“Knockin’ on Heaven's Door” is a Bob Dylan song, but I prefer the cover by Guns N’ Roses, which adds a rock inflection to what is basically a song about dying: “That cold black cloud is comin’ down / Feels like I'm knockin’ on heaven's door.” It's an apt title for Katy Butler's book, which details her father's slow decline after a stroke, and the relatively quick decline of her mother afterward.
As a child, Christie Watson could not decide what kind of career she wanted. Marine biology appealed to her, as she had “visions of wearing a swimsuit all day… and swimming with dolphins.” A teacher proposed law, telling her parents “[s]he can argue all day long.” After quitting school at 16, Watson took a job with an organization called Community Service Volunteers. A nurse there suggested she try nursing: “They give you a grant and somewhere to live.” To the surprise of Watson's family and Watson herself, nursing stuck, and I'm thankful it did.
In The Healing of America, journalist T.R. Reid considers what other countries’ health care systems can teach us.
A few years ago at a meeting of the ad hoc ethics committee at my hospital, we were discussing the issues that arise when treating obese patients. Someone brought up the case of an ICU patient, a young woman who weighed 500 pounds. The ICU nurses complained, sometimes loudly, every time she needed to be moved. Their grousing appalled our chief medical ethicist, but I understood the nurses’ reactions. They likely feared incurring a serious injury from lifting such a heavy patient. This conundrum—how do nurses safely provide high-quality care for people who are obese—will become ever more relevant as the prevalence of obesity in the United States continues to rise.
Most nurses probably don't know enough about the economics of health care and health care policymaking in this country. The idea that the provision of health care occurs within a complex political and economic system barely comes up in nursing schools—even though health care costs make up roughly one-sixth of the U.S. economy, and the public–private system under which health care is financed and provided drives many policy decisions.
“The conversation between doctor and patient… should be viewed as the single most important tool of medical care,” Danielle Ofri says at the end of her new book, What Patients Say, What Doctors Hear (Beacon Press, 2017). I find her conclusion gratifying, since nurses are trained in the importance of talking with and listening to patients (full disclosure: Ofri quotes me on this topic). In contrast, physicians are trained more in a “chief complaint–solution” model, so conversations often turn into physician monologues. While this is understandable, Ofri says, for the sake of high-quality patient care, it must change.
Sheryl Sandberg is the chief operating officer of Facebook, and her book Lean In: Women, Work, and the Will to Lead (Knopf, 2013) has become a manifesto of sorts for women who want to succeed in business.
American Journal of Nursing - What I'm Reading: Unforgettable: At the End of Life, Knowing What's Vital
Scott Simon, the NPR journalist and commentator, made news in the world of social media when he tweeted the details of his charming, theatrical mother's final days, which were spent in a Chicago ICU. His latest book, Unforgettable: A Son, a Mother, and the Lessons of a Lifetime (Flatiron Books, 2015), expands on those tweets, and it's a pleasure to get the full story, especially since Simon is a big fan of nurses. His mother, Patricia Lyons Simon Newman Gelbin, was a gem of a human being, and her larger presence in the book makes their story, well, unforgettable.
How current care for the very old and dying fails patients—and what might be done. Article available online for subscribers.