Articles : Nursing The Pro behind the Bedpan
04/01/06 by ELAINE CAREY
Tilda Shalof has dealt with life and death in 12-hour shifts for the past 18 years.
The young patients who die tragically, the old ones whose loved ones won't let go, the miracles in between ? all part of the dirty, sometimes ugly, often heart-warming job of an intensive-care nurse in a Toronto hospital.
Add to that the back-breaking work, stressful shifts and lack of respect from politicians and the public, and it's a wonder anyone works as a nurse any more.
But Shalof, 45, has written A Nurse's Story, published last week by McClelland & Stewart Ltd., to explain "why I do not find my work either depressing or distressing ? why in fact, I find it inspiring, challenging and endlessly fascinating," she writes in the introduction.
"I set out to tell my story, but I wanted to give a portrait of these extraordinary nurses," she said in an interview in the new ICU unit at Toronto General Hospital, where she has spent most of her working life. "This is a story that needed to be told. I don't think nurses have spoken out enough."
Nursing's not a job that gets much respect any more. Over the years, governments have slashed hospital budgets and nursing jobs, and infectious diseases such as SARS have put their lives at risk, but nurses remain largely anonymous to an indifferent public.
"Many nurses are exhausted from the burdens of shift work, impossible workloads and severe staffing shortages," Shalof writes. "In addition, there is another, and to my mind equally serious and pervasive stress ? the constant exposure to the suffering and despair that grave illness can bring."
But her book isn't a doom-and-gloom account of overworked nurses. Interspersed with tales of tragedy are accounts of the funny, often bizarre events that transpire on an ICU.
Some are truly strange, like the woman whose fianc頤ied in a motorcycle accident and insisted on getting a sample of his sperm before she would donate his organs. She got her wish. And there's the strange-but-true bedpan anecdotes that are too often associated with a nurse's job.
"We called ourselves the Poop Patrol, the Bowel Brigade, the S--- Shovellers, because at times that's how we saw ourselves," Shalof writes.
There is black humour at the nursing station, at times the only way to cope with the horrors nurses face.
"Maybe it takes having a loved one sick for people to realize what we do," she said. "If people know more about this world, they will feel empowered to make good choices for their loved ones."
`Maybe it takes having
a loved one sick for people
to realize what we do'
As incredible as some of the stories in the book is the fact that Shalof managed to write it at all while working 12-hour shifts and carrying for her two sons, 9-year-old Harry and 6-year-old Max, with husband Ivan Lewis.
She would write after a night shift when her sons had gone to school, the house was empty and she was still too wound up to sleep.
When Shalof first started working in the ICU in 1986, it consumed her life, she writes. "On days off from work, I lay in bed after I woke up, stared at the ceiling and relived whole scenes from the hospital, as if I were watching a movie."
Even now, no matter how stressful the work, she doesn't discuss it with her husband when she gets home. It would add even more stress to both their lives.
Shalof thanks the SARS crisis last spring for getting her 800-page manuscript accepted by McClelland & Stewart, because "I think in the aftermath there was a sudden interest in nursing."
The outbreak of severe acute respiratory syndrome makes up only a small part of the book because to Shalof, nurses are constantly dealing with serious communicable diseases.
Still, "it was an infectious disease that was killing people and there was so much we didn't know. It was terrifying. The first time I went into a SARS patient's room, I was shaking."
During her career, Shalof has watched nurses drop out of the profession in droves when faced with the day-to-day realities of the job. "`Who needs a university degree to give a bedpan?' other nurses said when they gave up the job," she writes.
The worst time in Shalof's career came when the provincial government under Mike Harris brought in the Common Sense Revolution, and "cutbacks, bed closures and nursing layoffs were the new realities," she writes.
Five-hundred nurses were laid off in one day at Toronto General, including Shalof and 19 others in the intensive-care unit.
"It was very, very devastating to have my job taken away," she said. "I was beside myself."
Many nurses left the profession or took lucrative offers in the United States, but within a week Shalof was hired back part time on contract, as part of a move to save money by having a flexible, transient nursing workforce.
Her fellow nurses at Toronto General are thrilled that Shalof has captured their lives on paper.
"Reading it, it was so real, although you live it every day," said Julia Piercey, who works in the ICU. "It makes us keep doing what we're doing, to be able to make sense of it, to realize it isn't all crazy."