"Nancy" and Babs

On my way to work I usually got the "performance jitters" - you see, I was not the Nurse my patients saw each day, that was a role that I played; I played it well. Nurses Announcements Archive Article

Each shift "Nancy Nurse", my character, was efficient, intelligent, quick thinking, compassionate, organized, quick witted and funny. She also had excellent assessment skills, and even better intuition. She always "knew" which patients required closer monitoring - sometimes it was just a "feeling", but over the years - she learned her feelings were rarely wrong. This was "Nancy Nurse" - ER nurse extraordinaire!

Inside "Nancy" was her other persona, Babs. Babs was a good nurse, but prone to anxiety, self doubts, afraid of things she might see like bones protruding, arteries pulsating blood around the room, taking off the boot of the farmer whose chainsaw "slipped" and cut through the boot, or looking under the bandaged foot of the patient whose every step dropped maggots on the floor - or worse, the elderly man who shot away half his head but whose heart still beat so we had to "work him" even though we all knew what the outcome would be. "Nancy" got an adrenalin rush from these things, Babs did not.

Babs has seen lot's of things. She and "Nancy" once spent 8 hours taking care of an 11 month old who was found not breathing while sleeping face down on a water bed. Every one told "Nancy" that dead babies look like "beautiful sleeping china dolls", Babs noted this baby was mottled, gray and looked dead - nothing like a China doll - and Babs was very sad and confused and thought a lot about this over the 8 hours she and "Nancy" spent keeping this child "alive".

"Nancy" was excited with this new challenge. She expertly administered chest compressions, medications, LOTS of epinephrine and when the babies heart was beating on it's own, it was Babs that noticed she was pale, but at least didn't look dead anymore. "Nancy" monitored everything from the ET tube to the foley. Both waited during the snowstorm for the transport team to come to pick up the baby to take her to a pediatric ICU 45 min away. By the time the transport team got there, "Nancy" and Babs had spent the last half hour cleaning up the blood coming from the ET tube, her eyes, nose, ears, every place we stuck her with a needle, her rectum, and her foley. Both suspected DIC. "Nancy" gave the transport nurse a concise and efficient report - even nodding in agreement when the transport nurse said "This is a waste of time". Babs just felt exhausted, and very sad, and embarrassed because "Nancy" agreed with the transport nurse, but Babs didn't. It wasn't a waste of time. If nothing else, it gave the family a longer time to come to grips with the inevitable.

One day "Nancy" was eagerly awaiting a code that was on the way in with a 34 y/o female. She had been seen in our ER twice that week for chest pain. Babs was DREADING the patient coming in. "Nancy" took over - because she had to, she managed things that Babs found difficult to handle.

In comes this asystolic women, CPR in progress, intubated. "Nancy" put her on the monitor, verified ET placement, listened to lung sounds. Continued ACLS protocol - all to no avail. Babs was content to observe - she noticed things like voices of the family in the hall, jokes told by all those involved in the code, both she and "Nancy" heard when the code was called. Both knew this would be a coroners case, so all IV's, and tubes were left on the body. Babs washed up around her mouth, and put a pillow behind her head and covered her up with a blanket. Babs noted she looked like the color of clay - and she looked very dead.

"Nancy" efficiently recorded the code happenings, notified the coroner and looked over all the testing done on this woman on her two other visits to the ER that week. She had had CXR's, VQ Scan, many labs, EKG's, CT scan etc... all negative. On the second visit the ER doc wanted to admit her - she declined and signed AMA paperwork - "Nancy" made a mental note that that could have been the difference right there - perhaps a lethal arrhythmia that only showed up from time to time - if she had stayed - maybe she would still be alive.

Babs noticed a man pushing a stroller go into this woman's room - the chaplain was with him. Babs went in, after all, this was still her patient (and Nancy's as well). This was the moment that Babs and "Nancy" both saw the same thing - these two nurses came together for the FIRST time.

When they walked into the room, they noticed the body of the woman, she was center stage on the gurney, still gray and lifeless. Then both noticed a man sitting with the chaplain, both talking quietly, then both heard laughter and giggling, and keys jingling. It was then that they saw this baby, a beautiful one year old cheerfully throwing her arms up and down, jingling the keys and smiling - two feet from her gray, dead mother.

This, for whatever reason, was the turning point for "Nancy" and Babs. They became one. The haunting image of this beautiful baby with her dead mother will follow Babs forever.

After 8 years in the ER, this image, more than any other, took the joy out of the ER for "Nancy" and helped Babs see that she was probably never meant for the ER in the first place. Babs left within a month after that for another position.

Now Babs relies on herself. Her horror coping mechanism "Nancy" is gone. I hope to never need "Nancy" again.

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

to beginning, god gave you a great opportunity, but you chose to take it = what a marvelous gift :) so glad for you.

Specializes in Med surg, Critical Care, LTC.

Beginning: Thank you for YOUR honesty, and your kind words. Don't give up your dream, sounds like you would be an excellent nurse.

God Bless

To Beginning,

Don't give up on your dream - a nursing instructor in nursing school told me I should leave and look for another type of work - I've been a nurse now for 27 years.

You can do it and I admire your perseverance - you sound like you will make a great nurse!

Thank you so much, I too saw myself in this piece, so I did med/surg, but now I've decided to go with the "Babs" part of me. I am doing infusion nursing where once in a while, when I have a busy schedule or an infusion reactions "Nancy" wakes up in me. For the most part I am at a "babs" stage now.

:heartbeatWhat type of nursing are you doing currently? Do you like it or still miss the ER every now and then? I'd suggest you go into nurse education. I will be glad to have your experiences imparted to my children.

Specializes in Med surg, Critical Care, LTC.

Tolos: Thank you for you kind words. I do miss some aspects of the ER, but not enough to go back. We had two personal tragedies within my last two years in the ER which did have an impact on my decision to leave. I currently work in the PACU (recovery room), so I get to continue to use my critical care skills, for the most part, on "stable" patients.

I would LOVE to teach. Unfortunately that would require me to have a masters degree, which I don't, and I cannot afford to go back to school. Even if my employer were to cover my tuition cost, I would have to pay up front, they would reimburse me end of each year. They don't cover books or other fees. So teaching isn't in my future.

Glad you live with your "Babs" and that your "Nancy" is available to help when needed. I will be posting another article in the next week or two, (probably closer to two) - with another "Nancy" and Babs episode. (all are true stories by the way).

Thank you again

Babs

All I have to say is wow! As a 34 year old mother of a 1 year old girl I am freaking out a little though....

wow, how many times i wondered who that was.

What a fascinating story. Such a sad ending. Thank you!

Specializes in Mostly LTC, some acute and some ER,.

WOW!!!

That is great. I have found nursing to be a real struggle lately. Maybe that is something that would work for me.

Thank you for such an insightful story. I am a new graduate working in an ICU, and so far we haven't had too many bad situations. I am working on developing my own "Nancy Nurse", because "Babs" is alive and kicking. I enjoyed this story very much.

I really enjoyed reading your article! We all have that split personality thing going - sometimes my "Nancy" has to emerge to get me through a really tough day - and when I get home my true self becomes emotional and stressed and I don't know how I did it - but I did!

I'm glad I'm not the only one that feels like a spectator sometimes, or some situations make me feel like I'm there (but on overdrive or something).....

Great Job! :yeah::yeah::yeah:

Specializes in telemetry, med-surg, home health, psych.

I was so moved by your article....Boy, did it ever hit home....You are an excellent writer.....I look forward to future articles of yours...

Thank you for sharing !!:D