Review: When Chicken Soup Isn’t Enough

If I could name only one writer who has helped shape my understanding of the nursing profession, it would without hesitation be Suzanne Gordon. Life Support was such an intense read for me last summer, that I devoted multiple posts to the discussion questions it raised.

So I was very excited to receive her anthology When Chicken Soup Isn’t Enough as a birthday gift last year. I read each section voraciously -the margins are filled with my notes, exclamation points, question marks and overall impressions. Annotation central! 😉

Suzanne Gordon’s thesis is that the “warm and fuzzy” stories of nursing don’t do our profession any favors. While they may be inspiring and emotional, they certainly don’t talk about what we actually do, the difference we actually make in health care. First-person accounts by real nurses need to go beyond the heart-wrenching to challenge and empower us, to transform our public image, to tell the truth about how integral we are to patient safety, quality of life and public health.

What I really appreciated about this book was that it actually represented nurses, in the voice of nurses, without resorting to stereotypes. While Gordon is a brilliant writer, she fully acknowledges that she herself is not a nurse. So when she created a space for nurses to share their own stories, I knew it would be good. Especially because she’d organize it in such a way that would leave me angry, challenged, frustrated and most of all inspired to be a nurse.

The book is divided into thematic sections, each with an introduction by Gordon, followed by related short essays written by nurses:

Set Up to Lose, but Playing to Win – The book started with stories of nurses who successfully advocated for their needs (sometimes covertly). This was an inspiring beginning, particularly because some of the essays described what appeared to be insurmountable challenges. To know that with blood, sweat and tears, they were able to overcome tremendous barriers made me feel energized, especially because sometimes important changes happen so.very.slowly.

We Don’t Have to Eat Our Young – I remember complaining to a nursing school professor about the gossiping and back-biting that was occurring within our cohort. I remember her telling me that when nurses feel threatened, we circle the wagons and shoot inward. I remember thinking how counterproductive that was. Sometimes it seems like we accept a culture of “eating our young” and turning against each other to be inevitable. So it was refreshing to read about nurses who challenged this as the status quo. We still have a ways to go in improving our nursing culture. But not everyone is buying into the hype.

Excuse Me, Doctor, You’re Wrong – Ah, the nurse-patient relationship. So complicated, so fraught. So rooted in a larger cultural narrative. It is the most interesting and most frustrating aspect of my practice. I have so much to say, I don’t know where to start. But you would do well to read this section, be you a nurse or a doctor.

Not Part of the Job Description – “Nurses are angels in disguise.” How many bumper stickers, ornaments, Internet memes and other trinkets have displayed this saying, or something like it? News flash: nurses are smart, hard-working human beings. Emphasis on the word “human”. Self-sacrifice has a limit. Nurses burn out for a reason, folks. I once had a patient tell me he didn’t think we got paid enough for what we did. He recognized the value of our work and thought we should be compensated fairly for it. What a novel concept.

When One Advocate Can Make a Difference – This section raises the point that “just having kind thoughts about a patient isn’t real advocacy” (p. 106). It challenges the notion that we all act as advocates for our patients, and challenges us to speak truth to power, even when there may be consequences. It points out that there can be a cost to patient advocacy, but that it can be done.

Choking on Sugar and Spice: Challenging Nurses’ Public Image – We’ll address this important topic more in Saving Lives, but I was glad Gordon devoted part of her book to the truth that “the public trusts nurses but doesn’t get what they do” (p. 133). It is possible (and so very important) to utilize even minor opportunities to educate the public about what we actually do. It’s why I keep writing here, even when everything else in my life is topsy-turvy. It’s a chance to give nursing another voice.

Applied Research – Yes, Virginia, there is such a thing as nursing research. And it is vital to health care. Evidence-based practice is way more than a buzzword – it should guide the way we do things every day. And yet, there are multiple barriers to both carrying out nursing research and implementing its findings. Nursing needs to be integral to health care research. We need to brave enough to ask “Why?” when someone tells us “this is the way we do things”.

Sticking Together – Valuing our profession and the contributions of our colleagues is an important part of transforming nursing culture. That whole “A house divided cannot stand” thing has an important ring of truth to it – if we don’t stand up for each other, we won’t improve our own lot, nor will we be doing our patients any favors.

Still Fighting – I thought it was apropos for the book to end with stories of challenges yet to be overcome. It speaks to the ongoing work we have to do, it warns us against becoming lackadaisical during the good times. There is always more to be done. There will always be a new battle. I closed the book ready to take on the world because ended with a call to arms. Time to get to work!

One of the major takeaways for me was the importance of organized labor in advancing the nursing profession. In my first two nursing jobs, I was a proud union member, and even became involved as a state delegate toward the end of my community health position. However, my current hospital is not represented (nor are many hospitals in this state), and it feels like something is missing. When we get into discussions about staffing and patient safety, I feel more vulnerable because I don’t have a contract to back me up. While I don’t think organizing is the end-all-be-all of nursing, nor is it a magical cure for the challenges facing our profession (as the book makes abundantly clear), I think it has an important place at the table, so to speak. Without organization, we are missing an important tool for self-advocacy and for patient advocacy.

I don’t know the first thing about organizing from the bottom up, but the book made me want to try. It challenged me to be gutsier, to get more involved, to take pride in my practice and my profession to such an extent that I want it to be better.

How did you feel about the book? Did any one essay stand out for you? Why did you identify with it? Did it make you as enthusiastic about unions as it did me? Were there any arguments with which you disagreed? Why or why not?

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