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Nursing Novellas Review: Mary Holtschneider


Mary E. Holtschneider, RN, BSN, BC, MPA, NREMT-P

Amy Glenn Vega’s two nursing novellas, “Lions and Tiger and Nurses” and “Broken Heart”, take us through the lives of nurses at the fictional North Carolina Dogwood Regional Medical Center, Med Surg South nursing unit.  Each of the nurses is at a different point in his or her career, which Vega so aptly captures as the stories unfold.

Donna, the nurse manager, struggles with how to most effectively bring out the best in her staff, while at the same time worries about her children, one of whom is in prison.  Miriam, the most experienced staff nurse on Med Surg South, engages in the practice of “eating the young” nurses on the unit, in this case new graduate Haylie.  Haylie is not only young in the nursing profession but also in age, and struggles to fit in to the unit as well as into the adult world.  Mel, a divorced middle age Filipino nurse who was once married to a well-off lawyer, is really brought to life in “Broken Heart” as she confronts her emotions regarding her divorce, her daughter’s unplanned pregnancy, and a special patient for whom she develops an unexpected love.  Brad, a relatively new nurse who served as a medic in the military, also is brought to life in “Broken Heart” as he confronts several different relationships, including a breakup with his girlfriend.

The theme of the first novella, “Lions and Tigers and Nurses” is the ongoing problem of lateral violence, often described as nurses eating their young.  Miriam is the main perpetrator on Med Surg South and when Donna assigns her to precept Haylie, she brings out all sorts of tactics to make Haylie feel incompetent and unwelcome.  All nurses will instantly recognize Miriam’s antics and will quickly think back to times that they have seen or experienced bullying behavior.  The reader still feels sympathy for Miriam, however, as her husband had recently suffered serious medical problems and eventually dies.  Miriam is burned out and highly stressed, and unfortunately finds it difficult to adequately handle these stressors in her life without making everyone around her miserable.

In this novella, Donna requires the group to attend a hospital educational program on lateral violence, which Haylie truly embraces.  The class teaches them to stand up to tactics of backstabbing, sabotage, infighting, and other negative behaviors by not accepting them as appropriate and fighting back.  Eventually Miriam and Haylie, through some emotional moments, come to realize that they indeed need each other and truly become colleagues, if not friends.  They literally and figuratively get on a roller coaster together and learn this important lesson, which concludes in some touching moments at the end.  The reader is left pondering whether it is Miriam who actually learns more from her relationship with Haylie than the other way around.

The second novella, “Broken Heart,” moves beyond the lateral violence theme of “Lions and Tigers and Nurses” and delves into the individual nurses’ lives even more.  Mel, the ultimate male basher since her husband left her for another woman several years prior, learns to trust and love again through a famous actor who becomes her patient.  Mel eventually loses her new love, but simultaneously gains a tremendous amount of personal growth from this important relationship.  Brad, struggling to commit to his longtime girlfriend Sue and then eventually losing her, finds other relationships that are not romantic in nature but very poignant.  The reader observes Brad maturing to a higher level in this novella that he otherwise might not have been able to achieve had he remained with his longtime girlfriend.  This novella focuses on grief and loss as each of the nurses experiences these emotions in different ways.

Neither novella is about medical problems or hospital issues, but about the lives and struggles that these nurses face both personally and professionally.  Vega, though not a nurse herself, captures the spirit of Med Surg South and all the emotions associated with it and the staff.  Non-nurses will enjoy the novellas as well as nurses, nursing students, and those close to nurses.  For those who have never personally experienced aspects of lateral violence, it will be not only educational but a bit disturbing to learn that such things can and do happen.  The general public consistently ranks nursing as the most trusted profession, but yet this internal abuse still abounds.  Nursing students in particular will appreciate how the story unfolds and can then hopefully choose to change this long-standing culture of abuse within the profession.

A bonus of the novellas is that the reader can get nursing continuing education credit by simply following the instructions in the back of the book.  There are good discussion questions that can be used for nursing school classes, journal clubs, self-reflection, or meetings.  This alternative means of education through novellas, rather than traditional lecture, is an innovative way to explore the concepts of lateral violence, grief, and loss.

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