A Nurse's Story by Tilda Shalof Book Review

Well-known best-seller A Nurse’s Story: Life and Death and in-Between in an Intensive Care Unit was written by the popular Canadian writer Tilda Shalof. This story introduces to the reader writer’s biography presenting her personal view on nursing. A Nurse’s Story is about professional lives of nurses, their working days and nights, the challenges and satisfactions in work and its frustrations and stresses.

Tilda Shalof is a great, dynamic and inspiring public speaker and media commentator, best-selling author, and outstanding writer of many useful booklets and books on nursing. She introduced real nursing story in her book. She combined work and pleasure, since writing has always been a hobby for her. She likes her work as a nurse very much. Tilda thinks it’s very privileged work, while it’s very intimate to be involved in people’s lives.

Her work is very fascinating, though stressful, but most of all she likes to help and cure people, to provide care for them and to save their lives. She is proud of personal achievements in nursing. Tilda feels like a travel-guide, presenting people a window into the world of nurses. When you read this book, you will know how nurses work: they work in research, disasters, manage patient’s condition, prevent diseases, save from suffering, prove people’s lives, and fight for justice.

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A deep love for profession of nurse inspired Tilda to write A Nurse’s Story in order to share her personal experience with other people. She has been working in the Medical-Surgical Intensive Care Unit at Toronto General Hospital of the University Health Network for twenty four years and decided to write about her work of a nurse, her relationship with colleagues and mentors, who have become very close friends later. A Nurse’s Story is not a particular story about Toronto Hospital, but instead, a story of general understanding of any hospital or clinic as a whole, where she gained fundamental knowledge, skills and practical experience in nursing.

The story introduces to a reader nurse Tilda’s journey as a personal chronicle from inexperienced nurse to expert. On one of Shalof's first days at the hospital, she faced an array of tasks she had only read about, but she had no practice in. A senior nurse saw her and commented that the unit needed some “real nurses.” With time she turned into a “veteran nurse” and amazing professional.

Tilda, together with well-trained professionals, Nicole, Tracy and Laura, are courageous, intelligent and generous women, who work as a team on day and night shifts and take care of their patients. Team of nurses deals with a bulk of problems and challenges, providing different type of care, like emotional care, and supports their patients, who seriously suffer from different illnesses.

For example, they were thinking which patient deserved to be the first to receive a donated organ, though all of them were seriously ill. The team of nurses was constantly struggling to prolong the lives of their patients who were dying. Here Tilda plyed the role of outspoken patient’s advocate, and passionate nurse leader.

In one of the chapters of A Nurse’s Story she describes the case, when the daughters of a patient found a course of medical treatment and told nurses to follow this prescription for their father. But the patient was almost dying and Tilda asked them to allow the man to die in peace and to accept DNR. They expected a 100 percent effort in curing him, even if he had a one percent chance of surviving.

A Nurse’s Story also emphasizes the difficulties associated with the restructuring of the 1990’s, when all nurses were fired; instead, the unskilled and newly graduated nurses were hired by the hospital in order to save money. This has really affected the patients’ care practices. Later on the hospital frantically rehired all the old nurses on the part-time and full-time basis, because it was cheaper. Anyway, the hospital didn’t have to pay out benefits.

This is what Tilda Shalof says about the place where she worked:

“The hospital can be inhospitable and hostile place. No one will listen to your concern if you worried about a patient, and nobody will ask on your questions. Even if you know what patient needed, but you can’t help him because your hands are tied. You know what to do, but are afraid to be wrong. Then you wait till the doctor come and pray he will listen to you seriously”.

Professional memoir of the writer teaches other authors about such things how to recognize and outline the essence of characters. She found some memorable characters in the hospital, such as independent-minded nurses and restrained doctors. Nurse Tilda is motivated by her personal moral principles and ideas. The team has helped her to overcome her initial fears of lack of self-confidence. Tilda involves reader in all ups and downs, and pros and cons of a professional nurse’s life.

Tilda Shalof is completely honest. She sets out difficult truths and confronts issues in the book A Nurse’s Story. Here she reveals the secrets about the profession of nurse, and depicts the situations, where she was not empathetic or avoided moral judgments to patients. She wrote about struggles and problems in the profession of nurse, as well as about nurses’ humor and anecdotes, which were often needed in emotional release from the stresses of nurse’s work.

Writing for Tilda is an absolute joy and delight, but the hardest thing to turn own experience into a best-selling book is editing. When she writes, she gives herself a lot of freedom. Reading of this story for nurses is a true confirmation of their work that received a kind of public interest, commercial success, and got media coverage. Tilda loves being a nurse and is proud for her choice of profession.

Nurses across the country responded Tilda that they were proud to read about their work that she had depicted in details in her book. Nurses from all specialties found their own experiences in A Nurse’s Story. The book shares with nurses the extensive knowledge, and specialized skills and responsibilities.

I completely agree with the author that uniqueness of A Nurse’s Story lies in voice and opinion that come directly from the nurses. This is a narrative about careers of nurses and interesting cases of their patients told absolutely from the perspective of nurses. A Nurse’s Story is addressed to such patient-care issues as responsibility, critical care, technology to prolong patient’s life, caring for patients with various infectious diseases, distribution of valuable resources and some ethical issues. Nurses are responsible for personal knowledge and skills they possess that help to determine patient’s condition, whether they feel better or worse, and they use all available inner assets and personalities as a therapeutic presence. Here is where the key of nursing lies.

Hui-Ling Lai (2007), Vice Director at the Department of Nursing at Hualien Tzu Chi Hospital, gives feedback on A Nurse’s Story. He declares this book is writer’s self-realization of Tilda’s daily nursing job, because it makes her energetic. She treats each patient in an optimistic and friendly manner, presenting in the book self-examination of everyday routine. Nursing job deserves great respect, because nursing service is very unique and entire humanity needs well-qualified nurses. Any nurse should constantly take professional trainings in order to develop personal skills and characteristics in this profession; and then, nurse’s career life would last long. But not everyone is suitable for this profession. Tilda Shalof performed this job in an excellent manner. And that’s why she admired to be a representative of this honored profession.

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A lot of journals give feedback on Tilda Shalof’s A Nurse’s Story. Among them is Edmonton Journal, which stated that she writes genuinely heart-rending, disturbing and thought-provoking narratives. Winnipeg Free Press puts down that while Tilda’s stories are compelling and beautifully written, besides they are naked and vulnerable.

After publication of the national bestseller, A Nurse's Story, in 2004, Tilda Shalof has become an active and outspoken nurse leader. She draws herself as experienced and critical care nurse. She is completely dedicated to nursing, and has raised awareness among general public of nursing's central role in health care and safety. She is passionate to help nurses to re-connect to the power and ideals of nursing profession, and inspires nurses to be all that they can be.

When Tilda has traveled across Canada and the United States, she was speaking to nurses, physicians of all specialties, other health-care professionals, and members of the public. A Nurse's Story is educational, intellectual, and emotional book. After that A Nurse’s Story became true international bestseller and was translated into four foreign languages: French, Taiwanese, Vietnamese, and Japanese, and received wide critical acclaim in the North America.

RN responsibilities in ICU and relation to the nursing concepts

Being a nurse is a very complicated job. Theoretical knowledge is the fundamental step for expansion in nursing development. In order to work in ICU one is expected to possess knowledge in different disciplines and apply them in practice as well. I think theoretical knowledge of nurses should be based on such sciences as sociology, psychology, physiology, pharmacology, anatomy, anthropology, chemistry, deontology, pathophysiology and other fields. All representatives of the medicine have to know Latin in order to be able to write prescriptions, recipes or read medical instructions. This is a very important criterion for them.

Duties of any registered nurse (RN) consist of caring for ill, disabled or dying patients, ensuring that they attain, maintain, or recover optimal health and functioning. Nurses are healthcare professionals, who provide support from basic triage to emergency surgery, and are competent in assessing, planning, implementing, and evaluating individual care. Nurses assist individuals to perform activities that contribute to their health, recovery, or peaceful death. They protect, promote, and optimize their patient’s health, prevent illnesses and injuries.

Critical care nurses perform daily a lot of assignments. They admit and discharge patients, prepare patients for medical tests and operations, measure the blood pressure, respiration rates and temperature in their assigned patients, administer medications to patients, talk to the patients about their treatment, explain them how this treatment can be carried on at home, transport their patients in helicopters, help patients to take bath, help to change clothes, record and evaluate monitor readings, make sure machines are working correctly, help the hospital porters to transport patients to different  parts of the hospital, answer on anxious patients’ parents calls.

Any student-nurse needs to have a good knowledge in the four fundamental concepts of nursing before he or she can start taking care of patients in practice. There are four nursing concepts that provide the foundation for programs of nursing education and teach appropriate skills for nursing. They are human being or person, environment, health and nursing. Above-mentioned concepts can also teach students how to interact with patients. These concepts may affect each other and include the main principles of nursing practice and philosophy.

The human being concept comprises several different aspects of each person; thus, explaining the person as a whole. The first concept includes the diverse aspects of a person's life: social, psychological, spiritual and physical areas. It includes cultural aspects as well. The second concept, patient’s environment, includes their socio-economic status. A person has access to health care, which is the most important aspects of environment. Individuals, who do not have regular access to quality health care might have similar problems, and as a result, less optimistic forecast.

The third important concept in nursing, known as health, should be focused first of all on the patient's principal health complaint and pay attention to any other possible symptoms, such as medication side effects. The fourth concept is the current process of nursing. According to the Chinese Medical University, nursing is considered to be not only a science, but also an art. It includes teaching and learning of ethical and legal training, teamwork, leadership, decision making, and meeting of patient's needs.

Each student in nursing, who wants to be trained medical practitioner, should take into account the responsibility to take care of all patients’ needs: medical, physical, emotional and mental, among such types of nursing concepts like processes, approaches and roles.

Students’ reflections

Famous best-seller A Nurse’s Story: Life and Death and in-Between in an Intensive Care Unit was a really labour of love for Tilda Shalof, a well-known writer from Canada. Nurse Tilda is diligent caregiver for patients at work. This story will be interested, useful and important to read not only for nurses, students, general public and anybody, who works in medical sphere, but also for everybody, who likes to read generally. It is a biographical story based on the real events, well-written and interesting to read, showing us good insight into nursing. The book is full of professional terminology in medicine, as well as medical jargon. The author shares professional and personal experience with reader.

Though the book is difficult to read, it is very educational. Also, A Nurse’s Story will inspire other nurses, who may be feeling disappointed or lost own confidence or enthusiasm in the profession. I think that this story makes any student to push really hard to achieve his or her goals of becoming a registered nurse. That’s why I think it will bring substantial experience for students on the nursing concepts.

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