4. New York Times Bestselling Author: Theresa Brown on Nursing and Writing

In this episode of The Bossy Nurse Podcast, Marsha Battee speaks with Theresa Brown, PhD, BSN, RN. This episode explores Dr. Brown’s unconventional path into nursing, her early experiences in the field, and how writing became a powerful extension of her nursing voice.

Find the all the resources mentioned in the show and full details on Dr. Brown at The Bossy Nurse website.

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Episode Transcript

SPEAKER_02 (00:06):
And I remember, because this was Bob Miller, who
then left Harper and was at FlatIron for a while, sort of
legendary figure in publishing.
But after I signed the contract,he called me and and I said,
well, he said he called me andhe said, Teresa, I am raising a
glass of champagne to you.

(00:26):
It's very sweet.
And uh and I said, okay, whathappens now?
He said, well, now you write abook.

SPEAKER_01 (00:36):
Welcome to the Balsi Nurse Podcast, a show about
nurse creators, innovators, risktakers, and the ideas that shape
their success.
I'm Marcia Batti, and on theshow today, how Teresa Brown
turned the invisibility ofnurses' day-to-day work into a
New York Times bestseller thatsparked national conversations

(00:57):
about the realities of moderncare.
Most people only see hospitalsin quick flashes.
TV dramas, a hurried ER visit, abill that makes no sense?
What we almost never hear is thesteady heartbeat of a nurse's

(01:19):
day.
Teresa Brown traded teachingEnglish in academia for the
bedside.
Then a sudden patient loss madethe story too heavy to keep in.
And so she began to write itdown.
She submitted that story to theNew York Times, and they
published it.
Agents took notice, and abedside nurse's voice broke

(01:41):
through.
In one book deal that laterbecame a New York Times
bestseller, Teresa wrote about asingle 12-hour shift.
And it clicked.
One day became the lens.
Real patience, real lies, andreal decisions.
But to understand how that voicewas formed, we have to go back

(02:02):
before the essays and book dealsto a place where her lens would
shape.

SPEAKER_02 (02:14):
So I grew up with this very strict sense of gender
roles and that my kids, when Itell them about it, they can't
believe it.
They find it so bizarre.
And sort of uh being the smartgirl definitely put me in a
category that wasn't always socomfortable.

(02:38):
And I also, well, I guess maybehad a sort of narrow sense of
what my future could be, whichmaybe a lot of kids do.
But one thing was my dad was aprofessor at Missouri State
University, which is inSpringfield, and seeing him go
to work, and I thought being aprofessor would just be the

(03:01):
greatest job in the world.
And you know, you get to talkwith students and think about
ideas and help people.
And um, that inspired me allthrough school, high school,
college, and then making thedecision to get a PhD, which
then I, you know, ended up doingsomething else.

(03:25):
So that's why I said I don'tthink in Springfield I got the
most expansive sense of careersand was sort of looking to my
parents as role models and alsowanting to be somewhere where
there was a real focus onlearning and it wasn't about,

(03:46):
oh, if you're a girl, you're notsupposed to be smart.

SPEAKER_01 (03:49):
So did you always know you were smart?
I mean, when you were growingup, did you always feel like you
were excelling in school?

SPEAKER_02 (03:56):
Actually, no, it wasn't until about the middle of
elementary school.
I actually had a teacher therewho she, me and another student,
she had us do math on our ownand work ahead of the rest of
the class.
And she picked some students whogot extra hard spelling words,
some of which I still rememberto this day, like poignant.

(04:19):
Um, these words I learned infourth grade.
Very cool.
So I think that's when I got myfirst real taste of it.
I mean, I knew I was sort ofbored because I could read by
the time I started kindergarten,and a lot of people couldn't.
But I don't think I thought Iwas smart.
I think I just thought thatschool was boring.

(04:40):
And and then once I started toget teachers who saw, oh, this
person can do a little more,school got a lot more fun.

SPEAKER_01 (04:47):
Wonderful.
So growing up with a dad whotaught at university and your
mom, my mom's a social worker.
Social worker.
Did you feel that was in yourcards to be a teacher or teach
at a university?

SPEAKER_02 (05:05):
I think I did.
And you know, it's it'sinteresting.
I've met so many nurses, thegeneration older than I am, who
said for their generation,women, there were three possible

jobs (05:15):
secretary, teacher, or nurse.
And I actually met the woman whowas the chief nursing officer at
MD Anderson in Houston.
And and that she told me that.
And she said, Well, I wasn'tgoing to be a secretary.
I did not want to be with littlekids.
And so this was the only jobleft.

(05:36):
Obviously, she excelled.
She was the chief nursingofficer of like the flagship
cancer hospital in Texas, ifnot, you know, that whole part
of the country.
Um, but yeah, I think I thoughtI could achieve what my dad had
achieved, and it seemed reallywonderful.

(05:56):
Like that would be a sort ofvery nurturing job in in some
ways, which which is interestingbecause nursing has that same
sense of nurture.
And I found when I was teaching,did get my PhD, taught English
for three years.
I really like working one-on-onewith students.

(06:17):
And and then when I became anurse, I thought, oh, this is
just like that.
It's, you know, because there'sso much education rolled into
the job, but people aren'treally aware that we're
educating them.

SPEAKER_00 (06:28):
Right.
Right.

SPEAKER_02 (06:29):
They just think, wow, my nurse is really helpful.

SPEAKER_01 (06:31):
Yeah.
Yeah.
So I'm curious about theteaching and university route
versus social work.
What made you think, oh, I wantto follow in my dad's footsteps
versus actually going intosocial work?

SPEAKER_02 (06:45):
Such an interesting question.
You know what?
I think my dad just seemed tolike his job a lot more than my
mom did.
I feel like I feel like I'm soshallow when I give these
answers, but um, I mean, it justseemed like social work was
amorphous, demanding in a waythat was kind of unpleasant.

(07:09):
Um, and it's interesting becausethen when I was actually
teaching myself, I found thatbeing in front of a classroom
three times a week was its ownform of difficult that was
unpleasant.
Um and I mean, honestly, I feelmuch more comfortable being at a
code, even though I hate codesand I hate that patients aren't

(07:32):
doing well than sort ofteaching, uh, which sounds
really weird.
And I think now that I've sometime has passed and I have a lot
more experience, I don't think Iwould feel quite the same way
about being in the classroom,but it had its own kind of
anxiety that I did not get thatvibe from my dad at all.

(07:55):
Um, but yeah, social work seemedtough and you know, lots of
stories about all kinds of crazythings happening.
And um, of course that happensin healthcare too, right?

SPEAKER_01 (08:08):
Right.
I was gonna ask you that, but Iknow we'll get to that.
I am interested though, withwhen you decided to, of course,
go off to college.
Did you always know that youwanted to do, you know, major in
English?
Or how did English come to be?
Were you always a, you know,really avid reader when you were
younger?
Or why was English?
Yeah.
Why English?
Yeah, good question.

SPEAKER_02 (08:29):
I was always a very avid reader.
I actually went to collegethinking I wanted to major in
biochemistry and cure cancer,very noble goal.
And um, I started at RiceUniversity in Houston, Texas,
which is what they call a weedout school.
And so freshmen going intoscience, they want them to take

(08:52):
chemistry, calculus, andphysics.
And I started in all thoseclasses, and this is a real
downside of having grown up inSpringfield, Missouri, which is
I just was not academicallyprepared for those classes.
And I was in classes withstudents who had already had AP
chemistry and AP calculus and APphysics, and I just I couldn't

(09:15):
do it and ended up droppingthose classes and switching over
to the humanities, and it feltlike the right thing at the
time.
Now I look back at it and Ithink it's such a shame that I
wasn't at a university thatcould be more nurturing with
someone who came from a not thatgreat high school who wanted to

(09:38):
go into science, but rice wasvery much a work hard, play
hard.
Like, are you tough enough?
Can you make it?
Um, and I I regret that.

SPEAKER_01 (09:51):
Um did you know that reputation before you got there?

SPEAKER_02 (09:55):
I didn't, no.
I didn't, I just knew it was agood school and that it was good
in science.
And and actually at that time,compared to a lot of private
schools, it was really cheapbecause they had this huge
endowment that they were stillusing to subsidize everyone's
tuition.
And it was, it was fun and youknow, it was Houston, so it was

(10:16):
warm all the time.

SPEAKER_01 (10:17):
How is that for you the change?
Because I imagine coming from uhMissouri to Texas um may have
felt a little different,although they're not that far
apart technically, I guess.
But I'm sure the change I I grewup in um I was born in Texas and
oh okay.
So I I know the difference inTexas.

(10:40):
Um, was it a culture shock foryou when you went there?

SPEAKER_02 (10:44):
It was, it was, and and I didn't expect it because
Rice is in Houston and Ithought, oh, it's a big city,
big cities are the sameeverywhere, but it it definitely
was.
I mean, one weird thing that ifpeople don't know this, Houston
has almost no zoning laws, andso everything is very haphazard.
You know, you can have a stripclub next to a diner, next to a

(11:07):
bank, next to wow, you know,it's just like very bizarre.
Um, and that was strange.
And there were definitely uh menthere who very much, again, this
this very strict sense of genderroles and not a lot of

(11:28):
creativity about that.
And um, and uh yeah, I was kindof hoping that college would be
a break from that.
Of course, now partly that wasnaive, right?
Because uh, you know, we're nowbeing maybe I shouldn't say
this, I'll just say it, youknow.
The administration that we havepresently also talks a lot about

(11:52):
fairly rigid gender roles.
And and it's not that I was umexploring my gender or I it's
it's just I wanted more of asense of possibility.
Um, so there was maybe a littlebit of a weird tension at rice,
like yes, women could bescientists, um, but then still
there was kind of this sense ofyeah, but you've got to fulfill

(12:17):
these other roles as well.
Um, and that wasn't so easy, butuh the weather was nice, you
know, it stayed warm.
It could be very likeunpleasantly humid.
Um but um I just I remember allthat sunlight, and that was
quite nice.

SPEAKER_01 (12:37):
Talking about the rigidity of the environment that
you were in, and I justremember, and I imagine for any,
you know, high school graduategoing off to college, what's an
exciting time, especially ifthey're going to another city,
another state, and it's theirfirst time away from home.
And so it sounds like that waspretty rigid for you in Texas.

SPEAKER_02 (12:58):
Yeah, in some, in some ways, and of course, um
also very car dependent.
And I didn't have a car, but Ihad friends with cars, and I
mean, Rice has a it's a reallybeautiful campus, and um, there
were lots and lots of things Iliked about it, but yeah, I felt
constrained.

(13:18):
Yeah.

SPEAKER_01 (13:19):
So you're in college and you decide to take up
English as a major.
Um, did you have any otherinterest in college besides
literature and English?

SPEAKER_02 (13:32):
Yeah, I did.
I, for the first time ever, Idid sports.
I did intramural sports, um, andfound out that, oh, I'm actually
sort of athletic.
That was, you know, where I grewup.
You couldn't be smart andathletic if you were a girl.
Like that was too much.
So I discovered I was actuallykind of athletic and what
sports?
Um, what did we do?

(13:53):
Flag football and soccer.
And those I was pretty good atbasketball, I was not very good
at um, yeah, and it was fun.

SPEAKER_01 (14:05):
Yeah.
So you graduate with an Englishdegree, and then you decide to
get your PhD.
You start teaching for threeyears.
And if I'm not mistaken, is itTufts University where you
taught?
Yeah.
So you're teaching English, andat some point I know you decide,

(14:25):
and you talked a little bitabout this in the very
beginning, the just what it isas a teacher, and how you know
it's really not exactly what youprobably expected.
Uh-huh.
Because there are challengeswith teaching as well.
So you're teaching.
And I did read that when youbecame a mom, that prompted you

(14:51):
to go into nursing, which if youwant it calm, it doesn't sound
like that.
That would be the route.
I'm interested in in yourmindset about that and what you
were thinking about thatdecision.

SPEAKER_02 (15:06):
Yeah, I I had a slow falling away from the
university.
And and I got my PhD at a timewhen there was a lot of emphasis
on cultural studies andpost-colonialism, which I think
is all very, very important tolearn about and think about.
But the a lot of the writingabout it was just very difficult

(15:27):
to understand, you know, whatpeople called theoretical, but
basically it was justunintelligible a lot of the
time, although I never wouldhave admitted that in the not to
your students either.
Yeah, right, right.
So I slowly just felt like, Idon't think this is for me.
And and and again, maybe ifgraduate school had been a

(15:50):
different kind of environment,you know, I would have felt
differently about it.
It's hard to say.
But then I got pregnant, had myson, and um was home with him
and got pregnant with twins.
Um, it was a planned pregnancy,but the twin part was not.
Um, and I had midwives for thatpregnancy and also a lot of they

(16:13):
were they're identical twins, sothere are more risks than with
fraternal twins.
So I had tons of ultrasoundswith perinatologists.
I mean, I just I got suchamazing care and learned about
pregnancy and what's going onand and didn't realize it at the
time, but was getting reallyinterested in health care.

(16:35):
And so when my daughters wereabout a year old, about 16
months old, a friend who's anurse came to visit and and I
was talking to her, and I said,I just thought the midwives had
the coolest job in the world.
And she looked at me and shesaid, Teresa, you could do that
job.
And honestly, it had nevercrossed my mind because I

(16:58):
thought of myself as I'm on thisacademic track, that's what I
do, that's the kind of person Iam.
And her saying that just openedup something because being a
mom, I found, yes, a lot ofchaos, but also that there was
this part of me that just lovedbeing with people and sort of

(17:19):
mixing it up.
And I always say I fell in lovewith the mess of life.
Okay.
I say that to nurses and theyall nod very nervously, whereas
everyone else just says, thatdoesn't really make any sense.
Um, so it was those two thingstogether.
And I I went, this was back inthe tight the day where you to

(17:39):
get on the internet, you had togo to the library.
So the library and looked up uhaccelerated nursing programs and
found out about them.
And literally a month later, Iwas taking chemistry because now
I had to go back to school anddo all those classes that I
didn't take when I was at Ricebecause they were uh too

(18:02):
aggressive and um made to seemimpossible.

SPEAKER_01 (18:08):
So, did you believe that you were going to run into
the messy once you got intonursing school or that it just
sounded like a really good ideaor career change that you just
wanted to try out and go into?
But did you know that it wasgoing to be a lot of what you
actually share in your books?

SPEAKER_02 (18:24):
And yeah, I think I had some sense of the messy.
I like that.
I like that phrase, the messy.
I had some sense of that.
And certainly with pregnancy,pregnancy and giving birth are
very messy.
Um, so I had a sense of that.
I think what I really liked wasthere's also this intellectual
component, understandingphysiology.

(18:46):
And, you know, you takechemistry.
It's not like chemistry itselfcomes up a lot, but it's
certainly important.
So I liked that combination.
And that's really what I got outof my pregnancy, too, is sort of
learning from the the midwivesand the paranatologist about
what's going on, and um, youknow, all these that you can

(19:07):
have twin-to-twin transfusions,you can have problems with the
placenta, just all these thingsthat were really fascinating to
me.
And I I just had no idea howbodies worked.
And I wanted to learn more andmore and more about that, and
that still fascinates me.
But but then the midwives wereso personal and hands-on.

(19:30):
And, you know, people have saidto me many times, why didn't you
go to medical school?
And you know, which is annoying.
And I just like roll my eyes.
But you know, the answer isbecause I wanted to be a nurse,
not a doctor.

SPEAKER_01 (19:42):
Yeah.

SPEAKER_02 (19:43):
Yeah.

SPEAKER_01 (19:43):
They're different And sometimes people equate
well, going to nursing school isjust a second sort of option
because you did not get into medschool.
Right.
Of course, we as nurses knowthat's not true because a lot of
us wanted to go into nursingbecause of the Work of nursing.
Right.
I am curious about your studies.

(20:06):
Were did you decide to take sometime off from teaching when you
applied to nursing school?
Were you was the plan to quitteaching in the moment and go
full time in an acceleratednursing program?
Or how did you juggle the two?
Good question.

SPEAKER_02 (20:21):
I'd been home with the kids.
And because with twins and atoddler, uh, the cost of daycare
would have just been out of thisworld.
And and I wanted to do that, tobe honest.
But so I started taking oneclass a semester of my
prerequisites that I needed.
And that's what I was being amom and being a student very

(20:43):
slowly, um, with very a verysupportive husband who helped
make it all work.
And it it was actually great tohave this academic outlet and be
taking these classes that werevery concrete after being in

(21:05):
grad school with all thisgibberish, honestly.

SPEAKER_01 (21:08):
Um, if I'm gonna make analysis of writing,
philosophy behind the writingand things.

SPEAKER_02 (21:14):
Yeah, it was it was nice to here's a redox reaction
in chemistry, here's the liver,you know, the lip, there's no
interpreting the liver, theliver.
Yeah.
And I really liked that.
Yeah.
And and taking, I took a cadaverclass for anatomy and held a

(21:34):
heart in my hands and uh lookedat lungs, and I would just fell
so in love with the idea ofhelping people whose bodies
aren't working right to workbetter.
Or in the case of midwifery, youknow, it's not that their bodies
aren't working right, butthey're leading up to a big

(21:56):
event.

SPEAKER_01 (21:58):
Exactly.
So you talked about midwiferyand being interested because
your friend talked about, youknow, you being able to do this,
you can actually do this.
But we know, I think, most ofyour work through critical care
and hospice or oncology.
Um, did you work in mother babyor in a nursery unit or anything

(22:22):
like that prior to or postpartumunit prior to going into hospice
or oncology?

SPEAKER_02 (22:28):
Or yeah, that's a good question.
And I did not because when I wasin nursing school and working up
to it, I talked to midwives andI found out it's a really hard
lifestyle because you never knowwhen you might have to leave.
And it's it's amazing work.

(22:49):
I mean, I can for the book Ijust turned in, I shadowed at
the midwife center here inPittsburgh, and I can talk about
that.
I mean, it's amazing, amazingwork.
And there's a part of me thatwishes I'd stuck with it.
But I as a mom did not want tohave to be constantly saying to
my kids, well, I think I can bethere.
Well, maybe I can be there.
I just was a completely personaldecision.

(23:12):
And um, and uh, and of course,working 12-hour shifts, there
are things I missed, but I couldplan.
I wasn't on call.
And um, that's why I chose notto pursue midwifery.
And then once I got into nursingschool and was doing clinicals,
I just felt like, wow, there'sso much you could do as a nurse.

(23:37):
Yes, I say that all the time.
Yes, so much.
There's a lot of cancer in mymom's family, and that's
honestly how I ended up inoncology.
I didn't I didn't think aboutmother baby.
And it I mean, now I could sortof see myself going to that.
Um, but at the time I felt morecalled to I I don't know if more

(24:02):
technical is the word, just moremedical, maybe.
More medical kind of care.

SPEAKER_01 (24:09):
So once you graduated from your nursing
program, of course, took theNCLEX.
You decided to go straight intooncology and in that route.

SPEAKER_02 (24:21):
Yeah.
So I yeah, started working bonemarrow transplant.
Um, and yeah, loved that.
Well, actually, I started Istarted on one leukemia lymphoma
floor, and I talked about thisin my first book, Critical Care.
There was a lot of bullying,which I found out later that

(24:41):
floor was known for that.
And I really want nurseslistening to know this.
If you're being bullied on yourfloor, everyone knows that it's
a problem on your floor.
Just like the doctors who arerude, everyone knows who they
are.
These are not secrets.
And the administration is notgoing to save you.

(25:01):
If you're being mistreated ortreated badly by your coworkers
on your floor, really, probablythe only solution is to get a
different job.

SPEAKER_01 (25:10):
Yeah.

SPEAKER_02 (25:10):
And I can maybe even at a different hospital.
Yes, that could be.
But for me, I left one floor,walked across a hallway that was
an elevator bay, and went to thetwin oncology floor, got a job
there with bone marrowtransplant, completely different

(25:31):
environment.
I mean, separated by literally20 feet and a set of elevators.
And uh there just wasn't thatsame kind of bullying.

SPEAKER_01 (25:41):
And would you say it, well, it's my opinion that
oftentimes it can be theleadership on the floor that
sort of not only allows thattype of behavior, but sometimes
may foster that type of behavioron the unit.
Did you find looking back, oreven at that time, did you know

(26:02):
that maybe it's an issue withleadership addressing the
bullying?
Because our leaders, of course,they know, uh they know as well.
Just curious about that.

SPEAKER_02 (26:11):
Yeah, it definitely was a problem with leadership.
And in fact, the the clinicianswho are uh floor RNs but have a
sort of elevated status, theywere the worst.
And if if the two of them wereat work at the same time, it was
just watch out.
I mean, terrible.
They really reinforced that ineach other.

(26:34):
And then it seemed like the unitmanager just didn't know what to
do.
Maybe that means she didn't wantto have to do anything, and
that's what I find so hard tounderstand.
Because why wouldn't you wantyour new people to succeed?

SPEAKER_01 (26:53):
Yeah.

SPEAKER_02 (26:53):
Why wouldn't you support them?
And so, for example, one thingthat happened was when I was a
new nurse on that floor, thestandard load was four patients.
Sometimes it happened somebodyhad to have a fifth patient.
For a while, I was alwaysgetting the fifth patient.
I was the newest nurse on thefloor.
And I asked this clinician, Isaid, Is there a reason why I'm

(27:14):
always getting the fifthpatient?
And she was silent for a minute,and then she said, Yes, there
is.
And then finally I went to thenurse manager and told her, and
then it stopped.
Oh, so um, yeah.
So she was the charge nurse oryeah, she did take care of that,
but just why would people thinkthat was okay?

(27:36):
Why, you know, why is hazingseen as being okay in nursing?
Why is it okay to put thebiggest burden on the newest
person?
I dislike that aspect of ourprofession so much.
And I know that doctors havetheir own form of ways that they

(27:57):
get hazed also.
And it it's just it's so sad tome that we're a caring
profession and yet we're oftenso mean to each other.

SPEAKER_01 (28:05):
Yeah.
And and I can I can relate tothat on my first nursing job.
I'm a second degree nurse asokay.
Well, second career nurse,second degree nurse.
And unfortunately, our director,our nursing director manager,
and everybody felt it.
I mean, I started nursing laterum at 35, 36, um, I started.

(28:28):
Um, and it was still hard as anadult, not as a 20-year-old
coming out of you know, college.
I I was still an you know afull-fledged adult at 36, and it
was it was a challenge.

SPEAKER_02 (28:40):
Yeah, no, same.
And right.
And then when people are justbullying you and making your
life harder, and it's not evenclear why.

SPEAKER_00 (28:52):
Yeah.

SPEAKER_02 (28:52):
Yeah.
Um, and and I think some of itwas because I had a PhD and
somebody told everyone, oh, wehave this new nurse that has a
PhD.
I don't know why.
Yeah.
Um, so yeah, obviously stillsome strong feelings about it,
but they had a rule in thehospital, you can't switch jobs

(29:15):
till you've been somewhere for ayear.
And I basically just said I'mnot listening to that and
wouldn't take no for an answer.
And they did let me switch jobs,which saved me because it was,
you know, it's it's a scary job,it's a hard job.
It's easy to make really seriousmistakes.

(29:37):
And if people are unfairlyriding you all the time so that
you don't want to ask for help.
Um that's when nursing becomesdangerous.
Yes.
Yes.
Yes.
And right.
And I felt that I don't want tobe in a position like that
because it's scary and it's notfair to patients.

SPEAKER_01 (29:59):
And yeah, um, well, I can definitely relate.
Um, I remember when I switched,and we had that unwritten rule
of you can't really go toanother floor without being here
for a period of time, and thenyou have to get permission.
If you apply somewhere else,they're gonna use permission of
your nursing director.
So I took the time when mynursing director was gone for
like a month off vacation.

(30:23):
Another floor, and all withinthat month's time, I got
accepted into another floor andjust kind of moved away.
But that's my little secret.
But um that's great.
Yeah, you you have to do whatyou have to do.
Like you said, sometimes youhave to switch jobs.
Sometimes it takes that.
So if you have the ability toswitch jobs, anyone listening,
if you're feeling bullied,sometimes yeah, you might not

(30:44):
get the help you need or thesupport you need from your
floor, from your leadership,from your management.
Sometimes it's just a matter ofjust switching jobs.
And nursing may seem like it'shorrible in the moment, but it's
probably just the job thatyou're in with the people, you
know, it may be the environmentthat you're in.
Um, yeah, that's yeah, that's soimportant.

SPEAKER_02 (31:04):
And I'm thinking I also want to say when you said,
you know, you you have to getpermission from the unit
manager.
I mean, people should knowthere's this, there's this
centuries, literally longhistory in nursing of sort of
very strict hierarchy, and um,everything has to be done one
way and there's one right way todo it.
And those attitudes havelingered, even though healthcare

(31:27):
has moved far beyond that.
And I hear this rap sometimeson, oh, yeah, the Gen Z nurses
or the millennials, they don'twant to work and blah, blah,
blah.
And I always say, um, isn't itmaybe that they have a sense of
self-respect and a sense ofrights and a sense of we're

(31:49):
adults and professionals and wewant to be treated like that and
we expect that.
So I'm I'm standing up for allour young nurses who come in
saying, you really don't have totalk to me like that.
And in fact, if you keep doingit, I'm just gonna leave.
Yeah.
And I hope we start to see somechange like moving up from that,

(32:10):
because those thoseauthoritarian hierarchical
habits are they're not doinganyone any good.

SPEAKER_01 (32:18):
Yeah.
And hard to break as well.

SPEAKER_02 (32:20):
Yeah.

SPEAKER_01 (32:21):
But I'm sure you've had that experience and and uh
congratulate you for figuringout how to we all figure out our
ways when you're when you'redesperate enough and you're
you're feeling threatened enoughor your back is up against a
wall, you feel like, okay, whatcan I do?
And take those opportunities asthey come.
So I know the basis of yourfirst book is off of your first

(32:44):
year in nursing and criticalcare is the book, and it is
actually taught or used innursing schools across the
country.
And I'll put that information inthe show notes for all of the
readers so they can pick up thatbook as well.
So you talk about your firstyear in nursing, and there's a
story I know that you have of anexperience you had with a

(33:08):
patient that had a sudden demiseor a sudden death, and which
caused you to want to write thatdown.
And I'm curious about why thatparticular incident what made
you want to actually document itand write it down for your own
personal reasons and how thatled to you just thinking, I'm

(33:31):
gonna submit this forpublication and see what
happens.
I'm curious about that story.

SPEAKER_02 (33:36):
Great question.
Yeah, my attitude was if youknow the Harry Potter books or
people listening know them.
It was like the idea of thepensive where you pull out
thoughts and you leave them inthis other thing.
That's what's called the penscreen that's what I was hoping.
If I write down the story, itwon't be in my head, it'll be on
paper somewhere else.
That is not uh how you treatPTSD, just to let people know.

(34:00):
Um taken me years to processthat experience.
And and I've also learned thatit's fairly universal among
nurses and doctors thateverybody has this sudden death
and they're not prepared for it.
And um, you know, I don't wantto say it's a kind of trial by

(34:21):
fire, but I think it's it's it'simportant to talk about it, that
people have those experiencesand they're difficult and they
shape you.
But so there I was thinking if Iwrite this down, it won't be in
my head anymore and I'll befine.
And um, which doesn't work, butI really liked what I wrote and
I thought, aim high, I'm gonnasend this to the New York Times.

(34:45):
And so here's the using myconnections.
Um, I sent it to one part of theTimes and never heard back from
them.
But also I had a friend, afriend of my brother's who was
an editor there, and I sent itto him.
And he said, I hope it's okay.
I like this.
I'm I send it to the ScienceTimes, the Tuesday section about

(35:06):
science.
And then they wrote back andsaid, uh, we want to publish
this.
Well, right.
Yeah.
Um, but so yes, I did use aconnection, um, and that was
very helpful.
Um, but then also it took themsix months to publish it.

SPEAKER_01 (35:24):
Wow.

SPEAKER_02 (35:24):
Where I thought I did I imagine this?
And I was just getting ready toemail the editor when he emailed
me and said, We're finallypublishing your piece.
And they sent a photographer outwho took these absolutely spooky
pictures through glass and toldme you're not allowed to smile.
And so the the title of thepiece is perhaps Death is Proud,

(35:46):
more reason to savor life.
And if you look it up on the NewYork Times website, you'll see
me looking like the mostserious, somber person you've
ever met in your life, um, whichis not really who I am, but
yeah, yeah.
Um, but that essay got a levelof attention I had not in any

(36:07):
way anticipated.
And I got Was it in the sciencesection?
Did it up in the okay?
Yeah, and online, yeah.
Um, and online.
Um, you're right, because atthat time, right, we'd moved
beyond the internet, it was onlyin the library.
It was now in all of our homes.
So um it it got all these views,and I started hearing from

(36:31):
agents, and what people said tome was this is a voice we never
hear, the voice of a bedsidenurse.
Um, so I feel like I was rightperson, right place, right
voice, right time, very lucky.
But I also saw it as a privilegeto get the opportunity to truly

(36:56):
and authentically represent whatnursing is.
And that's what I've alwaystried to do.
And so, uh, you know, as we weretalking before the recording,
and you said you felt likelistening to my book, the shift
was like working a shift.
It gave you that same feeling.
And I feel the happiest about mywriting when nurses say that, or

(37:21):
uh, Teresa Brown really nailedit, you know, this is really
what it's like.
And I I think sometimes that'snot the most comfortable place
to be because the general publicjust wants to believe that
healthcare is perfect anddoctors are amazing and it all

(37:42):
works really well.
And and then people get reallysick and they get in the system
and they find out it doesn'treally work that well all the
time.
Um, and I I always said I wantedto show the good, the bad, and
the ugly of healthcare, but alsoto to show what nurses do
because we do so much more thanpeople are aware of.

(38:05):
Yeah.

SPEAKER_01 (38:07):
That was a very long answer, but no, I appreciate
that, and I'm sure the listenerswill appreciate it as well.
Going back to knowing how towrite that story, uh, where you,
of course, there's a risk ofsharing patient information and
sharing that so publicly.

(38:29):
Were there any, did you have anyworry about sharing the story in
a in a New York Times?
And I'm imagining at that timeyou didn't know how big it was
gonna get at that time, how bigthat story was going, where it
was gonna go.

SPEAKER_02 (38:44):
I did not.
And and I was I was naive.
I mean, I I observed HIPAA, butbut beyond HIPAA, there's the
hospital's concern and notwanting to really give away who
the patient, I mean, I would Iwould hate for a patient or

(39:04):
their family member to read thatarticle and feel like, oh,
that's about us.
So that was I felt a sort ofethical obligation to not expose
my patients and even my myco-workers also, which also
sometimes led people to say, youknow, why does Teresa Brown
present herself as this lonewolf?

(39:25):
Well, no, I wasn't doing, I wasdoing that because I didn't want
to pull other staff into thestory.
It w it wasn't that I, you know,put myself above my coworkers,
but um, just a very strange kindof observation to make.
But anyway, um, yeah, so I knewhow to observe HIPAA, but I

(39:47):
wanted to protect the patient.
And I did end up checking inwith sort of my boss's boss and
things like I'd said the actualroom number the patient was in,
and she said, Well, we wouldwant that change.
And um, you know, I sort ofrealized, oh, the hospital just
doesn't want to be identified inany way.

(40:07):
And that's where we came up withthis.
Teresa Brown is a nurse inPennsylvania.
That's what we said, a nurse inPennsylvania.
So I could have been anywhere inthe state.
So a lot of thought went intohow am I going to de-identify
myself in a way to protectpatients, to protect the
hospital.
And people have even asked me ifTeresa Brown is a pseudonym

(40:30):
because it's just such a commonname.
Like, oh, that is my name.
Then I wondered if I should havecome up with a pseudonym, you
know.
But yeah.
Um yeah, and and that was achallenge the whole time.
And um, and I and I wrote aboutthis during COVID.
Eventually, I had to leave thatjob that I loved because the

(40:53):
hospital didn't want a writerbeing a nurse or a nurse being a
writer anymore.
And that was basically thechoice they gave me.
And I decided to keep being awriter and found a different
nursing job.
But it's it's definitely tough.
I think it's better now becauseof social media.

(41:16):
Uh I know there are, you know,nurses who are very public and
vocal on social media.
And some of them talk abouttheir hospital actually likes
it.
And I'm sure it's veryinstitution-dependent.
You know, there are some placeswhere I'm sure there's a PR
person who's monitoring all thisstuff and gets upset if

(41:40):
something's posted that theydon't like.
And other places are probably alittle more relaxed about it.

SPEAKER_01 (41:46):
Yeah.
And and curious about a littlebit more about that process.
When you got the call or theemail from the New York Times,
did you at that point say, Oh,let me go talk to my hospital
first to make sure it's okay?
Or did you arrange all of thatahead of time?

(42:07):
Like you knew you were going towrite the story, or you wrote
the story and you said, atfirst, let me go to my legal
department at my hospital or goto administration and see if
this is okay if I reach out toNew York Times and say I have a
story, or chicken before theegg, I guess.
Which one?

SPEAKER_02 (42:21):
Which one and that's why I say it was naive because I
didn't do any of that.
I had this strong sense of theFirst Amendment.
But people should know that aprivate employer does not have
to afford you the sameprotections as the government.
Um, and I didn't, I did notunderstand that.

(42:42):
I do understand that now.
Um, so it ended up working outactually for quite a while.
And I and I I probably blame myhospital because they never they
had meetings with me, but theynever just said, here's what
we're worried about, here's whatwe'd like to know that you're
gonna do or not gonna do.

(43:02):
And you know, I probably wouldhave said that's fine, but I
think they wanted some sense ofcontrol and not really showing
their hand, but that just meantthat I really didn't know what
they were worried about.
They would sort of post thesehypotheticals to me, like, well,
what if?
And there's a one of yourcoworkers and blah, blah, blah.
And I would say, like, okay, isthis something someone's

(43:23):
complaining about?
Or is this a hypothetical?
So it was very, it was veryconfusing.
And the next the the otherhospital system, I moved to,
it's just a very differentenvironment.
The the publicist wanted to,he's not a publicist, he's the
you know, communications officeror whatever it's called, but he

(43:44):
actually wanted to work with me.
He was very nice, um, justdidn't see what I was doing as
threatening in the same way.
The hospice I worked at was thesame.
So the attitudes can be reallydifferent.
And and I I came into it as I'mso proud.
I'm so proud.

(44:05):
I want to name my hospitalbecause I work at such a great
place.
And they were just, no, we donot want you to do that.
We do not want to be any part ofthis at all.
Um, so you know, I I I think I'minherently an optimist and an
idealist.
And my optimism and idealism didmeet reality, and I I learned

(44:29):
the score better than I hadknown it.

SPEAKER_01 (44:33):
So you're you're getting all the attention from
the article.
You have agents calling, and I'massuming those agents are
wanting to get you on a biggerplatform by having you write a
book, or was it, oh, we're gonnawork with New York Times because
they're interested in having acolumn, regular publications
with you, or how did the firstbook come to be?

SPEAKER_02 (44:53):
Right.
So uh yeah, actually, an editorreached out to me and but also
um Tara Parker Pope, who was theeditor of the Well blog for
years at the New York Times, shesaid, um, hey, I heard you're
getting all this notice.
Would you like to talk to myagent?

(45:14):
Which was incredibly nice.
And so again, I was very luckyand people were very helpful.
Um, but this editor at what wasthen Harper Studio Division of
Harper Collins uh emailed me andsaid, Can we talk?
And um, and then he justhonestly offered me like a lot

(45:36):
of money to write a book.
And I it was I I felt likeCinderella for a month.
Um just yeah, like and and Ijust really liked him.
Um it's funny, I was justmentoring a friend of a friend
who was trying to getrepresentation for her novel,

(45:58):
and and she did and she sold it.
She has a book contract, whichis wonderful, but she's very
analytical and sort of had allthese details about different
agents and publishers.
And I said, you know, this isgreat.
I just go with my gut instinct.
And um so I just I really,really liked this editor and um,

(46:24):
and then to had just havesomeone say, we're gonna pay you
to write a book.
It was it was having a dreamcome true, and I didn't even
know it was a dream that I had.
Like I that just makes me feelso tremendously lucky because I
hadn't said I want to write abook.
I in fact, I didn't think I'd bewriting at all once I became a

(46:46):
nurse, which was fine.
I had regrets.

SPEAKER_01 (46:50):
Yeah.
Which is interesting too,because you came from a writing
background and didn't think thatthis would be in your car.
It's for another wholeprofession, I'm assuming.
Going from a professor teachingEnglish to nursing and then
actually having your writingcareer.

SPEAKER_02 (47:06):
Yes, I did off, yeah.
Right.
And and I knew there are doctorswho write, but there just aren't
nearly as many nurses asdoctors.
And I so I didn't really haverole models and um it it came
into being.
And as I I said already once, Ifelt like it was an incredible

(47:30):
privilege to do my best to tellthe true story of nursing.

SPEAKER_01 (47:36):
Did you have a lot of editorial control?
Like, did you know, okay, youknow, you got the book deal, and
did you know right away what theexpectation was for you to write
about?
Or did you come in with your owncreative ideas and say, hey, I
think it'd be a good idea if Iwrite about my first year in
nursing on the floor?

SPEAKER_02 (47:56):
That may have been, I can't remember, that may have
been my agent's idea togetherwith the editor, but that's that
was the book we sold.
Like it was like untitled firstyear of nursing, sort of was
what the contract said.
And I remember, because this wasBob Miller who then left Harper
and was at Flatiron for a while,sort of legendary figure in

(48:20):
publishing.
But after I signed the contract,he called me and and I said,
Well, he said he called me andhe said, Teresa, I am raising a
glass of champagne to you.
It's very sweet.
And uh and I said, Okay, whathappens now?
He said, Well, now you write abook.
Okay.

(48:44):
And that was kind of it.
Um, and then I I wrote the bookbased on my first year of being
a nurse, and the the memorieswere so close to the surface and
so raw.
It it actually came out almostlike a data dump.
And then people have told me alot of first books are like

(49:08):
that, and it's never that easyagain.
Um, I don't know if easy is theright word, but just quick, you
know, just like I couldn't likethe stories and lines were just
in my head all the time.
I was really living with thebook.
And, you know, then there werethings like he read it.
I think there was a chapter wethrew away.
I wrote another chapter.

(49:29):
Um, you know, I remember a firstdraft, him saying, you know,
you're not a you're not a policereporter.
Like you like, but these kind ofdetails.
So I had to learn a little bit.
Yeah.
Um and and realize that I'mwriting, I was writing a book
for the general public.

(49:53):
Um, I'm not writing for a courtof law.
And and once he made that clear,then it became easier and I kind
of figured it out.
But that first piece also justcame out so fast.
Um, and it's if you write, Imean, it's so wonderful when

(50:17):
that happens, and it doesn'thappen to me at least that
often.
I mean, I'm not someone who likestruggles over a paragraph, but
um, just to have things beflowing like that and the words
come out and they're just bam,this is this is right.
I really like this.
Um, that it felt good.

SPEAKER_01 (50:39):
How far away were you from your first year when
you wrote the book?
Was it a recent?

SPEAKER_02 (50:45):
Yeah, maybe that's a really good question.
Um two or three years, maybe.
Okay.
Is that right?
It's hard for me to remember.
Um, I'm really bad at years andnumbers and but you know, they
have those cheap cards for likenormal values.
Yeah.

(51:07):
Yeah.
So it was still very fresh in mymind.
And I realize now if I sat downand tried to write that book
again, I would not be able towrite it because I would never
be able to recapture thatfeeling of what's going on?
Do I know how to do this job ornot?

(51:28):
Um, sort of, you know, the wholeidea of what are all these tubes
with different colors and youknow, all the all the things
that you're learning when you'rea new nurse that I thought would
never make sense.
And then they do.

SPEAKER_00 (51:45):
Yeah.
Yeah.

SPEAKER_02 (51:47):
Um, yeah, but I I couldn't, I couldn't write that
book now because I've I've,which is good, right?
But I've completely lost thatsense of what's going on here.

SPEAKER_01 (51:57):
Yeah.
So when you released that firstbook out into the world, did you
feel like you got the same typeof attention on your writing as
you did that first article thatyou wrote in the New York Times?
And then how did that propel youinto your second book, which is,
of course, a New York Timesbestseller, The Shift.
Um, wondering how you went fromthat first book into the second?

SPEAKER_02 (52:20):
Yeah, unfortunately, the book did not get a huge
amount of attention.
I got definitely some and umwhen it first came out, because
the Harper Studio, the imprintor the division of
HarperCollins, I was part of,HarperCollins had actually
closed it because it was using adifferent financial model and

(52:44):
they didn't like it.
And actually, Bob Miller, whowas my editor, left.
So is in this position of havingwhat people call an orphan book,
um, which is not uh somethingyou want to experience.
Although I've I've heard ofother people who had much, much,
much worse experiences than Ihad.
I mean, they gave my book to adifferent editor who really

(53:07):
cared about it and worked reallyhard, and and they sort of kept
a skeleton staff, and thosepeople worked really hard for my
book, and I'm infinitelyappreciative of them for doing
that.
Um, but but yeah, we were justsort of a little bit behind the
eight ball, if that's the rightmetaphor.
But the book got picked up byschools of nursing and kept

(53:30):
selling, and actually I'm stillearning money on that book, not
a lot of money, but but peopleare still buying it, yeah.
Um, which, you know, and and soHarper is still earning money
too.
Um but that's very, verygratifying.
So yeah, and then and then Iended up getting a different

(53:52):
agent.
Um, and she and I together cameup with this idea of what if I
told the story of one shift?
And actually, you'll you'llappreciate this, and the nurses
listening will appreciate this.
She said, when I first told herabout the idea, I don't think

(54:14):
there's enough there.
And I said, Let me show you.
And oh, and did you, yes?
Yes.
And so I spent the weekendwriting, and I don't even
remember what I sent her, butthen she called me and she said,
You know what, Teresa?
You surprised me.
There is enough here.
And um, she was the one who cameup with the title, let's call it

(54:36):
the shift.
Um, and I I I think so theprogression from critical care
to the shift was I really wantedto show the texture of nursing.
And the only way to do that isto show an actual shift.

(54:57):
And the the tagline I gave,which the publisher really
liked, was it's not just a dayin the life in the hospital, but
all the life in one day in thehospital.
And and you know, there's everynurse knows this, you know,
every single shift.
Heartbreaking things happen,amazing things happen, bizarre

(55:18):
things happen.
Maybe not every single shift,all those things, but that's
like it's all happening.
Yeah.
Yeah.
Um, you know, experiences thatwarm your heart, experiences
that are really hard to take in,people you want to uh care for
forever, people who you reallyhope they get discharged.

(55:40):
Yeah.
Um, just and um I was glad thatI could tell that story all the
the texture of healthcare, theemotional as well as the
clinical and personal andeverything, the whole ball of

(56:00):
wax.

SPEAKER_01 (56:02):
I have to say, and I know we talked before we started
to hit record.
If you haven't read The Shift,and you're a nurse or nursing
student, if this is a book youdon't know about quite yet, I
have to say it's really asnapshot in the life of what it
means to be a nurse.
And it's it's a book that I wastelling you before we started,

(56:25):
how if I would have just hadthis book when I was in nursing
school, I would have had abetter understanding of what
nursing was.
And it's not only a good, it'snot only a masterclass of what
nursing truly is, but it's alsoa patient education tool for any
patient who's going into thehospital who has no idea how

(56:46):
healthcare works.
You see it all.
I know it's from the eyes of anurse and from a nurse's lens,
but you you actually will learnthe inner workings of how it is
to be on a nursing floor as apatient and as a nurse.
Um, and and I love it becauseyou color it so much with a lot
of just different descriptors.

(57:07):
I mean, you explain everything,which is, you know, you explain
what, you know, uh cathetersare.
You explain what, you know, justit's just such a great tool for
anyone to read.
I was listening to it, theaudiobook, and I was telling you

(57:29):
how I got chills just listeningto the audiobook and got very
emotional on my walk because Iwalk every day and was listening
to it on my walk, and I wasgetting very emotional.
My chest was getting heavy, justgetting towards the end of the
book because you realize it'sgonna end.
The shift is almost over.
And you're saying in your mind,you know, because it feels so
real.
And um, you're saying in yourmind, oh my God, okay, the book

(57:51):
is almost over.
Please don't let anything happento these patients.
Oh, you know, you don't wantanything to happen.
And just listening to the book,and I was listening to it on a
faster speed.
I think I was at 1.3 or 1.5speed and listening to it.
And I was saying to you howwithout the speed, it's like a
seven to eight hour book andseven to eight hour book.

(58:15):
And you know, there's stillthings missing on that shift
that we would never hear aboutbecause they're just, you know,
the little nuances of the day.
And so you fit in all the colorof that shift, and you, you
know, have to leave out, ofcourse, a lot of things that
happened during that day.
And it actually feels like ashift in your ears.
And with it on the 1.3, 1.5speed, I swear that's normal,

(58:37):
some normal speed in nurses'time because you're saying
you're going into a room to helpget a patient discharge and then
your phone rings while you're inthe room and you're trying to
concentrate.
I want to just discharge mypatient because she's been
waiting, her and her husband, oryour patient who has a perf, you
know, you want to get her tosurgery.
And so, you know, they just gotbad news and you chase the
doctor down the hallway just tosort of advocate for.

(58:59):
Can you just please give her,please consider doing her
surgery tonight?
Um, it it just feels like ashift.
As a nurse, it feels like ashift.
It feels like I'm walking rightbeside you as you're going from
teacher to patient to patient.
And it's such a wonderful reador listen.
Listen for me, I think, probablyum, you know, required reading

(59:22):
in every single nursing schooland should probably be required
for patients in the hospital ifthey have nothing to do here.
Read this book.
It's so good.
So um I'll I'll make sure Iinclude the details for the
shift in the show notes, whichis a New York Times bestseller.
And I want to say just thank youfor that book.
It just wonderful book.

SPEAKER_02 (59:42):
Wonderful.
Oh, you're so welcome.
And you've made me think about Idid a lot of radio interviews
for the shift, and then for mythird book, it was podcasts.
But um the the uh one of thethings I got over and over again
was people said, now Iunderstand why it takes so long.
To be discharged from thehospital.
Yes.

(01:00:02):
I wasn't even, you know, Iwanted to tell the story of
someone being discharged.
It's a it's a real day, but alsoa composite day.
But I wanted to tell that storybecause it's happy, right?
Someone goes home.
But the patients and familymembers reading it, it's aha,
this light bulb went off.
Yes.
You know, why does the doctortell us we're going to leave at

(01:00:24):
11 and we always leave at 3p.m.?
Um, and and at one point I evenwent to my manager and I said,
please tell the attendings tostop telling people they will be
discharged at 11 in the morning.
They know they won't bedischarged at 11 in the morning.

SPEAKER_01 (01:00:41):
And we as nurses, of course, know you won't be
discharged at 11 in the morning.
And that's why I think it's sucha great read for patients or any
individuals who don't have abackground in healthcare,
because at some point we may allbe in the hospital at some
point, and we may all have a badtime in our life where we need
the care of doctors, nurses,clerks, techs who come and draw

(01:01:05):
your blood, phlebotomists, orum, you know, just transporters.
I mean, you talk about, youknow, some transporters in your
book and how we sort of movepast one another and not really
interacting because it's justthe the way of the the way of
the shift.
Um, so yeah, it's it's it's it'sgreat because I feel like a lot

(01:01:26):
of patients will will realizethat, yeah, we're trying to get
you out and we're actuallythinking about it.
We're actually and you're andyou're putting your thoughts on
paper in the book, but we'reactually really thinking like,
oh my God, my patient is waitingfor me.
They're waiting for me to bedischarged.
And I'm in the room with anotherpatient because this patient is

(01:01:48):
demanding me change their showercurtain.
And we're like, I really want toget to discharge my patient
because she's waiting.
Um, and it just, it's aneye-opener, I think, just for
the inner thoughts and the innerworkings of the nurse and what
we go through day by day and thethings that we want to do and
the things that we want toadvocate for.
And no matter, sometimes nomatter what advocacy you do for

(01:02:09):
your patients, sometimes itdoesn't work in the end.
But um yeah, great, great,wonderful book.
And moving to your third book, Iknow you write about in healing
your own experience about beinga patient.
Now, when you were a patient,did you think, you know, after

(01:02:30):
all of that was over, that thisis a story that I should tell in
healing?

SPEAKER_02 (01:02:35):
Yeah.
So the the story is in 2017, Iwas diagnosed with breast
cancer, and I am I am doinggreat.
So um that's good.
Um obviously did not expectthat.
Um and right away I I felt likethe nurse part of me was kind of

(01:02:55):
disappearing, and becoming apatient just felt like my whole
world was turned upside down.
And what happened was I startedseeing all these places where
the system fails patients.
And I knew about those as anurse, but I thought, well, we

(01:03:18):
get people their chemo, we dothis, we do that, we make up for
it.
But as a patient, there reallyisn't any making up for it.
And so that's the story I wantedto tell because there's always
gonna be disappointment forpatients.

(01:03:38):
And any nurse who says, orphysician who says, I'm gonna go
in and I'm gonna give 110% everysingle day to every single
person.
That person is gonna burn outbefore they know it, right?
You can't do that.
And and as you just said,sometimes there are things you
want to have happen for yourpatients and you just can't make
them happen, or they're just notgonna happen.

(01:04:00):
And that's hard.
And so, how do we balance that?
And and that's what I reallywanted to get across, and just
obvious things that didn'thappen.
Like I had a very small, veryslow-growing cancer.
No one ever sat down with me andsaid, you know what, this is not
gonna kill you.

(01:04:21):
Don't even worry about that.
And you know, that's atwo-minute conversation, right?
No one said that to me.
And I felt like I sort of got onthis conveyor belt and then just
got, you know, moved around likea box, like going all over the
place.
And no one just taking the timeto say, hey, this is a human

(01:04:44):
being who just got a harddiagnosis.
It was even hard to get thediagnosis.
Um, ended up, you know, gettingreally angry about um when they
were telling me when I wasactually going to get the
results of the biopsy.
And and there was just a wholeseries of encounters like that
where it just was so clear thesystem was not designed to be

(01:05:08):
compassionate or to really seepatients as human beings.
And I knew that as a nurse, butI didn't know how it feels when
you're the patient.
So I think I did feel like Ihave to write this book, and um,

(01:05:31):
you know, I it's a it's an angrybook in some ways, and it's not
the typical illness book where Isay, Oh, this was my cancer
journey, and I really learned somuch about what's important.
I mean, I didn't have learnedabout things that are important,
but I would rather have not hadcancer.
And I, you know, I think Iprobably could have figured out
some things on my own.

(01:05:53):
Other, it's not a journey, it'snot a blessing, um, nothing like
that.
I and I refuse to sugarcoat itin any way.
Um, and so this book didn't sellas well as my others, but for
the people who read it, theythey email me and they feel it
so personally.

(01:06:14):
It it just makes me feel reallygood that for people who had a
similar kind of experience andthey were able to be in touch
with that, they felt seen.
Um, they really did.
Like I talk about it, felt likeDIY cancer care is and do it
yourself.
And people have emailed me andquoted that back to me like this

(01:06:37):
is exactly what it felt like, orthis is what it was like for my
mom.
And um, in my hope wasadministrators would read this
book and managers and would say,Wow, we can do better.
Let's do better.
Yeah.

SPEAKER_01 (01:06:50):
Not too late.
You can you can read it now.
It's never too late.
And you have and you had thecredibility with those patients
as well, those patients who werewriting you, because you were
you were a nurse in the system,and now you can really tell the
story what was really happeningbehind the scenes in nursing
from your perspective already ofbeing a nurse.
And I'm sure those words were ofcomfort to those patients who

(01:07:12):
felt like, okay, someone inhealthcare is is listening to
me.
Someone does hear my story.
Yeah.
Yeah.
Yeah.
Yeah.
So now you're on your fourthbook.
Yes.
Or you you've you've you'vewritten your fourth manuscript.
And from what I know, you'vealready submitted that

(01:07:33):
manuscript.
Yes.
Yeah.
And I think it's a nurse finds,a nurse finds hope and
healthcare.

SPEAKER_02 (01:07:40):
Yeah.
And we're still working on thetitle, so that might change.
Okay.
But but the idea was actually, Iduring the pandemic, realized,
and I didn't work during thepandemic, basically because my
kids didn't want me to, becauseI was just coming off breast
cancer.
And I thought, that's fair.
Um, I'm not gonna ask that ofthem.

(01:08:00):
So, but I realized also I wasburned out.
And um, you know, that could bea whole nother podcast, right?
But I decided to look for hopeand healthcare.
How could I find hope inhealthcare?
And then I thought, hey, I thinkthat's a book.
And so it was actually a verypersonal quest.

(01:08:21):
Um, and I look at four differentsites around the country that
follow the cycle of life.
So the midwife center inPittsburgh, in-home primary care
in Portland, elder care inDenver, and then hospice and
palliative care in the Midwestand in Connecticut.
Um, and all places giving justincredible care.

(01:08:45):
I mean, just incredible care,like sort of breathtakingly good
care, all struggling to paytheir bills.
Um, so it's it's really lookingat this amazing dedication of
these clinicians, and then alsotalking about the system and the
weird payment structures and um,you know, it people probably

(01:09:08):
don't know this, but part of whya lot of labor and delivery
units are closing in ruralhospitals is because they don't
make enough money for thehospital.
Well, that's because thereimbursement rates are low.
But, you know, thosereimbursement rates are set by
people.
I mean, somebody could decidewe're just going to reimburse

(01:09:28):
labor and delivery a lot moreand you know, less for knee
replacements, right?
Just for example.
Um, so we could really makechanges like that, and they
would make people's lives a lotbetter.
And it's it's so it's it's notabout wrecking the system, it's

(01:09:49):
about saying we're choosingbadly, and that American health
care is twice as expensive as inmost other industrialized
countries, and our outcomesstatistically are worse.
There's just no denying theextent of the problem.
And so let's do something aboutthat.

(01:10:11):
Let's find a way to better carefor our people.
Um, and I'm I'm happy to saythat writing the book worked for
me.

SPEAKER_01 (01:10:18):
I'm thinking about going back to the bedside
instead of So how did you howdid you find those healthcare
centers that were the focus ofthis fourth book?
How did you come?

SPEAKER_02 (01:10:30):
Yeah, the the midwife center I knew about, and
and basically I just cold calledsome places.
I had I had done a little workwith the place in Portland.
I I'd done a New York Timesarticle on a different aspect of
their program.
They're called house callproviders.
Um, the capable program, peoplewho review grants connected me

(01:10:55):
with them.
And then I just had a connectionfor the hospice and palliative
care.
And there were there were alsoother options and choices that
ended up not working out.
Um, I mean, the midwife centerwas golden and um house call
providers, but there was a lotof negotiating about um, you

(01:11:17):
know, what was I gonna do andwhen was I gonna be there?
And and really with the midwifecenter, it had to be somewhere
local because I had to be oncall with the midwife, um, which
would have been hard to do.
Yeah.
Um just but but I went to allthe other sites and stayed and

(01:11:37):
chatted and um it was it was agreat experience, made friends,
learned so much, watched thesestellar clinicians giving me a
master class and you know, justall this really great stuff.
Yeah.
I I feel so lucky that I got todo that.

SPEAKER_01 (01:12:01):
So you mentioned just now that you're thinking
about or going back to thebedside.
What's in the works for TeresaBrown moving forward besides the
bedside?

SPEAKER_02 (01:12:10):
Yeah, so I've been slowly applying for jobs and you
know, I want to make sure thatit's the right thing.
I've realized I don't want towork nights.
Um, I mean, the occasional nightis fine, but not a lot of
nights.
Um, I'm not sure I want to worka 12-hour shift again.
Um, so I'm sorting all that outand going slowly and then

(01:12:36):
thinking about what else do Iwant to write?
And lately I'm thinking, youknow, I could write an article
on burnout.
Um, because it's like a term wehear a lot, right?
But I don't think people reallyknow what it means, what it is.
And I was just speaking at aconference and presentation

(01:12:56):
before me was on burnout, andthere was a list of, you know,
and I've read all this stuff.
And but some, you know,sometimes you you have to be in
the right frame of mind toreally absorb something.
And one of the traits theyposted was separates oneself
from like co-workers, or I don'tremember the exact wording, but
I realized that's what I hadsort of lost touch with nurse

(01:13:19):
friends, not all of them, butand I I and suddenly I saw, oh,
that was part of my burnout.
Like that was feeling like Ijust need a break.
Um, and it made me feelempowered to get back in touch
with people and um think howimportant it is to get a job

(01:13:40):
where I can be a nurse, but Idon't have to feel so
overburdened all the time.
And I I hope that's possible.
I think it might be.

SPEAKER_01 (01:13:52):
I think so.
I think so.
So for all of the nurses who arelistening who have some writing
in them, what would be your bestadvice knowing that you've
written the three books, you'reon your way to putting out the
fourth and thinking aboutwriting more essays or books to
come?
What's your best advice that youcan give to them, knowing that

(01:14:14):
they may not know any of theprocess?
I know you mentioned that youdid have a good connection or a
lucky connection with the NewYork Times.
How would a nurse go about it ifthey didn't have any of that?

SPEAKER_02 (01:14:30):
Yeah, I mean, I would say, you know, Substack is
really big right now.
You could always, I have aSubstack, um, just comes out
about every couple of weeks, butthat's one way to just start
getting your voice out in theworld.
Um, make sure you observe HIPAAabsolutely.
And uh people need to know thatuh the rule of HIPAA is that not

(01:14:52):
that someone can't identifythemselves, but that someone
else couldn't identify them.
So what I got really good at wasleaving out details.
Like if someone's really tall,but that doesn't matter to their
diagnosis, just don't say that.
Don't say what their height is.
If someone has long blonde hair,don't say that.

(01:15:13):
Um, and in journalism, you youcan't make up stuff.
Like you can't use pseudonyms,you can't say change someone's
hair color, but you know, youcould definitely write a
substack where you do that, justbe very upfront about it.
Um and so that's one thing.
Um, also the Bellevue LiteraryReview, which you can find

(01:15:35):
online.
And I'm an editor, not an editorfor, a reader for, a reviewer
for, um, publishes articlesabout healthcare and I mean, not
articles.
Well, yeah, nonfiction, but alsofiction and poetry.
And it's always hard to findnurses who are writers.
So send in your submissions.

(01:15:58):
Um, or you can also tell patientstories too.
There's a lot of patient storiesthat get submitted.
And as for larger big nameoutlets, I'm gonna be honest and
say that right now I'm havingtrouble getting things placed.
And I think we're in such afraught political moment that

(01:16:20):
people's uh capacity maybe totake in more nuanced healthcare
stories just doesn't seem to bethere.
But also, I you know, look atany newspaper or news website,
right?
It's all gonna be about politicsalmost all um, you know, or
sports, right?

(01:16:40):
Or fashion or arts.
But um I it's just it's reallyunfortunate.
But I feel like there's not thatmuch room right now for like
true, meaningful healthcarestories.
But so if you write a Substack,if you write letters to the
editor, you know, maybe yourlocal paper, you could write an
op-ed for.

(01:17:01):
Um there is no shame in thinkingsmall and working small, and
then seeing where it leads you.
And and I would people, youknow, if you write a blog or a
substack and the people readingit are your mom, your favorite
aunt, your siblings, and yourcollege roommates, you have a
book.

(01:17:21):
Well, that's 10 people who nowwill know more about nursing
than they did.
Yeah.
And that's wonderful.

SPEAKER_01 (01:17:29):
I love the starting small too.
I love that you say there's theopportunity in your smaller
newspapers, human intereststories that if you're writing
about patients, especially insmaller markets, even pitching
probably yourself to local news,news channels, news networks.
So I think such good advice.
And I also like the advice ofSubstack.

(01:17:51):
I come from a world of blogging,having my own website and
blogging on my own website, buton platforms like Substack,
other people who are not on youremail list or on your
newsletter, other people willcan discover your work who may
have never discovered your workif you're just staying it within
your bubble.
So I love the idea of Substack.
Of course, lots of well-knownauthors, people from the news

(01:18:15):
world, journalism actually movedto Substack when they couldn't
tell stories the way they wantedto tell stories sometimes.
So I think it's a it's a good,good place to go, a good
platform to go.
So uh wrapping it up withnursing.

SPEAKER_02 (01:18:28):
Oh, go ahead.
Oh, just the hard thing is youmay not be able to make money
right away.
And um, you know, the truth isthat a lot of writers don't make
a lot of money.
So it's gotta be you're doingthe writing because you want to,
you feel it, you want to seewhere it takes you.
I would start there if you'rethinking I'm gonna do this and

(01:18:50):
it's gonna get me really rich.
I mean, that might happen, butprobably it won't.

SPEAKER_01 (01:18:55):
Yeah.
Yeah.
Anyway, go ahead.
Also great and realistic adviceas well as well.
Thank you.
So to wrap up, I I would love tohear a story that is dear to
your heart in nursing orsomething that always brings you
back to that feeling of homewith nursing.

SPEAKER_02 (01:19:17):
Yeah, when you asked me that, I I thought instantly
of this one story that I'vewanted to write, and I couldn't
figure out a way to write itbecause it's a it's a very small
vignette.
I was I was working a nightshift, and the patient was of

(01:19:38):
Scandinavian origin, I can'tremember which country, and she
told me about when people arereally sick, they say if you
open a window at night, theirtheir soul can fly out the
window, and then that's whenthey've died.
And she was really worried aboutthat.

(01:20:00):
Um, and of course, the windowsin the hospital don't open, but
um it was it was really on hermind, and we I remember sitting
and talking to her about it, andthen in the morning I went in,
she hadn't died.
Um and I remember she opened hereyes and we looked at each other

(01:20:22):
and she said, no open windows.
And I said, no open windows.
And just something about that isso perfect to me.

SPEAKER_01 (01:20:35):
That was Teresa Brown, nurse and New York Times
bestselling author.
Hey, thanks so much forlistening to the show this week.
Please make sure to rate andreview this episode in your
favorite podcast app.
Then don't forget to click thefollow button so you won't miss
an episode.
This episode was produced andedited by yours truly with

(01:20:56):
administrative and researchsupport from Liz Alexandry and
Renan Sova.
I'm Marsha Batti, and you'vebeen listening to the Bossy
Nurse Podcast.