Theresa Brown on “The Shift,” her patients and the power of nurse writers

A book that really captures the essence of nursing is more than just a good read. Whether it’s offering new nurses an authentic introduction to the world they’re stepping into or simply chipping away at long-standing misconceptions, a nurse’s story is a powerful thing, especially when it’s laid bare on a page.

That’s why we’re so pleased and excited that Theresa Brown, longtime Scrubs contributor, author, speaker and nurse, has published a book that does just that, titled: The Shift: One Nurse, Twelve Hours, Four Patient’s Lives. And while we don’t want to give too much away, we can tell you that the narrative takes place over the course of just one shift in the cancer ward, highlighting Theresa’s various relationships with four patients—all with real-life counterparts. Brutally honest but equally touching, her account of this one shift, placed under a microscope, may just remind you of why it is you do what you do.

Eager to learn a more about Theresa, her intertwining careers and her experiences as a nurse, we had a little chat. Here’s what she had to say.

Can you tell us a little bit about your transition from English professor to nurse?

My dad’s a professor, and I thought he had a really great life. But I found that I didn’t feel passionately about it—it wasn’t what I really wanted. Then, when I had kids, I fell in love with what I call “the mess of life,” and I wanted a job that was about being with people intimately and also trying to help them in very specific ways.

When writing about nursing and dealing with such profound emotions, do you ever feel like words aren’t quite enough—as if your experiences simply can’t be translated? Is that frustrating? A challenge? Maybe it drives you?

I think all three of those things. Even with my husband, I would come home and just, you know, rattle off for 15 minutes. And he would listen very intently, but then I found out he really didn’t understand what I was saying. So, when I got the opportunity to start writing, I really thought of it as a mission—to translate the world of nursing for general readers. So that’s really a lot of what motivates my writing.

There is a point in The Shift during which you talk about turning your patient’s pain “into a story he could accept.” Do you think all the qualities that come together to build a writer’s instinct help you to be a better nurse?

Yeah, I definitely think so. And also, even more than that, having an [awareness] of the subtleties of narrative helps because most people don’t explain things linearly. Sometimes, I ask a patient one thing and they answer something else. You know—they understand their story their way, and it’s my job to make sense of what they’re telling me. So, I think I have patience, because I like figuring out the narrative, just as I would with books—and I’ve had a lot of practice.

Do you ever feel a twang of fear that one of your former patients will read your book and identify themselves as the inspiration for a  character? 

The patients who have found out that I wrote about them, either because I told them or somebody else told them, were all gratified by it, because they felt like somebody actually saw them while they were in the hospital, and that their experience could be used to show other people what healthcare is like.

Why that 12-hour shift? Is it a compilation of many others? The characters seem so rich.

The two characters, Mr. Hampton, the really frail gentleman, and Sheila, who is the patient with the blood disorder—the two of them I had on one shift. And since they both ended up turning out quite differently than I expected, it was really a profound day for me—to realize that no matter how much we know from our tests and our scans, there are always going to be things we don’t know.

So I kept that experience in my back pocket. And when I started to write this book, I pulled it out. The problem is, the only thing I remember about that shift is those two patients [laughing], so I pulled in some other real patients with an eye for making it like a real shift. You know—not impossibly dramatic. I was just trying to capture the flavor of a real shift.

Of course, sometimes those very personal connections can be difficult. How is it you achieve a kind of emotional, mental and spiritual self-preservation?

I try to keep a pretty strong barrier between work and the rest of my life, and that’s really important. For example, I made a decision that if a patient were to die, I would never go to a funeral—because that’s, you know, more time away from my kids, and I felt like I needed that as a barrier. Other nurses I know would go to funerals, but wouldn’t visit patients in the ICU just a floor below, because they wanted to remember patients the way they were during their time together. So I think everybody finds their own limits. Otherwise, you’ll give and give and give, which is great, but nobody can keep that up.

It’s good to have a sense of entitlement to your own life—that’s very important.

Could you be a nurse without also being a writer? Or do both aspects of your life absolutely need to go hand in hand?

Now they really go hand in hand and I can’t imagine one without the other. When I first started nursing, I sort of shut the door on that other part of me. Then, I had a really terrible experience on the job as a pretty new nurse and decided to write it down. I liked what I wrote and thought to myself, “Why not aim high?” So, I submitted it to The New York Times, and they took it. So, all that came on completely out of the blue, and now I feel so lucky because I love being a nurse and I love writing.

What advice do you have for new nurses interested in writing and publishing stories about their own experiences?

It’s so important to be careful to disguise patients. Also, before you start, depending upon where you want your work to show up, it’s important to find out what your employer’s point of view is. If you’re just beginning your own blog, using a pseudonym might be a good idea; don’t state where you work. Be careful, but also keep in mind that doctors have been writing books and telling stories for years, and it’s so important for nurses to be doing the same.

Any final words?

Just that I’ve never regretted leaving teaching behind to become a nurse.

Psst! Want your own copy of The Shift? Algonquin Books is generously giving away several copies to Scrubs readers! To win, just visit our Facebook page and comment on this post, tagging a nurse you love working with. Winners will be selected at 9am on 10/5!