I Wasn’t Strong Like This When I Started Out: True Stories of Becoming A Nurse

Women in Medicine

           “I Wasn’t Strong Like this When I Started Out: True Stories of Becoming a Nurse”  is a collection of stories written by nurses that share about the trials and joys of becoming a nurse, edited by a man named Lee Gutkind. The book highlights the lack of acknowledgment and credit that is often given to nurses, Gutkind opens the book by sharing facts proving just how crucial good nurses are to good healthcare. Gutkind has explored the medical world in his writing for 20 years, which gives him experience and validity discussing the subject of nursing. He makes the point that nurses make up the largest group of individuals in healthcare, 2.7 million, which to add perspective, even surpasses the number of engineers in the United States. Furthermore, he points out that nurses are on the “front lines” and are the most reliable in knowing about patients and their needs. In other words, they are the ones working closest with patients, therefore they have the most important say in any decisions regarding patient care. The stories Gutkind includes are all very different, written by both male and female nurses at both the beginning and end of their careers, however, there are many common themes that bring this book together so well.

            All the authors of this book display passion and strength for this profession that is inarguably both demanding and mentally challenging. They share such contrasting experiences, many in completely different branches of patient care, however, all agreed upon one fact: they are stronger as a result of nursing. Each have their own “methods” of dealing with patient’s family.

Who compiled the Stories?

              As Lee Gutkind discusses in the introduction, the nurses in each of these pieces of writing share very similar stories- stories of survival, stories of heartbreak, stories of selflessness, stories of healing, stories of strength. Each short story in this collection is written by a nurse, and each tells a personal and emotional story about unique aspects of nursing, both the good and the bad. This book contains stories told by nurses in many different times and roles in their nursing careers, but they all come together to tell beautiful yet sometimes heartbreaking stories of their rollercoaster lives as nurses. We will use this book as the main source for our project by picking out our favorite and most memorable stories as we read and then combining the themes and messages to showcase the nursing profession in the most raw and true way possible. As Karen Wolk Feinstein states in the foreword, “Good healthcare is built on good nursing.”

                To understand why Lee Gutkind chose to compile a book of short stories by nurses, it helps to understand more about him and his background. The words his website chooses to describe him are “Writer, speaker, innovator” and states that he is a pioneer and best known for his creative nonfiction writing. He says, “I wanted to teach them how to write true stories that inform, entertain and compel readers to want to learn.” Therefore, his website was an excellent way to learn that through these true short stories in I Wasn’t Strong Like This When I Started Out, he wants us, the readers to learn something. Through our project, we hope to discover what it is we learn about women in nursing from the combination of these short stories and the knowledge we get from our additional resources.

Who Wrote the Stories?

             Karla Theilen wrote the short story “Listening and Other Lifesaving Measures”.  In her story, she focuses on the importance of actively listening, something she learned from her instructor Sally Kelly. Listening is an important skill for nurses to have in order to fully serve and treat their patients according to their needs. Furthermore, she discusses the bond a nursing student and her instructor begin to form, especially as they learn to trust one another.

             Nora Casper wrote “Nurse Nora at Nineteen”. When the book was published in 2013, Casper was pursuing a bachelor of science in nursing at the University of Pennsylvania. In other words, Casper wrote her entry while she was a nursing student. This provides a raw and fresh perspective of a modern nursing student and shows where a nurses head may be at before entering the “real work world”. She discusses the nerves that come along with this stage and the importance of learning from one’s mistakes. Her story provides a good reference point in contrast to the other stories, many of which are current nurses.

           Janice Dvorak’s short story is titled “Four Sticks”. Her story highlights the passion involved with patient care and the raw human connection nurses experience. She is now retired and her story is told as she thinks back on her life, giving it a wise and reflective perspective.

        Denis Elliot is a registered nurse working in palliative care. She has spent twenty four years working in both pediatric and adult nursing, giving her ample experience in different areas of nursing. Although it is not uncommon to move around in the nursing field, her writing provides an example of just how diverse different fields of nursing can be. Furthermore, the experiences she has had have provided her with a well rounded set of not only nursing skills, but people skills. Palliative care focuses specifically on maintaining pain and symptoms of patients as they all have life-limiting illnesses. These nurses make huge differences in the lives of patients, in contrast from the doctors who provide the diagnosis. Nurses are the most crucial figures in patient care as they have the most hands on and face-to-face interactions, a point that Lee Gutkind discusses in his foreword.

         Due to all being in different stages of nursing as well as being such unique women, this book really provides a great testament to the power and strength of nurses. As the title suggests I Wasn’t Strong Like this When I Started Out, all of the short stories have something in common. Nursing school as well as a career in nursing have made them rounded and strong individuals. Even without “credit” or recognition from society, these authors found new strength within themselves and grew as people. Gutkind combined vastly diverse short stories into a cumulative piece that is a beautiful testament to the heros that are nurses.

Historical Context

           Our book “I Wasn’t Strong like This When I Started Out: True Stories of  Becoming a Nurse” is a fairly recent book, published in 2013. There have been many accounts of nurses throughout history, as well as many contemporary issues that arise in this field.

           Nurses have always been on the front lines of patient care, making them extremely valuable in the say of policy or management changes that can affect these patients. They also make up the largest group of employees in the hospital. As a result, they can often hold huge “political” opinion within the hospital systems.


World War I created a high demand for nurses, particularly nurses with with special skills. About 23,000 nurses served in the military as they cared for the armed forces. About 78,000 nurses served in World War II, although after the war, there was a severe shortage of nurses due to the high demand of work accompanied by low pay and poor working conditions. The article goes on to provide more details on how nursing became what it is today, and how even in modern time, nursing still has its challenges.

             Knowing more about nursing in history gives good insights into how we as a society value these men and women today. In I Wasn’t Strong like This When I Started Out: True Stories of  Becoming a Nurse”, many of the authors include memories of their nursing schools, therefore looking into how the training of nurses have evolved gives us good context. Furthermore, the groups like the American Red Cross can relate to the different nursing groups or units that each of the individuals in our novel are a part of.


 There are many authors in this book and few of them are well known, so we decided to focus in on the editor, Lee Gutkind. Gutkind is known as the “founder of creative nonfiction.” Creative nonfiction is described as “true stories, well told,” and is often compared to jazz music in that “it’s a rich mix of flavors, ideas, and techniques, some of which are newly invented and others as old as writing itself” (creativenonfiction.org). There are many other authors that write creative nonfiction, however we were unable to find a source that directly compared any of the authors to Lee Gutkind.

           The book written by Atul Gawande, Being Mortal, reminds me of the book I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse in many ways. One major theme in the book is how active listening and being the patient’s advocate truly saves lives. When I read the short story in our book, Listening and Other Life Saving Measures written by Karla Theilen, I immediately connected it to this exact theme in Being Mortal. Theilen displays her shared belief  with Gawande that active listening is key when, “We needed to listen to and really hear the patients before the sacred work of nursing could begin. The simple act of listening, she told us, was a lifesaving measure” (Theilen, 158-159). 


All of the essays in this book were written by nurses who are writers too, nonetheless the quality of the writing varies considerably. Most of the nurses are very caring people who don’t flinch from some of the nastier jobs of looking after people with horrible personalities and/or disgusting illnesses that involve nausea-inducing exudations, vomit, pus and all the rest. One or two of them are very entitled people who seem to think that if nurses were put on pedestals and paid as much as investment bankers (they surely deserve that) it wouldn’t be enough, their feet should be licked clean by the masses.” – Goodreads.com 

             “Before reading the book I had the maximum amount of respect and appreciation towards nurses. After reading the book, it quadrupled. If you can afford reading only one book of non-fictional medical narratives this year, this book should be it!” (Yale Journal for Humanities in Medicine).

     These reviews offer very similar thoughts and themes for the most part. The New York Times points out a major theme of Gutkind’s book- that nurses are under appreciated. For a highly reputable journal as The New York Times to acknowledge this message is both influential and important. It shows us that society does recognize and understand how these nurses, men and women, are “semi-invisible” people. Our text is unique in that it is a fairly new book making it especially interesting to us as we are both aiming to enter to nursing profession soon. Although AIDS is not an easily discussed subject in our society, working as a nurse and sharing her story has pushed this particular author and many others to break these boundaries. This brings up one of the many themes in the book- nurses pushing boundaries and despite doing this, still not getting adequate recognition or “credit.” This is telling of our society because it also highlights how being acknowledged and appreciated is extremely important to humans in not just nursing but in any career. This is relevant to this class in which we discuss women in all fields who have worked and earned the right to this appreciation and credit that they deserve.

Works Cited

“American Nursing: An Introduction to the Past.” Penn Nursing Science,  Gawande, Atul. Being Mortal. Picador, 2017.

Gutkind, Lee, et al. I Wasn’t Strong Like This When I Started Out: True Stories of  Becoming a Nurse. Underland Press, 2013.

“Nurse Burnout: Overworked and Underappreciated.” Medical Bag, 15 June 2016, www.medicalbag.com/nurse-practitioners/nurse-burnout-overworked-and- underappreciated/article/472514/.

Uniform.” Pulse Uniform – Medical Nursing Scrubs, www.pulseuniform.com/coffee-time/25-famous-nurses-past-to-present-wolrds-popular-nurse-professionals/.

“Writer – Speaker – Innovator.” Lee Gutkind, leegutkind.com/

“25 Famous Nurses Past to Present World’s Popular Nurse Professionals | Coffee Time – Pulse