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Life Support

Life Support: Three Nurses on the Front Lines

Foreword by Claire M. Fagin
Copyright Date: 1997
Edition: 1
Published by: Cornell University Press,
Pages: 368
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  • Book Info
    Life Support
    Book Description:

    In this book, Suzanne Gordon describes the everyday work of three RNs in Boston-a nurse practitioner, an oncology nurse, and a clinical nurse specialist on a medical unit. At a time when nursing is often undervalued and nurses themselves in short supply, Life Support provides a vivid, engaging, and intimate portrait of health care's largest profession and the important role it plays in patients' lives.

    Life Support is essential reading for working nurses, nursing students, and anyone considering a career in nursing as well as for physicians and health policy makers seeking a better understanding of what nurses do and why we need them. For the Cornell edition of this landmark work, Gordon has written a new introduction that describes the current nursing crisis and its impact on bedside nurses like those she profiled in the book.

    eISBN: 978-0-8014-6503-1
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Foreword to the Cornell Edition
    (pp. ix-xviii)
    Claire M. Fagin

    In 1996, when I wrote the introducion to the first edition of this book, I began with an example of the media’s coverage of nursing. At the time, a young woman had been brutally attacked in Central Park, and the papers were full of the story. In particular, the New York Times and New Yorker ran excellent articles on the plight of this woman, who was unidentiied in the Times and called Urgent Four in the lengthy New Yorker profile. Accounts in the New York Times highlighted the care and concern of this woman’s nurses. But as she began to...

  4. Preface
    (pp. xix-2)
  5. Chapter 1 The Tapestry of Care
    (pp. 3-20)

    It is four o’clock on a Friday afternoon. The Hematology / Oncology Clinic at Boston’s Beth Israel Hospital is quiet, almost becalmed. Paddy Connelly and Frances Kiel, two of the eleven nurses who work in the unit, sit at the nurses’ station, an island comprising two long desks equipped with computers and constantly ringing phones. They are encircled by thirteen reclining blue leather chairs in which patients may spend only a few minutes for a short chemotherapy infusion, or an entire afternoon when they receive more complicated chemotherapy or blood products. The two nurses write the results of their day’s...

  6. Chapter 2 The Care of Strangers
    (pp. 21-54)

    The first patient of Nancy Rumplik’s day is Deborah Celli.* I think of Debussy’s melancholy refrain from “The Girl with the Flaxen Hair” when I first meet her. Her thick blond hair falls across her face as if it were a shield. Her head forlornly bends into the cascade.

    She is waiting in Hematology / Oncology Clinic’s so-called family room — an office that has been temporarily equipped with a couch and upholstered metal office chair — for her nurse, Nancy Rumplik, to administer her chemotherapy. But it takes Nancy a few extra moments to reach Deborah. That’s because the...

  7. Chapter 3 Not on the Charts
    (pp. 55-92)

    It’s a Monday morning in May. The day has begun with a parade of mishaps worthy of the movie Hospital. At 7:30 a.m., just half an hour after Jeannie Chaisson arrived at work, an alarm goes off in a patient’s room. Upon hearing its steady bleating, nurses exit from patients’ bedsides or leap up from behind computers in the unit’s central work area. With Jeannie Chaisson among them, they sprint down one of the unit’s two long corridors to find out if this emergency signal indicates a cardiac arrest or if a patient has simply hit a button by mistake....

  8. Chapter 4 A Special Visitor
    (pp. 93-120)

    In 1987, when he was eighty-three years old, Albert “Mac” McKay* left his aparment near Symphony Hall to do his weekly grocery shopping. A 190-pound, five-foot-ten-inch former bus driver, with florid skin and a bulbous nose, he had until that morning been suffering from the more minor ailments of the aged. A touch of arthritis in his knees bothered him occasionally, and he had an enlarged prostate. But none of this was troublesome enough to cause Mac to see a physician.

    Mac took his time in the market, carefully checking the price of toilet paper, cereal, and frozen dinners before...

  9. Chapter 5 The Meaning of Illness
    (pp. 121-150)

    When Nancy Rumplik first heard about the spousal abuse, she was not surprised. Deborah Celli, her breast cancer patient who had survived Hodgkins’ disease in her teens, was used to being a victim. Just as she was reaching adulthood, she was given what she thought would be a terminal sentence. She recovered, but the worry never really ended and seemed to become an inalterable fact of her life. “I want to know it’s not going to happen again,” she once begged Nancy. “If someone could only promise it won’t happen again, but I know they can’t. I dreaded this. I...

  10. Chapter 6 A Mentor of Their Own
    (pp. 151-169)

    On the Friday before Mother’s Day, Jeannie Chaisson is sitting at the high counter at the central work station, going over charts. A young nurse with reddish curly hair wearing blue scrubs and a worried look approaches her. Can I talk with you for a moment, she interrupts.

    Jeannie sets aside her work, swivels in her chair, and says of course. The young nurse then launches into a long story about a patient for whom she is caring. The woman is in her seventies and has just had a massive stroke. As a result she also has a severe pneumonia...

  11. Chapter 7 Collaborative Care
    (pp. 170-192)

    On Thursday mornings, the Beth Israel Home Care Department holds its weekly team meeting. There is no time for Ellen to fit in patient visits before his ten o’clock session begins. So she goes directly to the Home Care Department when she comes to work. A receptionist’s desk sits immediately in front of the two glass doors. The large room is partitioned into smaller sections, each of which contains cubbyholes with a shelf, a drawer, and a small desk and phone for the nursing staff. The charts of the department’s three hundred patients — most of them elderly, but some...

  12. Chapter 8 A Good Enough Death
    (pp. 193-215)

    The United States is not winning the war against cancer. Despite advances in the treatment of some cancers, overall cure rates for most of the major cancers — lung, breast, colon, prostate — haven’t changed much in thirty years. Patients whose cancers recur are likely to die of them. There have been, however, significant advances in keeping people comfortable, dealing with their pain and symptoms, and alleviating their suffering.

    Each year, five hundred thousand Americans die of cancer. In addition, a relatively new group of patients suffer from AIDS-related malignancies. They die from AIDS and its complicaing infections and cancers....

  13. Chapter 9 Final Checkups
    (pp. 216-230)

    In February of 1994, Ellen Kitchen discovered that she was pregnant. It was obviously a much welcomed event. But it also led to a difficult decision. What should she do in the months before she delivered, and how long would she take off work afterward? While she wanted to continue caring for her patients, she new she also needed to care for herself. She could, she recognized, continue to see her patients until only weeks before her due date. But she worried about the effect of stress on her pregnancy. Summer months are some of the most highly charged and...

  14. Chapter 10 A Good Enough Death II
    (pp. 231-247)

    There are days, Jeannie Chaisson says, when Six Feldberg slips into battlefield mode. This week is a perfect example. First a ninety-seven-year-old woman was admitted after having had a massive heart attack. The woman, who was unconscious when she was discovered on the floor of her apartment, never woke up during her admission. She could not make her wishes known. There was no advance directive registered in her chart — no Do Not Resuscitate order to indicate she did not want to be resuscitated should she have a cardiac arrest. She was thus being fed through a feeding tube; her...

  15. Chapter 11 Unraveling the Tapestry of Care
    (pp. 248-286)

    When I began researching this book in the late 1980s, it seemed that nursing was finally on the cusp of true societal recognition and far greater financial rewards. In the mid-eighties, hospitals reported high rates of unfilled positions for registered nurses. Press and scholarly accounts documented the negative impact this nursing shortage was having on patient care. Public attention was drawn to the important role nurses play in health care. As a result, hospitals raised nurses’ wages and offered better benefits and working conditions. As the new decade began, the nursing shortage ebbed. By the late eighties, most hospitals had...

  16. Conclusion Preserving the Tapestry of Care
    (pp. 287-308)

    Each year in May, a week is set aside to celebrate American nurses. Planned to coincide with the anniversary of Florence Nightingale’s birthday, May 12, it has become the occasion for a variety of commemorative events sponsored by hospitals, professional associations, or nursing unions. Over the past several years, however, many nurses feel there is little to rejoice about during Nurses’ Week. In many cases, the annual event has been marked by protests rather than celebraions.

    In this spirit of protest, about four hundred nurses from the Massachusetts Nurses Associaion (MNA) assembled at the State House in Boston in May...

  17. Afterword to the Cornell Edition
    (pp. 309-318)

    When I began to do research for Life Support in the early 1990s, my goal was to help people outside of nursing understand the work that nurses do. As I explain in the preface, I had been utterly oblivious to nurses before 1984, when I went to the hospital to have my first baby. The fact that my father was a famous physician, coupled with a steadydiet of Hollywood’s medico-centered version of the hospital, had shaped my view of health care work: to me it was a doctor-only affair. Yet, when I became vulnerable enough to need hospital care, I...

  18. Notes
    (pp. 319-324)
  19. Selected Bibliography
    (pp. 325-334)
  20. Index
    (pp. 335-339)