In a hospital nurse’s vocabulary, a “handover” is when a nurse coming off shift provides updates on every patient’s condition to the nurse coming on shift.
Canadian ICU nurse, nursing mentor, and author Tilda Shalof chose this term as the title of her latest nonfiction book. It was written at the brink of her retirement and envisioned as an alphabetical “compendium of practical clinical tips interwoven with more personal stories about doing, thinking, listening, attuning, feeling, and witnessing.”
Framed as an ongoing exchange between Shalof and student nurse Lisa Mochrie, who was just 16 when she first contacted Shalof seeking advice about her career plans, The Handover moves from the SARS era through COVID-19 along a bumpy nursing highway pockmarked by burnout, moral distress, and severe understaffing.
Shalof packs a lot into 344 pages, sharing not only her knowledge and vast experience for the benefit of Mochrie and other new nurses but also abundant observations and insights of value to any healthcare worker, patient, or patient relative – in other words, everybody. Her warm, candid, and entertaining treatment of these heavy topics alternately moved me and made me smile.
One of the devices I appreciated was her inclusion of passages from the 1950s children’s book series about “pretty, angelic Nurse Cherry Ames… who enjoyed exciting adventures as a tropical cruise nurse, a dude ranch nurse, and even a department store nurse.” I fondly recall borrowing library books from that series in the late 1960s, dreaming of following in Cherry’s footsteps.
It’s obvious that Shalof adored Cherry as much as I did, but her perspective is rooted in a reality that would have wilted Cherry’s crisp white nursing cap.
For example, Shalof opines that “few places are less hospitable than hospitals. Even in a prison, you are met by the warden, a mug shot is taken, you are introduced to your cellmate, and issued an orange jumpsuit. In the hospital, we ‘process’ the ‘patient’ in ‘admitting’ and toss them a flimsy, faded ‘gown’ that exposes more than it covers and says, now, you are a prisoner – oops, I mean patient…
“What if we could find it within ourselves to invite patients in rather than act like we are ‘dealing with them’ or doing them a favor? What if we could welcome them – not only the clean and pleasant ones, but the hostile, smelly, and ungrateful ones too. What if we treated patients as guests and acted as hosts (of a party to which no one wants an invitation)?”
The text flows like a conversation, structured casually by myriad alphabetized keywords that examine aspects of the profession. From adulting (“Nursing requires a level of maturity few possess at this [student nurse] stage of life. It’s a very ‘grown-up’ profession. Even a novice nurse has to be the ‘adult in the room’”) to zozobra (“the existential anxiety we all feel about the fragility of our planet in this post-pandemic time”), the book covers a wide territory.
A Jewish lens on nursing
The book also contains an unexpected Jewish angle; unexpected because, outside of Israel, nursing isn’t a predominantly Jewish profession. Though Shalof describes herself as “not at all religious,” she was raised in “a liberal Jewish community whose members were social justice activists.” A strong Jewish sensibility informs her outlook.
As she reflects on her decades of hospital-based work in Canada, she sees how Jewish humor and its paradoxical mix of tragedy and comedy mirrors a shift nurse’s daily experience.
Shalof quotes Jewish texts and writers, from Pirkei Avot (Ethics of the Fathers, a Talmudic compendium of wisdom) to author Anita Diamant. She half-jokingly proposes that aspiring nurses be “turned away three times” as are prospective converts: “Nursing is not a religion, but like one, it is an undertaking that demands commitment. Both ‘clubs’ have entrance requirements and membership responsibilities. Only the serious need apply.”
She teaches student nurses “some juicy Yiddish words for various emotional states. Words like ferklempt for feeling overwhelmed; tzedrait for being mixed up or confused; and being on shpilkes, for anxiety due to too much nervous energy… I teach them the word meshugge. It means ‘crazy,’ but in the nicest possible way.” She writes that an ideal nurse must be a mensch, above all else.
Perhaps to illustrate the latter point, she includes a supportive email sent by Mochrie on October 8, 2023, “the day after the violence and atrocities committed against the Jewish people of Israel, a day that set off a global rise in antisemitism. I was at home, feeling devastated, horrified, worried about my family who live there, when I received this,” she writes.
Mochrie wondered how Shalof was “coping with this heart-wrenching news… I feel a loss for words about what to say and do. Just know that I am keeping you all close to my heart and in my prayers.”
Though The Handover should have been more carefully proofread to correct typos and style inconsistencies, it is an intelligent and thought-provoking book, which I highly recommend.■
THE HANDOVER:
A NURSE’S LAST SHIFT
By Tilda Shalof with Lisa Mochrie
University of Toronto Press
344 pages; $35