A Nurse's Story: Life, Death, and In-Between in an Intensive Care Unit

Ian W. Toal is a registered nurse in Winnipeg, Manitoba.

Tilda Shalof is a critical care nurse in a major hospital. This book
follows her life as part of a nursing team in an Intensive Care Unit.
Some of the stories she recounts are horrific, others are funny, and
still others are tragic. For example, one 76-year-old patient with
cancer has surgery, then a cardiac arrest on the ward, with a prolonged
resuscitation. A CT of his head shows irreversible brain damage. In
spite of this, his family wants everything done for him. The patient
begins to develop numerous complications and is on maximum life-support
measures, but his family refuses to stop treatment. He stays in the unit
for more than six weeks. As his condition worsens, the doctors and
nurses argue about the ethics of keeping him alive when there is no hope
of recovery. Eventually, Shalof refuses to take care of him because her
conscience can no longer let her do what she sees as harm to the
patient.

This story exposes some of the flaws in the book. We never find out if
the author managed to stick to her principles (there is a hint that she
did not) or what happened to the patient and his family. The ethical and
legal problems are discussed, but not in enough depth for the reader to
form a clear opinion. There are interjections into the story that break
up the flow of both the ethical debate and the human story.

A Nurse’s Story is generally well written and provides a good sense
of what it is like to nurse with critically ill patients. The book’s
failure to resolve some of the ethical problems may leave some readers
dissatisfied, but moral ambiguity no doubt reflects the reality of
hospital life.