Sunday, November 11, 2007

A Nurses's Story - Book Review

A Nurse's Story
By Tilda Shalof
McClelland & Stewart 2005

Tilda Shalof is an critical care nurse in the ICU at Toronto General Hospital. She's been there for over 20 years. This book is the real story of what happens in the ICU and how patients are really cared for.

Tilda Shalof went to University and obtained a degree in Nursing long before they became compulsory. When she started working at the ICU (in the mid 1980s) she was laughed at for having a university education.

Someone told her "We need REAL nurses here".

Shalof offers insights that come from experience with some of the toughest health issues society confronts. She touches on the difficulties associated with the restructuring of the 1990's, which led to cutbacks and nurse layoffs, and the 2003 SARS crisis, which threatened and burdened nurses far more than any other class of health care workers.

She tells the story of one aged patient whose two daughters were researching cures on the internet and dictating to the ICU nurses what they wanted done next. Despite the fact the patient was obviously dying, the daughters refused to accept a DNR (do not resucitate) solution. "As long as Dad has a 1 percent chance of surviving, we expect a 100% effort in caring for him". Shalof theatens to get a court order to allow the man to die in peace. Unfortunately she does not say what the outcome was.

Shalof is very blunt about the cuts in nursing numbers and how it affected patient care. She talks about how the hospital went through a period of firing all the nurses and wanting to hire unskilled (newly graduated) nurses to "save money". And then she mentions how the hospital was frantically rehiring all the old nurses on a casual and part time basis, because it was cheaper that way. The hospital didnt have to pay out benefits.

The book is not an easy one to read. It took me several days. Some of the stories are depressing. Especially where the nurses themselves complain about how they dont get any respect or credit for their work. It's the doctors who get the credit.

Now for my family story about the Toronto General Hospital.

When my husbands grandfather went into hospital (on the Friday before Thanksgiving in October 2001) with pains in his chest, he was kept in the ER for 3 days waiting for a bed. During this time he had 2 strokes. When we went to his apartment on the Sunday to take him up to my brother-in-laws house for Thanksgiving dinner (like we do every Thanksgiving Sunday), Grandpa was not at home. Noone knew where he was.

We spent the Thanksgiving Monday calling all the hospitals looking for him. All the hospitals kept telling us "No, he's not here." Finally on the Monday evening Toronto General Hospital told us, "Yes, here he is. He was in ER for 3 days waiting for a bed." By the time he was admitted, he had had 2 strokes, plus the doctors discovered that he had lung cancer (he was a heavy smoker).

When we went to see him in hospital, my husband became the only "next of kin" available to make a decision. Hubby is the oldest grandson. My parents in law were living way up north (near Timmins at the time) and it would take them 2 days to drive to Toronto. His mom did not want to make any decision. she was too scared. She told my husband "You do whatever you think is best".

The hospital were wonderful. They told us that after two strokes, he was a vegetable, and that the cancer had already spread throughout his body, and the chances were not good. Early on Tuesday morning, the hospital called us to tell us that he had another stroke, and was on the machines. He could no longer breathe by himself. So on the Tuesday after Thanksgiving, (October 10 2001) my husband signed the papers, and we sat with him, said our goodbyes and had the machines turned off.

Whether or not Tilda Shalof was one of the nurses who helped care for Grandpa, I have no idea. She might have been.


John Mutford said...

Your own experience with the TGH must have been in the forfront of your mind while reading this. She sounds like a pretty admirable character. Did she ever come across as boastful?

pixelrn said...

I don't think she came across as boastful at all... I am also an ICU nurse and I was amazed by what an accurate portrayal of ICU nursing this book provides. I would say that is an excellent read for anyone who is thinking about pursuing a nursing/medical career.

heather (errantdreams) said...

This sounds very difficult, yet very educational, to read. I'm glad you shared this with us.