A Tale of Two Nurses

When my sister got very sick on her second round of chemo for colon cancer, she spent weeks in the hospital. Her first two ICU nurses were complete opposites- and both of them inspired me in my journey to become a nurse. Nurses Announcements Archive Article

A Tale of Two Nurses

It was the worst of times. My 42 year old sister's first couple chemo treatments for colon cancer went so smoothly, we were all surprised when she woke up unable to hold anything in either way, in pain. She was placed into the ICU, since they had only one other patient in the unit at that rural hospital. We were told not to visit if sick.

Since I also had stomach cramps and diarrhea, I stayed away for the four days it took to get over it, feeling guilty that perhaps I had somehow shared it with her, or given her food poisoning, since I was cooking for her family.

When I finally got to suit, glove and mask up to see her, it was such a relief to see her faint smile, even though she was sallow and gray, hardly able to open her eyes, let alone sit up. I asked how she had been. Not so good.

She asked me to please put the untouched dinner tray out of the room. The milk, ham, broccoli and potatoes scent was making her feel ill. Her nurse kept bringing solid food when she couldn't even keep water down. Beep. Beep. Beep. She grimaced in pain and clutched at her abdomen. I asked if she was on any pain killers. She told me yes, but the nurse had been swapping stories right outside her room at the station, and had given it to my sister 90 minutes late when she remembered. It hadn't kicked in yet.

Beep. Beep. Beep. She also was given Imodium as big as a horse pill to swallow, even though it came right back up. That was her only medicine for diarrhea. Beep. Beep. Beep.

She rolled her face to the side, and I saw that she had been losing clumps of hair. It was imbedded all through the pillowcase, scratching her. She tried to pick it off, but then gave up and asked if I could get her a new one. Beep. Beep. Beep. I poked my head outside the door. No one around. No one to stop the incessant beeping, or to tell me where the linens were, but I saw a cart, and grabbed a pillowcase.

When I went back in, my sister had thrown up again, and was writing down the volume, as her nurse had instructed her to keep track of her fluid intake and output. Beep. Beep. Beep.

Can we do something about that noise? What does the doctor say? My sister hadn't seen him for days. He came in one night while she was asleep, she is told. Beep. Beep. Beep.

What does the nurse say? Nothing. Just takes the vitals and says maybe the doctor will come visit tonight. Beep. Beep. Beep.

As I was about ready to knock over the machine and stomp on it to get rid of that sound, her new nurse came into the room, introduced herself, apologized, and made the noise stop. She rested her hand gently on my sister's arm and asked how she was. When I told her I had some questions and concerns, she listened carefully to each one. She told me the procedure to request a liquid diet, suggested we could get my sister some Imodium that dissolves in the mouth ourselves, since the hospital did not provide it ever, and then brought her some herbal tea to sip on.

She made my sister feel cared for, and human. She made me see the difference between a nurse who keeps patients alive, and a nurse who adds care to the basics. The other nurse, she also showed me something. She had been an ICU nurse for over twenty years, so she obviously knew her job. My sister was still alive, hydrated, and her potassium levels were getting to where they needed to be. But nursing should be much more than that. And I want to be a nurse who makes that difference of caring in patient's lives.

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BookishBelle

About BookishBelle

Nursing student; piano teacher

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

Thank you for sharing this. It's easy for us nurses to go on "auto-pilot"; however your post reminds me of the reasons why we should be cognizant not to do this. Our pts are humans deserving individualized care.

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Specializes in ICU; Telephone Triage Nurse.

I'm glad your sister is feeling better and doing well enough to go on vacation with her family.

You know sometimes the little things make all the difference to someone who is inpatient: a clean pillow case, a blanket straight from the warmer, a cup of tea or coffee, a smile, a bit of extra attention. It costs so little, but means so much.

I think we should all aspire to be that nurse. You never know when it will be you or a loved one who will be admitted next. Being on the other side of the patient care stinks.

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Specializes in Travel, Home Health, Med-Surg.

Sorry you both had to go through this, hope your sis stays well! Sounds like nurse #1 could have done more (for what ever her reason). We all need to be aware of our actions/lack of actions. Working in oncology can be very demanding for a number of reasons, not everyone is cut out for it.

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I'm glad your sister is feeling better and doing well enough to go on vacation with her family.

You know sometimes the little things make all the difference to someone who is inpatient: a clean pillow case, a blanket straight from the warmer, a cup of tea or coffee, a smile, a bit of extra attention. It costs so little, but means so much.

I think we should all aspire to be that nurse. You never know when it will be you or a loved one who will be admitted next. Being on the other side of the patient care stinks.

So true- thank you very much!!

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Thank you for sharing this. It's easy for us nurses to go on "auto-pilot"; however your post reminds me of the reasons why we should be cognizant not to do this. Our pts are humans deserving individualized care.

Thank you for this!

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Sorry you both had to go through this, hope your sis stays well! Sounds like nurse #1 could have done more (for what ever her reason). We all need to be aware of our actions/lack of actions. Working in oncology can be very demanding for a number of reasons, not everyone is cut out for it.

Thank you for your well wishes!! Unfortunately these nurses were both in ICU, with only my sister and one other patient, so it wasn't that they were overworked. She was having a lot of personal problems, as I can attest from having to listen to them for an entire shift! She kept retelling than to each co-worker she ran across, and then called a few people who might not have heard. As my sister's room was right in front of the nurses station, I got to hear it over and over.

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Another perspective was that the first nurse had a patient in a lot worse condition that needed her attention rather than an annoying but non life threatening beeping sound and the expected diarrhea, nausea, vomiting, and hair loss from chemo of a patient that is alert and oriented enough to capture and measure their vomit.

I bet this nurse was busting their ass caring for someone really needing her, like keeping someone alive. Or maybe not, but I'm open to other perspectives.

What I think you might have seen was the current state of some hospital administrations. One nurse can't do everything, but they are expected to, with their license on the line, because the hospital is thinking money.

edit: I read your other comments about the nurse spending a lot of their time telling dramatic stories about their life... Yeah, I know a couple of those and I hate working with them.

There is one nurse that stood outside a room, tapping her foot, waiting for me to finish helping a patient who was very hypoglycemic. She didn't bother to ask if I needed help. Just waiting for me to finish up so she could take her break.

Wishing the best to you and your family.

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Another perspective was that the first nurse had a patient in a lot worse condition that needed her attention rather than an annoying but non life threatening beeping sound and the expected diarrhea, nausea, vomiting, and hair loss from chemo of a patient that is alert and oriented enough to capture and measure their vomit.

I bet this nurse was busting their ass caring for someone really needing her, like keeping someone alive. Or maybe not, but I'm open to other perspectives.

What I think you might have seen was the current state of some hospital administrations. One nurse can't do everything, but they are expected to, with their license on the line, because the hospital is thinking money.

edit: I read your other comments about the nurse spending a lot of their time telling dramatic stories about their life... Yeah, I know a couple of those and I hate working with them.

There is one nurse that stood outside a room, tapping her foot, waiting for me to finish helping a patient who was very hypoglycemic. She didn't bother to ask if I needed help. Just waiting for me to finish up so she could take her break.

Wishing the best to you and your family.

Unlike the many fine nurses I read about here who are running from crisis to crisis, totally overworked, this nurse had two patients (one my sister) and the other one who was also alert and sitting, no crash carts or emergencies every time I walked past. She just had a lot of taking about her personal problems to do.

I'm not a nurse yet, so maybe it is normal to give people medicine by mouth that they then vomit up for four days. To me that seems like a waste of time and medicine. I appreciated the other nurse's novel solution- get her medicine she can't throw up.

Also to bring someone solid, undigestible, odiferous food 3 times a day for four days when they don't ever touch it seems like a waste. And somewhat cruel, since the smell is sickening. Why not apple sauce? I still don't understand why that happened. Maybe after nursing school it will make sense.

The nurse had put a measuring cup thing directly into the toilet, so my sister was supposed to write down the ml of things that came out of her. She wasn't all that good at it, since by the time she got back into bed the number had left her mind. I appreciated how the other nurse wanted to do that part herself, rather than get my sister to. She said that you can tell a lot about how a person is progressing by seeing what comes out of them.

She may not have seemed like her life was threatened to someone who sees this daily (and it certainly helped when the doctor let me know a few days later that they could keep her fed on of for weeks) but for me with her unable to eat or drink for days, gray skinned, not getting better, I was afraid she was dying. Then. Not waiting for the cancer to get her. So it was particularly jarring to have a day nurse who was consumed with her own drama.

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Unlike the many fine nurses I read about here who are running from crisis to crisis, totally overworked, this nurse had two patients (one my sister) and the other one who was also alert and sitting, no crash carts or emergencies every time I walked past. She just had a lot of taking about her personal problems to do.

I'm not a nurse yet, so maybe it is normal to give people medicine by mouth that they then vomit up for four days. To me that seems like a waste of time and medicine. I appreciated the other nurse's novel solution- get her medicine she can't throw up.

Also to bring someone solid, undigestible, odiferous food 3 times a day for four days when they don't ever touch it seems like a waste. And somewhat cruel, since the smell is sickening. Why not apple sauce? I still don't understand why that happened. Maybe after nursing school it will make sense.

The nurse had put a measuring cup thing directly into the toilet, so my sister was supposed to write down the ml of things that came out of her. She wasn't all that good at it, since by the time she got back into bed the number had left her mind. I appreciated how the other nurse wanted to do that part herself, rather than get my sister to. She said that you can tell a lot about how a person is progressing by seeing what comes out of them.

She may not have seemed like her life was threatened to someone who sees this daily (and it certainly helped when the doctor let me know a few days later that they could keep her fed on of for weeks) but for me with her unable to eat or drink for days, gray skinned, not getting better, I was afraid she was dying. Then. Not waiting for the cancer to get her. So it was particularly jarring to have a day nurse who was consumed with her own drama.

I don't know that you'll "understand" more by going through nursing school, but you'll definitely see more of both types of nurses. I disagree with the idea that the first nurse was meeting minimum standards of good patient care. It's one thing not to spend time chatting or to not pat someone on the arm. It's another to fail to meet a patient's most basic needs (meds that will get absorbed, tolerable nutrition - you don't need a special order to try oatmeal or applesauce!) and to expect an ICU patient to track their own intake & output for you. That is the NURSE'S JOB. I'm fairly burned out right now but I would never treat a patient that way.

I'm glad you experienced what it's like with a better nurse, and I'm sure the experience will help you to be a better one yourself.

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Specializes in Med/Surg/.

Well first off I am sorry you had to go thru that.....I worked oncology for 5 yrs. and i assure you they never had a regular diet after chemo unless they were able and had no nausea issues. That could have been stopped with IV med which she apparently didn't get...That would have helped her in all her other areas. Everyone is different on chemo so trial an error sometime are necessary on diets....I am so glad she is well enough to enjoy her life..

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Thank you! It seemed pretty odd to me... She was on iv meds, several of them, so I was surprised they also made her take (big) pills by mouth.

Well first off I am sorry you had to go thru that.....I worked oncology for 5 yrs. and i assure you they never had a regular diet after chemo unless they were able and had no nausea issues. That could have been stopped with IV med which she apparently didn't get...That would have helped her in all her other areas. Everyone is different on chemo so trial an error sometime are necessary on diets....I am so glad she is well enough to enjoy her life..
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