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I am pleased to announce the publication of my new edited collection When Chicken Soup Isn’t Enough: Stories of Nurses Standing Up for Themselves, Their Patients and Their Profession. This book is a collection of 73 stories of nurses from all over the world – nurses who know what real advocacy means and who are both an example to and reflection of nurses everywhere. You can get a better sense of what the book is about, not only by looking at the cover, but by reading a bit from the Introduction and checking out the table of contents. Also on this website you’ll find some interviews I did with several authors of the essays in this book. I hope you’ll find the book of interest and pass on the word not only to other nurses but also to anyone concerned with high quality patient care and the future of health care.

From the Introduction:

I’ve been thinking about putting this book together for several years. During two decades of writing about nursing, I’ve read many inspirational books, articles, and essays that offer up the literary equivalent of comfort food for RNs. The authors invariably mean to be helpful to the nursing profession by lifting the spirits of its practitioners at a time when so many are feeling tired, stressed out, dispirited, or unappreciated. The problem is, in this heavily sentimental genre, the real-world context of long hours, increased patient loads, and chronic under staffing quickly fades into the background. In the foreground we see traditional images of nurses as people (generally women) who “make a difference” through their touch–always gentle–and niceness. Rarely are their abilities or technical knowledge–represented in a true-to-life setting–the subjects of the story…

No wonder the public clings to this sentimentalized vision of nurses and texts that are produced to inspire nurses deliver up story after saccharine story that reinforce traditional stereotypes of nursing and women’s work. Nurses are plied from every direction with a narrative that depicts them as modern angels endowed with extraordinary powers of empathy and compassion–qualities that are never depicted as the products of education or experience on the job. In the mirror that reflects nursing back to nurses, rarely is it shown that nursing requires more than caring, demanding technical, medical, and pharmacological–to mention only a few–mastery. Just as these texts are soothing and reassuring, so too is the nurses’ role in the health care system to be soothing and reassuring: nurses hold hands, anguish over or embrace patients and their families, administer back rubs, or conduct late-night vigils. Both they and their patients seem to be downright etherealized. Indeed, in books like Chicken Soup for the Nurse’s Soul, the critical intervention of RNs is often powered not by their skill but by their personal belief in ghosts, guiding spirits, or the divine.

It is not surprising that when nurses themselves write in these volumes, they too downplay the extent to which their professional judgment and experience are responsible for positive outcomes. With typical modesty, they minimize the role of RNs in the health care team, at times portraying the nurse as doing little more than be present. These writings thus embrace the notion that professionalism in nursing is an advanced form of self-abnegation. In them female nurses–and male ones, too–are all sugar and spice and everything nice.

Also missing from these well-meaning attempts to honor and celebrate nurses is any mention of the obstacles that many RNs face–and must overcome on a daily basis–as they try to do their jobs well. In the idealized world of these comfort food volumes, there aren’t many nurses advocating for patients in the tough, persistent, creative, and courageous manner that I’ve seen repeatedly in hospitals throughout North America and the world. Typically, these books refer to workplace challenges and issues but gloss right over the crucial tools needed to deal with them: bureaucratic maneuvering, accessing of resources, negotiating with doctors and hospital administrators, and conflict resolution. Nor is there mention of any role for nurses in public policy debates related to health care, or even unity and support among nurses. And what about the contributions made by nursing researchers and teachers in developing new forms of practice or raising the profile of nursing in academic circles? For the nurses in the inspirational narrative, advocacy is a matter of feeling rather than action, having good thoughts but not taking the kinds of personal and professional risks nurses face every day at work as well as in the educational, social, and political arena.

So, as I read this growing body of fundamentally flawed, so-called uplifting literature, I became more convinced that nurses and the public are long overdue for an antidote to the platitudes that purport to feed the nurse’s soul. There are so many better stories to tell. We need a collection, I felt, that spotlights the real experience of nurses and their advocacy–in the voices of RNs themselves.

What you find here is the result: stories from nurses from the United States, Canada, England, Australia, New Zealand, Japan, Scandinavia, Iceland, Switzerland, Italy, Ireland, Spain, and more. In this volume you will also hear from nurses in many different institutional roles and settings: bedside nurses and their managers; chief nursing officers; hospice, home care, and school nurses; nurse practitioners and professors; nursing researchers; and organizational leaders. I have divided the book into nine thematic sections, each with a brief introduction, although many of the stories have overlapping motifs.

Because I have asked nurses in a variety of roles to recount their experiences, there are multiple perspectives represented in these pages. The RNs in this book don’t necessarily agree with one another. In fact, many disagree passionately about certain issues such as staffing ratios or unionization for nurses. Some of the stories involve deftly navigated challenges to conventional wisdom, small victories over bureaucratic inertia, or individual acts of resistance to the often-dysfunctional medical domination of our hospital system. Some contributions provide inspiring examples of collective action or health care related political activity. Some recount how a single nurse stood up for–or to–a patient (e.g., when faced with the threat of physical abuse). Some stories describe complicated interactions with doctors. Some describe tensions among working RNs or between RNs and their managers. Some sections of the book involve people near the top of the health care hierarchy, for example, a nurse executive helping a hospital CEO and board of trustees to do the right thing for patients and his or her profession.

Most of the stories have happy endings. The nurse was able to ensure quality patient care, protect herself or her patient from harm, and successfully advocate or innovate. In some instances, at least in the short term, the nurse was unable to affect needed change but struggled nonetheless. These instances of persistence and courage also provide important lessons. All of the stories offer nurses an alternative to the kind of role model presented in the comfort food literature.

Table of Contents

Part One – Set Up to Lose but Playing to Win

Part Two – We Don’t Have to Eat Our Young

Part Three — Excuse Me Doctor, You’re Wrong

Part Four – Not Part of the Job Description

Part Five — When One Advocate Can Make a Difference

Part Six — Choking on Sugar and Spice: Challenging Nurse’s Public Image

Part Seven – Applied Research

Part Eight — Sticking Together

Part Nine – Still Fighting



INTERVIEWS WITH THE AUTHORS.

Judy Boychuk Duchscher. RN, BScN, MN, PhD is the founder and executive director of Nursing the Future. She is Assistant Professor – Faculty of Nursing, University of Calgary.

Faith Simon. RN, FNP, is a family nurse practitioner who works in a rural clinic in Northern California. She was an emergency nurse for 20 years before becoming an FNP.

Jenny Kendall, is a nurse at Wellington Public Hospital, Capital and Coast District Health Board, Wellington, New Zealand.

Carol Youngson. Is a Registered Nurse with over 40 years experience, primarily in the Operating Room. In 1998, she left the nursing profession and currently works as a Medical Examiner Investigator for the Chief Medical Examiner in Manitoba, Canada.



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