With any profession comes its ups and downs, pros and cons and good days and bad. However, a career in nursing, and the healthcare field in general, comes with these plus life and death. Throughout their careers, nurses experience the ups and downs of the job, life and death, and the healthcare hierarchy, however they overcome their hardships and arrive at a caring response for the good of their patients. Theresa Brown in the novel Critical Care, relates the career of nursing to a poem written by Frank Bidart which states “I hate and love. Ignorant fish, who even wants the fly while writhing.” This relates to the idea of both loving and hating a career in nursing because as a nurse there are parts of the job that everyone hates, and parts that everyone loves. As a certified nursing assistant (CNA), I have had a glimpse of what a career in nursing entails and there are pieces that I hate but also pieces I love. I know that these will slightly change as I move into becoming a registered nurse, however I am able to begin my journey of knowing the ups and downs of a career in nursing as a CNA. Those pieces I love completely overpower the parts of the job that I hate. I love getting to know my patients, their history and their families, however this comes with the possible decline in health or death of a patient that I become close to while working with them. 

Death in Nursing

No matter what path is taken in the nursing profession, death is inevitable. It is something that is extremely difficult to cope with and it is a part of the job that everyone hates. In the novel Critical Care, Theresa Brown writes about her first asystole patient, or what they call “Condition A.” Her patient came into the hospital with lung cancer, but she was stable. Unexpectedly, she started coughing up blood and eventually her heart stopped beating and they had to call a code. After a long time of trying to get her heart beating again, she passed away (Brown 2011). As I was reading, this experience stood out to me because it was her first “condition A” as a nurse. I was impressed by how calm she was during the situation, and completely understand how she was feeling “Jumpy at work and depressed at home” (Brown 2011) after the patient died. Personally, I will always remember my first encounter with death as a CNA. I was working the evening shift and one of my patients was on hospice and had a hospice aide with her. The call bell rang for that patient and we were notified by the aide that she had passed away. The aide acted completely unphased and didn’t seem to care as much as me and my coworker, but I later understood that was because she didn’t get to know the patient as well as we did. As I was driving home that night, I couldn’t help but cry because it was difficult to learn that a patient who I had grown to love was gone.  This experience was different than Theresa’s because the death was expected however “death is always death, […] whether violent and gruesome or unbelievably prosaic, is unsettling.” (Brown 2011)

Healthcare Hierarchy

In school, we are taught about the healthcare team and who is a part of it. This word “team” is often seen when caring for someone, however it is sometimes taken for granted by members who don’t appreciate others work. In the novel Critical Care, Theresa Brown illustrates the healthcare hierarchy through multiple situations. In one example, a patient’s family member asks the charge nurse if her husband is dead, however during this time, the code team is still performing CPR on him, so the charge nurse asked the family member if she wanted to stop CPR. Neither person would answer the others question because it would answer their own. Theresa felt “trapped, because nursing has an often unacknowledged but rigid hierarchy” (Brown 2011). Since this was her charge nurse, Theresa felt that she couldn’t intervene in the conversation because the charge nurse was higher than her in the nursing hierarchy. Another example seen in the book was when Theresa had to call an attending because one of her patient’s family members felt that all of their questions were not answered in the previous conversation they had with their doctor. Theresa was very nervous to call this doctor because she felt that she was a burden to him and not that she was a part of the health care team trying to help the patient. The doctor ended up being very nice to Theresa on the phone and said that he would talk to the family tomorrow as he was on his way to pick up his daughter from school (Brown 2011). This is an example of healthcare professionals working as a team and ignoring the hierarchy. In the novel, Brown writes “But nursing is too difficult and too important a job for help to come with a hierarchy” (Brown 2011). Those in the healthcare team need to understand that they all have a mutual goal of meeting the needs and the caring response for their patient, there should be no hierarchy.

Critical Care

In the novel Critical Care, Theresa Brown explains the day-to-day life as a nurse. A passage that truly stood out to me was:

“What can you do? Go home, love your children, try not to bicker, eat well, walk in the rain, feel the sun on your face, and laugh loud and often, as much as possible, and especially at yourself. Because the antidote to death is not poetry, or miracle treatments, or a roomful of people with technical expertise and good intentions-the antidote to death is life” (Brown 2011).

This passage was very meaningful to me as I move closer to becoming a registered nurse. I need to remember that even though my job occasionally involves death, I need to make sure to still live my life, stay positive and focus on the good parts of my job. This passage, and reading this book opened my eyes to realizing how hard but also how important the profession of nursing truly is.

References

Brown, T. (2011). Critical care: a new nurse faces death, life, and everything in between. New York, NY: HarperOne.