review: The Nurses
November 26th, 2016 21:49![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
alibi_shopThe Nurses: A Year of Secrets, Drama, and Miracles with the Heroes of the Hospital, by Alexandra Robbins (2015)
(I've been reading various nonfiction books about nursing, to compare to my own limited experience [I'm a former med/surg nurse who practiced mostly in the 2000s] and as background for some fiction I'm working on. This was a book written by a non-nurse, a journalist who's done several similar case-study pieces in other fields.)
My feelings about this one are very mixed. Overall I think it's an interesting and informative(*) book, and the writer's heart is definitely in the right place; Robbins clearly loves nurses and wants to raise public awareness of their work and the pressures they're under, and takes a strong stand for better working conditions and labor solidarity, while also acknowledging the many ways nurses can sabotage themselves. A particularly nice touch is near the end, where she gives patients and their family members some pretty reasonable tips on how to simultaneously advocate for their own care and make nurses' lives easier.
It was really hard for me to get past how it's written, though. Half of it is straight nonfiction presentations of facts and statistics—clear, but not particularly well organized and full of repetition. The other half is narrative dramatizations of four pseudonymous real people (or composite characters?) as they face various job challenges, and even though the individual scenes are interesting enough and the background information is explained without any terrible mistakes, the style is very clunky and flat. I realize that this is meant to be more of an educational presentation than a work of literature—and this kind of thing is in the eye of the beholder, so it may read perfectly well to other people—but to me it's just very careless writing with no rhythm, no nuance, no difference in tone between different narrators, and every point hammered into the ground. It's also weirdly melodramatic and cliché-ridden, considering how much Robbins (in the non-narrative sections) talks about wanting to debunk misconceptions and stereotypes: there's a long discussion of why the "sexy nurse" image is so pernicious, but then a young nurse is introduced with a scene where she checks out her own "ample bosom"; whenever the main characters are given an ongoing subplot involving anything in their personal life, it's from a checklist of predictable big-ticket items (finding romance, staying sober, trying to have a child); there's some good discussion of the many pressures that contribute to mismanagement and bad working conditions, but in the narrative the bad managers just happen to be amazingly bad people in every way; and there's some abstract acknowledgment of how easy it is for anyone to make mistakes, but apart from a drug addiction story that happens in flashback, the main characters basically never do anything wrong. Even if it's entirely based on real people's experiences, if you choose to present this stuff in the style of a fictional narrative, I think it's worth using more fictional craft than this.
There's also an oddly limited perspective here: the book presents itself as a comprehensive cross-section of the profession (and literally tells readers that they'll never see health care the same way again after this!), and also talks about how TV and movies don't give you the real story... but then looks exclusively at ER nursing, just like every TV show. There is literally one mention of acute-care floor nursing, and it's only as an unreasonable obstacle to the ER nurses who are mad at the floor nurses for not wanting to take patient transfers during shift change (Robbins does mention later that maybe the floor nurses kind of have a point there, but it's an afterthought)—and she really doesn't seem to have spent any time in any other part of the hospital, let alone in any non-hospital health care settings. That's a big missed opportunity; most nurses will go through very different kinds of jobs in a career, not just the same position at different hospitals.
A minor pet peeve that I only bother mentioning because it would've been so easy to not do this: "murse" as slang for "male nurse" is a jokey term that some people are fine with and others dislike, so it really isn't a great idea to refer to every single male nurse in the book exclusively as a "murse" even when the word "nurse" would've worked just as well. I presume Robbins would prefer not to be constantly called an "authoress." (Sort of related: she mentions that "murses" shouldn't be stereotyped as effeminate—and then massively overcompensates by making every one of them a big burly boy with bulging biceps.)
I know I've made this sound terrible, but again, I do respect the research(*) that went into it, and Robbins' advocacy for nurses (and the way she addresses specific institutional issues like over-reliance on patient satisfaction surveys). She really does capture the essence of a lot of interactions and work dynamics that I recognize from experience... even if the way that essence is presented in prose is pretty unsatisfying to me as a reader.
(* I should mention that not everything in the book is equally well researched— basically, whenever Robbins cites one of her nurse characters as an authority on something that isn't directly part of the job, I would take it with a big grain of salt. The biggest WTF moment in that regard was, as another reviewer mentioned, the casual assertion [as a fact, not as the character's opinion] that teenagers are constantly making up rape stories. This is a relatively tiny part of the book, but good grief.)
(I've been reading various nonfiction books about nursing, to compare to my own limited experience [I'm a former med/surg nurse who practiced mostly in the 2000s] and as background for some fiction I'm working on. This was a book written by a non-nurse, a journalist who's done several similar case-study pieces in other fields.)
My feelings about this one are very mixed. Overall I think it's an interesting and informative(*) book, and the writer's heart is definitely in the right place; Robbins clearly loves nurses and wants to raise public awareness of their work and the pressures they're under, and takes a strong stand for better working conditions and labor solidarity, while also acknowledging the many ways nurses can sabotage themselves. A particularly nice touch is near the end, where she gives patients and their family members some pretty reasonable tips on how to simultaneously advocate for their own care and make nurses' lives easier.
It was really hard for me to get past how it's written, though. Half of it is straight nonfiction presentations of facts and statistics—clear, but not particularly well organized and full of repetition. The other half is narrative dramatizations of four pseudonymous real people (or composite characters?) as they face various job challenges, and even though the individual scenes are interesting enough and the background information is explained without any terrible mistakes, the style is very clunky and flat. I realize that this is meant to be more of an educational presentation than a work of literature—and this kind of thing is in the eye of the beholder, so it may read perfectly well to other people—but to me it's just very careless writing with no rhythm, no nuance, no difference in tone between different narrators, and every point hammered into the ground. It's also weirdly melodramatic and cliché-ridden, considering how much Robbins (in the non-narrative sections) talks about wanting to debunk misconceptions and stereotypes: there's a long discussion of why the "sexy nurse" image is so pernicious, but then a young nurse is introduced with a scene where she checks out her own "ample bosom"; whenever the main characters are given an ongoing subplot involving anything in their personal life, it's from a checklist of predictable big-ticket items (finding romance, staying sober, trying to have a child); there's some good discussion of the many pressures that contribute to mismanagement and bad working conditions, but in the narrative the bad managers just happen to be amazingly bad people in every way; and there's some abstract acknowledgment of how easy it is for anyone to make mistakes, but apart from a drug addiction story that happens in flashback, the main characters basically never do anything wrong. Even if it's entirely based on real people's experiences, if you choose to present this stuff in the style of a fictional narrative, I think it's worth using more fictional craft than this.
There's also an oddly limited perspective here: the book presents itself as a comprehensive cross-section of the profession (and literally tells readers that they'll never see health care the same way again after this!), and also talks about how TV and movies don't give you the real story... but then looks exclusively at ER nursing, just like every TV show. There is literally one mention of acute-care floor nursing, and it's only as an unreasonable obstacle to the ER nurses who are mad at the floor nurses for not wanting to take patient transfers during shift change (Robbins does mention later that maybe the floor nurses kind of have a point there, but it's an afterthought)—and she really doesn't seem to have spent any time in any other part of the hospital, let alone in any non-hospital health care settings. That's a big missed opportunity; most nurses will go through very different kinds of jobs in a career, not just the same position at different hospitals.
A minor pet peeve that I only bother mentioning because it would've been so easy to not do this: "murse" as slang for "male nurse" is a jokey term that some people are fine with and others dislike, so it really isn't a great idea to refer to every single male nurse in the book exclusively as a "murse" even when the word "nurse" would've worked just as well. I presume Robbins would prefer not to be constantly called an "authoress." (Sort of related: she mentions that "murses" shouldn't be stereotyped as effeminate—and then massively overcompensates by making every one of them a big burly boy with bulging biceps.)
I know I've made this sound terrible, but again, I do respect the research(*) that went into it, and Robbins' advocacy for nurses (and the way she addresses specific institutional issues like over-reliance on patient satisfaction surveys). She really does capture the essence of a lot of interactions and work dynamics that I recognize from experience... even if the way that essence is presented in prose is pretty unsatisfying to me as a reader.
(* I should mention that not everything in the book is equally well researched— basically, whenever Robbins cites one of her nurse characters as an authority on something that isn't directly part of the job, I would take it with a big grain of salt. The biggest WTF moment in that regard was, as another reviewer mentioned, the casual assertion [as a fact, not as the character's opinion] that teenagers are constantly making up rape stories. This is a relatively tiny part of the book, but good grief.)
