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 disquieting place in the whole hospital. Bombs are detonated in...
Author: Tilda Shalof
An intensive care unit nurse with twenty years of experience in Israel and Canada, Tilda Shalof now lives in Toronto.
"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." - The Calgary Herald
"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." - Canadian Press
"A compelling book laced with humour." - Times & Transcript
"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." - Edmonton Journal
"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." - Montreal Gazette
"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." - Winnipeg Free Press
"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." - Brandon This Week
"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." - Quill & Quire