively care for their patients.
Anonymous More than 1 year ago
As a nurse i found this book easy to read & easy to relate to. It took me back to my first year in nursing. It gave me a few good laughs. Im not sure this book would be interesting if you werent a nurse or in nursing school.
Anonymous More than 1 year ago
I had trouble putting this book down, except to pause to talk about what I'd read in it. Theresa Brown's account of her first year as a nurse on a cancer floor -- after an earlier career as an English professor -- is wonderfully written, thoughtful, poignant, funny, and enlightening. It speaks to all of us who have ever interacted with the medical system or have contemplated starting a new job. A great read!
walterqchocobo on LibraryThing More than 1 year ago
Theresa Brown left her job as an English professor to be a nurse in the oncology department of a hospital. This book includes a number of her observations about her first year on the job. At times, this was a tough book to read but it gave me a better understanding of the amount of effort involved in providing care to patients. This book shows that Ms. Brown is a very caring individual and really enjoys her work but that it is tough and emotionally draining. It was interesting to read from a nurse point of view as they are the ones that we take for granted when in the hospital. I would definitely read more from Ms. Brown. The book seemed too short--I was hoping for more of her stories.
mj.greenway on LibraryThing More than 1 year ago
The life experience of an English professor helps this author's experience as a first year nurse be brilliantly described. Her language is expressive of hospital treatment and the vulnerable emotions of patients, families, and professionals. This insightful book is a pleasure to read and a treasure trove of end life understanding.
Judgejudy2u on LibraryThing More than 1 year ago
This is one ofthe best memoirs I have read in a long time. I just wish it was longer. Ms. Brown's is the nurse you would want if you were hospitalized. Most of us have dealt with hospital nurses but probably have not considered their feelings toward patients and their job in general. This book does that and will make you think again before you have an attitude towards your health care providers. It was well written and an easy read. It's good to know that most nurses, the ones that do have a true calling, like Ms Brown, are out there.
madforbooks on LibraryThing More than 1 year ago
This book was written by a nurse who changed careers midlife. Formerly, she had been an English professor. That fact gives you an idea about how important the profession of nursing is to this dedicated lady.Nurse Brown takes you on a fascinating walk through her first year of on the job experiences in such a way that you can't help but be moved by the rigors of her profession. You will experience a wide array of emotions as you traverse the territory with her. And, as a bonus, you will learn much about medicine if you are so inclined.This memoir is well crafted and easy to read. I recommend it for anyone interested in nursing and the health care field and especialy for anyone likely to become a patient. A top rate chronicle!
belgrade18 on LibraryThing More than 1 year ago
Nonfiction work by a woman who changed careers from being a college English professor to a hospital nurse. Overall rather interesting, though the writing can be a bit pedantic and repetitive at times. The focus of her practice is oncology nursing, so there are many rather harsh and depressing stories of patients suffering through cancer and chemotherapy, many of whom died. She is thoughtful and philosophical, however, and I admire her for being willing to work with cancer patients and do it with concern and warmth. Recommended for those interested in nursing as a career and those interested in hospital culture and oncology care.
voracious on LibraryThing More than 1 year ago
Theresa Brown's memoir of her early experiences as an oncology nurse are a candid, touching, and sad glimpse of the struggles patients and families live every day in oncology units across America. As a young nurse Theresa attempts to understand the skills, rules and social complexities of hospital life. As she tries her best to help patients find relief and peace, she often finds herself challenged by the inner workings of the hospital and social heirarchy which challenges her ability to efficiently serve patients. This book is well written and enlightening to those who want to take a peek behind-the-scenes in a busy hospital unit. I enjoyed this brief memoir and felt it spoke of the humanity of those who choose to work with the most desperately ill and dying. It also is a challenge to us all to truly experience life while we can and not to take our lives and loves for granted. A good reminder for all.
metermaid1 on LibraryThing More than 1 year ago
Critical Care is a memoir about a new nurses first year on the job. It is a mix of touching, sometimes heart-wrenching scenes and funny anecdotes. I didn't think there was much or a story to it, but I liked the book overall. There were parts of the book that made me very emotional. It gave me a new understanding and respect for what nurses do. It was well written and a quick read, and I enjoyed it very much.
Naren559 on LibraryThing More than 1 year ago
Critical Care: A New Nurse Face Death, Life, and Everything in Between by Theresa BrownAn autobiographical account of the more immediate consequences of a career change, from a University English professor to Registered Nurse.Because this is an auto biographical account, there is no problem assuming what the author relates is genuine. That, in addition to her excellent narrative skills, Theresa Brown, forces me, as the reader, to become quite introspective (hypochondriacally?) wondering if I also might be suffering from the various maladies she describes the patients with having. Interspersing her own ¿slip on the ice¿ accident with her own subsequent hospital stay, made this entire book quite easy to read¿a real page-turner
kaulsu on LibraryThing More than 1 year ago
Theresa Brown, as should be expected from a Tufts University professor of Writing and of English Literature, has written a very readable book. In it she takes a lay reader behind the scenes of what those nurses are doing sitting at the desk (instead of in my relative's room!); of what type of training they go through to get to be where they are; and of the unfortunate realities of "office politics" and how they can affect (infect?) the conditions on a hospital floor.I doubt this book would be very enlightening to a practicing medical professional, but I would recommend it strongly to someone considering working in this environment (even in a non-nursing position). I would also recommend it to someone who has a friend or relative undergoing a long-term hospital stay.The bottom line: we need more "Nurse Browns" in our hospitals. Nurses who care about their patients, who care about being professional, and who listen to what their patients have to say.
tymfos on LibraryThing More than 1 year ago
Critical Care is Theresa Brown's account of her first year as a nurse, after making a mid-life career change. (She was previously an English professor who taught writing, so she does know how to write.) Brown brings us the tremendous highs and lows and the absolute minutiae of nursing.This arrived on a Saturday, and I didn't mean to start reading it right away -- I had another book I needed to read stat for a book discussion group. But I peeked inside the cover and was soon reading away. I fretted when I found myself with time on my hands on Sunday, wishing I had the book with me. I read a chapter during my lunch break on Monday. And, as soon as I got home from work, I finished it. Obviously, I found it engrossing. It also had its gross aspects. A whole chapter about "poop" -- surprisingly interesting. And the story of her first "Condition A" -- what they call it at her hospital when a patient experiences sudden, unexpected cardiac arrest -- came complete with a massive respiratory hemorrhage, the details of which could give a squeamish reader nightmares.But this is the stuff of nursing, along with dispensing meds and charting and all the other details of work in a medical oncology unit. In one chapter, the details of her work briefly became tedious. Yet, she achieved exactly what (I believe) she set out to do in that chapter -- demonstrating effectively the conflicting demands and details which occupy much of a nurse's typical shift at work. The danger of all memoirs is that they are "I" centered upon the writer, and can become self-serving. Brown doesn't pretend to be "the expert" in all things medical. She admits to the steep learning curve at work which left her, at times, feeling totally insecure. I think she does come across, sometimes, as a little too good to be true. I'm sure she often goes the extra mile for her patients as she indicates, but everyone has a day now and then when they just have to do the job that's there, without heroic efforts.In the end, the book left me feeling a bit depressed. The nature of her work in oncology means that many of her patients wind up dead. And her total lack of religious belief means that she sees that as "The END." How depressing to see death as the end, rather than the gateway to eternal life! I couldn't stand to do the work she does, with that viewpoint. But Brown obviously sees it as her mission to make what time her patients have as comfortable as possible, and to do all that she can to help her patients live in as long and healthy a way as possible. She takes seriously her role as patient advocate. I think she genuinely cares about people. And that made me care about the patients about whom she was writing -- which is probably why the book was so hard to put down, and what made the book a worthwhile read.
missysbooknook on LibraryThing More than 1 year ago
I enjoyed getting a peek into a nurse's world, and what goes on in it. Theresa Brown changed careers at mid-life, and found that nursing was her calling. She told stories of past patients that she had cared for and how their lives had an impact on hers. Some of the stories were heartbreaking. I never knew how much nurses did and were responsible's a high energy, very knowledgeable, some times fast paced, emotional profession. Theresa mentioned that when she was in school, that nursing students were advised not to share their personal lives with their patients. She did not totally agree with that. She found that it put her patients at ease just to mention her children, or home life. Patients are often afraid, and feel nurses know more about their illness than they are letting on. Theresa learned to be honest with those in her care, and she found it very rewarding. I really enjoyed Critical Care and would recommend it to others.
SamanthaMarie on LibraryThing More than 1 year ago
I've read a few other narrative nonfiction books about medicine, but all from the doctor's point of view. This book really illustrates the difference between doctors and nurses. Doctors treat (and focus on) the disease, nurses treat the person-medically, emotionally and spiritually if needed. This was an interesting, quick read about the beginning of a nurses career and the motivations, frustrations and triumphs. I would recommend this book for nurses, those who want a book on the more humanitarian side of medicine and anyone who wants to know what exactly it is that nurses do. This is a LibraryThing Early Reviewers book.
Taphophile13 on LibraryThing More than 1 year ago
Theresa Brown was an English professor at Tufts University who did not find her passion until she met the nurse-midwives whoo assisted at the birth of her children. She made a mid-life career change and became an oncology floor nurse. This is the story of her first year as she faces her fears and doubts, helps patients deal with the toxic treatments that may save their life, fights the bureaucratic maze of insurance and hospital regulations and runs interference between standoffish doctors and desperate families. She sees patients come in looking healthy and within weeks they are weak, wasted and willing to die because of the side effects of chemotherapy, It is as she says, "a Faustian bargain, a deal with the devil." She learns the hard way that if you want several bags of platelets you must order them separately, the opposite of how you order units of blood. She is present when a patient dies and sees the absurdity when the hospital cannot stop resuscitation until the family says stop but the family wants the staff to tell them when it is time to stop. Brown is the kind of nurse that we would want to care for us or our family. My Advance Reader's Edition About the Author page was blank but I hope that other editions have some information about this compassionate nurse who found exactly where she belongs.
jillstone on LibraryThing More than 1 year ago
I often read medical memoirs and found this one especially enjoyable. Part of it's appeal is the author's elegant writing . The author changed careers from English Professor to Oncology Nurse. She occasionally invokes stories (such as Rikki Tikki Tavi) to invoke the emotions or situation she is dealing with, which surprised and delighted me.Her stories of patients and what they experience on the Oncology Ward will both sadden you and warm your heart. This is a nurse who understands the confusion and grief that a patient and family feel in the terrifying environment they have found themselves in. My hope is that Theresa Brown R.N. is one of many, so that anyone facing a cancer diagnosis has a nurse that can be counted on at their side.You will appreciate the inclusion of her life away from the hospital, her husband and her children and how they help her deal with a difficult job. The writing is wonderful and the author's struggle to deal with unexpected death is moving. The Epilogue gives beautiful life to the idea that life should be lived in the present with all the joy we are capable of finding and giving.
jlhowson on LibraryThing More than 1 year ago
I received a copy of Critical Care as an early review. When it arrived, I opened it, intending to read the first chapter. Instead, I found myself 2 hours later finishing the book. Brown has written an engaging, easy to read book about her first year of nursing, as she served on oncology floors. The book is about her experiences, and gives a good picture of the vital and valuable role nurses can, and most often do, play in hospital care. In the book, she explores some of the dynamics between the different levels of hierarchy within the medical system (nurses, nurse managers, interns, residents, fellows, lab techs), and her own role that she plays in patient care. The insights are valuable, and shed light on a system that most of us don't fully understand.Overall, the book is well written and easy to read, as it more or less flows chronologically though her first year as a nurse. I found the fourth chapter somewhat distracting, as we left the main story of the hospital and instead hear about Brown's knee injury. While I understand that this was a critical factor in her life, and while it sheds some additional insight on the switching of roles from nurse to patient, I felt it distracted from the main plot. At the very least, it could have been integrated slightly better into the flow of the main story. Otherwise the insights that Brown provides are very useful, particularly as I have a mother currently receiving oncology care. The controversies and conflicts she covers are a fascinating look into the ultimately human nature of medical staff. While some reviewers have rightly pointed out that Brown does not admit to any personal fault in any of the controversies, I think that is part of what makes this book so human - for which of us like to admit our own shortcomings?Overall I consider this a good, engaging, and interesting read, particularly if you have any cause to be spending time in a hospital either personally, or with a loved one. It is a fairly short book, so I would consider visiting your local library, or finding a friend with a copy if you are able.
JennyMcb on LibraryThing More than 1 year ago
I received this as an early reviewer.I have worked in four different hospitals and Theresa's account as a new nurse explains why it's difficult to get information about patients for the lab. It's interesting to read Brown's views of nurses and patients because I don't think that many can appreciate what it takes to be a good nurse. However, she came off as too intense and didn't acknowledge any mistakes that she might have made.In explaining her change of career, I feel that including her friend's comment about smart nurses was an insult to nurses who have been in the field for years. It would have been interesting to hear about her challenges as being an older new nurse having to take direction from younger nurses. I would recommend this book to nursing students and other healthcare professionals to understand a nurse's point of view.
Bonni208 on LibraryThing More than 1 year ago
Brown describes her transition from being an English professor, to her vocation as nurse. She provides those of us who have only ever been on the receiving end of medical care a great perspective on what it is like for those who are providing the care. I was captivated by Brown's story from the very beginning of the book. Her constant seeking of how to navigate a complex system (both in terms of the medicine and the hierarchy) was a joy to explore with her. I was grateful to have received this book as a part of Library Thing's early reader program, though for those of you who missed that opportunity - this one's well worth purchasing.
kraaivrouw on LibraryThing More than 1 year ago
The author of this memoir used to be an English professor, but she chucked all that to become a nurse. The memoir is about her first year as a nurse on a medical oncology ward. The book is well-written, but ultimately there's just nothing special about it. It's essentially a series of stories about caring for patients with cancer - there's value in that, but it doesn't really stand out for any reason.I would have liked the author to be more self-reflective. It's a big change from Professor to first year nurse - tell me about that. Tell me how the books you've read and studied contribute to your understanding of our job as a nurse. She just never manages to really do that. Instead she tells stories of patients and spends a large chunk of the book talking about her challenges with some supervisors at her work - a section of the book that actually made me squirm because it felt so inappropriate. I would have been moderately alright with her slagging her co-workers (it's something we all do) had she been able to analyze her own part in the conflict, but instead it's heroic Theresa against the evil nursing supervisors who eat their young and it makes her very unsympathetic. Add to that the typical nurse's awe of doctors/attendings which is presented as a completely rational set of behaviors without any context to explain them and chunks of this just weren't worth reading.In the end, it's obvious Ms. Brown cares about her patients, I just wish she wrote about them better. What could have been a really good book ended up being just okay.Thanks to the publisher for sending me an advance reading copy of this book.
MsGemini on LibraryThing More than 1 year ago
This was an interesting realistic story about the nursing profession. I am a registered nurse and was able to relate to many aspects of this book. Theresa loves her job and her positive approach to the profession and nursing care allows her to be a wonderful nurse. This book was sad, funny, inspiring and uplifting. I recommend it to readers like myself, a part of the profession but also to lay people. It will allow the lay person to have a greater appreciation of nurses and their trying but yet rewarding careers.
macygma on LibraryThing More than 1 year ago
Theresa Brown went from being a professor at Tufts University to being an RN on an oncology ward. From teaching students to understand dying from literature to helping patients and their family understand that dying is inevitable and, sometimes, we can't control when it happens.This account of Brown's first year in hospital nursing and of her choice to go into oncology - one of the toughest nursing specialities there is - is both enlightening and memorable. She quickly learns that she has more power than she knows but that the power she controls cannot save someone's life if they are too far gone to save.She introduces us to various patients, some live, some die but all leave a bit of themselves with her and with us. From the eleven-year-old to the ancient, they all make themselves known in the way they handles the cards dealt to them and we are richer for learning about them.Ms. Brown has written an easy to read, hard to forget account of her introduction to nursing. Read it and then, next time you need a nurse, thank her. Out soon. Pick it up.
reenum on LibraryThing More than 1 year ago
The first couple of chapters were very well written, but the book ultimately failed to hold my interest. Perhaps reading Atul Gawande has set my bar for medical memoirs too high.
Blankenbooks on LibraryThing More than 1 year ago
A really insightful look at the joys and challenges of a nurse's first year on the job. Sometimes surprising in its honesty, this account shows that the nursing profession--like any other--is much more than the romanticized notions that many people harbor.