A nurse looks at what nursing means. Some of the things we see are heartbreaking, and some is beautiful. Much of it affects us, and some of it we carry forever. I've carried a lot with me over thirteen years of nursing. Here's a glimpse...
Every so often, a thread pops up around here: "What's in your pockets?" In other words, what do you carry that you know you'll need before your shift is up? Most of us carry alcohol swabs (never enough of those), penlights, probably a syringe or two, some 2x2s, tape, and it's a running joke on my unit that real nurses carry hemostats.
And heaven help the soul who arrives at the end of shift and can't find her brain sheet. That's painful in a way only a nurse can understand.
Not too long ago I stopped to help at the scene of a vehicular accident as I was driving into work. Looking at the single car involved, it was a miracle anyone survived, much less had a patent airway. One of the other first responders had gloves for us but PPE can be a bit limited when you're standing in the middle of a highway. Back to the point, I got back in my car and got to work a little late; as I was driving in, I noticed a smear of blood up my arm that wasn't mine. Not ideal, but it happens.
I got to work, gave everything a good scrub, and got thinking.
All these things I've mentioned are visible things we nurses carry with us, sometimes permanently and others not. But we carry so much with us that no one will ever see or know about. It's usually a mix of (to quote a classic movie) the good, the bad, and the ugly.
What do I carry?
I carry with me the tears of a father that he cried over his baby who never had a chance to take his first breath. The baby they'd tried for four years to have.
I carry with me the woman who had lived with domestic violence for over two decades, her arms covered in scars from shielding herself as he attempted to stab her to death. "No matter where I go, he will find me and kill me," she said.
I carry the gratitude of a twenty-something man who had what was then called 'full-blown AIDS' and still being written off by too many as a 'gay plague' and other nonsense. He was dying and he knew it, suffering from horrible neuropathy and on amounts of morphine that would knock everyone I know into the next world. It barely touched his pain. No one ever came to see him. I'm not sure which hurt him worse. We bonded over the course of several days and he mentioned in passing that he was really craving a Butterfinger. Hospital policy dictated that we weren't supposed to bring food to patients, but I pretended not to know that when I got a couple of Butterfingers from the gift shop (yes, he was still on a regular diet). The look on his face when I snuck them into him.....I can still see it. He died a couple of weeks later.
There are the twin daughters of a patient who was with us for months before she died. I remember their names and faces. They were never anything but kind and grateful for the care their mother received, even when they had their grief over her impending death to smack them in the face every day.
I carry the exhilaration and happy tears shed when men and women become fathers and mothers. The delight that overtakes a new mom when her baby looks at her like he's known her forever, or a daddy when a contented baby falls asleep on his chest, is something that can't be bought.
I carry the memory of a 13 year old in labor. My gut told me then and still that her own father was the baby's father. During her long labor, which resulted in a c/section, he verbally abused the staff and before 24 hours was up, he was banned from the facility. She had a long recovery, including an ileus that required a second surgery. She had no visitors for two weeks, was afraid of her baby, thought she wouldn't get to take the baby home with her. The staff started "mothering" her....we bought fun gowns for her and grannie panties to wear over two incisions instead of the ugly mesh ones, decent shampoo, hair clips. I personally got into the shower with her to help her shampoo her hair and then I braided her hair. This was a kid you couldn't touch on the shoulder without her recoiling. We did 1-1 care as much as staffing would allow. I carry the memory of the night before her discharge. Before I went home, she said "I am going home tomorrow and you won't be here yet". I said that was correct. I will hold in my heart forever what she said next to me: "will you give me a hug before you go home tonight?" That was at least 15 years ago and every second I spent with her for those two weeks is etched in my very soul.
I carry with me the 5 month old child with bright blue eyes, brought into the ER, who's caregiver drugged her with Benadryl then propped a bottle in her mouth where she aspirated. I was the one chosen to meet the parents as they ran into the ER and place them in a room all the while not answering their questions about their child. I have never forgotten the anguished cry they both had when told she was gone.
I was the one standing beside the bed of a 88 year old woman who's husband of 63 years is looking at his wife asking me "What will I do, she is my bride "as his bride is taking her last breaths.
I was the one standing beside the bed of a 5 years old girl who's father has molested her and then tried to drown her in the tub, as her mother comes running in screaming " No" "No" "No' then collapses while having a stroke.
I was the one standing in the room, waiting on EMS to bring a Cardiac Arrest then realizing it was my uncle we would be doing CPR on to bring him back to life.
I carry with me the 14 month old baby who's mom had thrown a boiling pot of hot water on him cause he cried. Changing his dressings and hearing him cry due the pain always turned me into a red faced crying mess.
Not all of my nursing has been seeing the worst, I have had the pleasure of seeing Miracles while working in the ER, people brought back to life, moms giving birth with joy and seeing happiness as they hear that first cry of their new baby.
Even on the worst days I know being a Nurse is what I am meant to be. I am blessed beyond measure to be able to help people and be part of some of the worst and best times of their lives.
I carry the patient who had published multiple scientific findings, educated, refined, having raised educated and refined children now with it just enough to know he is confused, combative yet still somehow charming, restrained to his bed due to multiple, unfailing, passionate attempts to rid himself of all medical devices and interventions and go home to die.
I carry the memory of my first death, a 44 year old woman, nonsmoker, healthy, fit....drawn low by end stage lung cancer. I carry how she cried out mere moments before her death, staring at the ceiling in wonder "Amen! Amen! Amen!". I carry her husband's relieved and loving acceptance as he bid her farewell for the last time. I carry also the memory of her mother telling me my conscience was between me and God, her anger at the loss of her child unable to land on anything but the baby nurse who could not save her daughter.
I carry the memory of the dying man whose family finally succumbed to acceptance and placed him on comfort care. All he wanted from me was water, having been NPO and tube fed for weeks. I will never forget the blissful relief on his face, his gurgling proclamation of "Wonderful!", barely audible as he swallowed the water I brought him. He died mere hours later.
I will never forget the man who had been thrown from his vehicle, had a brain bleed, was recovering nicely and who decided the day before he left the hospital was a good time to verbalize not his thanks but his fury at his favorite jeans being cut off his body at the scene of the accident.
So many more.
But primarily, I carry the memory of my 13 year old son, body decimated by pneumonia post bone marrow transplant. I will never forget his solemn, adult-like instructions not to keep his body artificially alive if he could not truly live. I will never forget asking him, as he struggled to breathe, if he were afraid and he quietly told me "no". I'll never forget the awful decision to allow the ventilator and never forget the horror of the decision that had to be made three weeks later. I will never forget my inability to continuing singing to him as the machines were turned off, my weak inability to keep my hand on his chest and feel his erratic, fluttering heartbeat fade and then stop. I will never forget how his courage changed me and propelled me into the reality I now live, keeping his experience close to me, anonymously and with inner hope fueling my ability to help others in their dark hours of fear and illness until my life is done. His cancer journey was the most difficult thing I have ever done. When being a nurse gets hard, I remember him. It is good to have a personal reason to push through the foibles and nonsense our medical system can be.
My condolences to you. Your strength is impeccable.
Specializes in peri-operative, rheumatology, renal.
Thank you so much for sharing your personal experience. I am so sorry for the loss of your son. I lost two little nephews (ages 8 months and 2 1/2 yrs old) in a car accident and know how devastating the loss of a child is. Also have a friend who lost her 13 yr old son to brain cancer. Certainly a reminder that this life is short and precious. God bless you for your continued compassion towards your patients. I would want you as my nurse!
I try very hard to put down all that I carry in the locker room with the contents of my pockets (I can't believe that there are actually nurses that don't carry hemostats) before I leave every morning.
Thank god for this post. I have always wanted to talk about the patients that haunt me.
my ones:
the man who hung himself in his closet in a nursing home with a scarf because he couldn't go on living that way anymore.
the 26 year old man who became a quadriplegic after a car accident- he was the reason I refused to work in med/ surg/ spinal/ rehab wards. I couldn't cope with the lives that were decimated and changed beyond repair.
The 40 year old man living in a nursing home because he was severely depressed and suicidal in life and tried to kill himself with carbon monoxide. It left him so brain damaged he was like a child. He'd spend his whole life in a nursing home surrounded by people twice his age- there was no other suitable accommodation for him other then locked psychiatric or locked dementia- and locked dementia was deemed less stressful and more homelike rather than a hospital psych ward.
the man at my last nursing home who everyone complained about- refusing medications, refusing care- then yelling at the nurses and doctors because his condition was worsening and we were all "terrible nurses/ doctors" despite the fact he was refusing all treatments. You never knew what hew as going to yell Or cry about next- it was terrible. His lungs were failing him and he was dying a slow agonising death and it was brutal, heartbreaking, soul destroying to watch. The day he knew he was dying, he chose to do so in hospital, so I was sent to sit with him while we waited for the ambulance. I have never felt so guilty that all the nurses thought he was so annoying and hardworking, so angry and grumpy all the time- those last few hours he was a different person. He told me his life story and his greatest regrets- he'd never even made love to a woman even though he always wanted a wife or someone to love- he was a terribly lonely man with no family or friends, who'd missed out on love and sex. He was on the edge of hysteria over his fear of death- he was crying loudly about how scared he was. All I could do was hold his hand and try to tell him how physically it would be- that his pain would be controlled, he could be sedated so his breathing problems would not distress him, they'd sedate him so he would feel calm not distressed... He believed in god so we talked for a long time about his belief on heaven and afterlife- the idea of heaven comforted him.
ill never find out what his death was like- he went to hospital. But I prayed so hard when I got home to the god he believed in that he could be allowed to die without pain and in a calm state of mind- I hoped there was a nurse who could comfort him at the hospital and a doctor who could ease his pain and anxiety.
the last one was a woman in her 40/ who had advanced multiple sclerosis. Over the months I knew her she lost the ability to talk, she lost heaps of weight, she lost what was left of her ability to move (she couldn't walk but had been able to use her hands- she lost almost all that. Then she lost the ability to swallow and had to make the terrible decision of "starve to death now or extend the misery of multiple sclerosis with a feeding tube". The decision destroyed her- she had a 20 year old son and she cried and cried all day and all night for months on end because even with the tube she wouldn't get to see what his life would become- him graduate and get married and have kids. She used to talk about how she'd give anything to walk out of that hospital with him- to watch him grow up. She loved her son with all her heart. And she was terrified of how she would die- the prediction was that one day it would get harder and harder to breathe. Most of all she feared what her death would do to her son, who was clearly traumatised and grieving. Many nurses couldn't cope with her extreme emotional distress- looking back I now believe they should have put that poor woman on some antidepressants or sedation, and given her some counselling, she was suffering mentally and there was no psychiatric help for her. I wonder why- surely there's help for people in that kind of suffering?
after she got the tube she could move to a nursing home but she came back to our ward heaps with infections, tube problems, pressure sores- you name it. She felt like a friend to me. I dearly cared for her and often asked to be allocated to her care, which they always let happen because she loved having me as her nurse, and for some reason I was able to cope a bit better with her distress then some other nurses did- it was the most amazing time of my career that i could care and look after her- I somehow managed to calm her and help her find peace during my shifts with her. We shared genuine moments of joy and laughter and she often thanked me for bringing her some happiness.
she asked me many times to come visit her in the nursing home, which was just down the street, because I quit the ward to work somewhere with less pain and suffering- and I promised her I would. I was her friend as well as nurse.
But I never did. I couldn't face it. I'd grown too close and I just couldn't bear it- I couldn't watch her fade away anymore.i just couldn't. I can't forgive myself for that- I was selfish. I failed her. She was scared and alone and suffering and for some reason she liked me and got close to me and considered me a friend as well as nurse- and I let her down. I never got the courage to go and see her. Her needs we're greater then mine- she needed me to visit her more than I needed to protect myself. Didn't she? And yet I chose to protect myself.
rationally I know that I did what any nurse has to do- to protect myself emotionally because at the end of the day we are professionals and we need to protect out own hearts and minds so that we can continue caring for others- we can't let one patient destroy us. I had to cut myself off from her if I was to keep my career and not become destroyed by it- I know that. But I'll never stop regretting it- because I wonder if she blames me, or dislikes me, or feels betrayed that I dint come to see her. It's been two years and I know she's still alive but I also know I'll never go to see her. I can't face it. I hope that maybe she has forgiven me, and there are other nurses at that nursing home that can give her the love I just couldn't anymore.
i found some measure of peace when I ran into a Nurse who worked at her nursing home by chance- as soon as I realised it was the same nursing home, I asked about my old patient. She was the favourite on the ward- everyone loved her and pitched in to care and offer her friendship and love. She'd come to terms with her distress and impending death- she'd founds. Place of peace.
thsts the way I'll choose to remember her- I don't want to go and see her. Can I be forgiveness or that? Am I a horrible selfish person?
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank god for this post. I have always wanted to talk about the patients that haunt me.
i found some measure of peace when I ran into a Nurse who worked at her nursing home by chance- as soon as I realised it was the same nursing home, I asked about my old patient. She was the favourite on the ward- everyone loved her and pitched in to care and offer her friendship and love. She'd come to terms with her distress and impending death- she'd founds. Place of peace.
thsts the way I'll choose to remember her- I don't want to go and see her. Can I be forgiveness or that? Am I a horrible selfish person?
NO you aren't horrible...you survived. Sometimes we do need to leave the environment if it gets too much ((HUGS)) I think you were there for what you could giver her. and that is more than anyone can ask for.
I carry the regret of not doing more...Three months after starting working as a CNA in the hospital, I took care of a man with no family or friends. He has a big open abdominal surgery and the first few days was doing well. Every morning, we would talk while I helped him bath and got vitals and weight. One the 3rd day, he was different and things changed within a few hours. The nurse was in the room and I had just completed our daily routine a little over an hour before. I was telling him to breathe and he would breathe. The next night, he was doing "ok." I explained to the new nurse what had occurred over the weekend and expressed my concern that I did not think he would make it through the night. I did my rounds to collect vitals. Once I sat down, I got a strange feeling. I asked the nurse if she had checked on the man. She said yes. I went to the patient's room anyway...the man had died...alone...
I carry the memories of stories from each patient I have had the honor to take care. Whether the patient noticed me or not. I carry the memories of pain, anger, hate, happiness, and love my patients (who are mainly veterans) carry everyday. Each of their story touches me. Three veterans have really etches those memories in my heart...
One was a POW in the Korean war. So grateful of being cared for. Things got rough and complications got worse. The patient began having flashbacks...swinging and fighting with all his might. During this time, his son came in and was in tears. He stated "I have never seen Dad like this." I let the son know what was going on, but the son got scared and left. The patient came back around and apologized for his actions which he did not know what occurred. The POW had tears in his eyes as he thanked me for taking care of him.
The second is a veteran who had a lung removed related to cancer discovered during a CT scan for back pain. A patient with severe PTSD, who's only comfort was his wife. After multiple nights of working with the patient and his family. This strong man did not have to have is wife within hands reach and was sleeping the best he had for years (per the wife). I heard their story and also discovered their oldest son was dying of a brain tumor which was not operable. The last night I took care of this patient, he told me I was his angel and thanked me for the time I spend with him and the care I gave. He had tears running down his cheeks and a smile on his face. He said he feels free. I wished him luck because he was going home. His wife followed me. She had tears in her eyes and with a big hug thanked me for everything I did. She said it was the first time she had ever seen him so calm and feeling his feelings.
The third and last I must speak about right now is a veteran ventilated who had bilateral neck dissection with a hemiglossectomy. The first night he was very sedated. The second night he was lightly sedated, but in a lot of pain and still vented. The family came in to visit and I had to ask them to leave related to substantial elevation of heart rate and blood pressure. He had tears in his eyes and was withdrawn. I gave him more pain medication and talked to him, trying to calm him down and letting him know it was ok to be scared. He opened his eyes and looked directly at me with tears still running down his face. I told him how strong he was for staying so calm on a ventilator with minimal sedation. I told him I was watching him right out his room and to get some sleep. I can't say he slept much but he was calm. In the morning, I did my routine of assessment, labs, bathing and changing bedding. I always talk to the patient and always let them know every detail. At one point he indicated that I talk to much with a twinkle in his eye. After getting him comfortable that morning, of course the physician awoke him. Strutted into the room and jammed his fingers in the patient's swollen and very painful mouth. The patient looks to me with tears in his eyes again. I increased his sedation and pain medication as the physician continued to dig in the patient's mouth for a good 20 minutes. After this the only thing the physician said was "Looks good" and leaves. The patient looks at me in tears. I started to talk. He asked for paper to write and told me I was great because I took the time to talk. I of course was in tears, but said "but I thought you said I talk too much?!" He smiles and mouths "thank you." three days later the patient was out of our unit, but I ran into him on his checkup. He gives me a big hug and verbally tells me thank you with tears in his eyes. I told him how great he looked especially without a tube in his mouth. He gets a big grin and tells me to continue to be an angel.
Whether the memories are positive or negative they all have a special spot in my heart. I will never forget the strength of the patient's fight life or death and eventually finding their inter peace. even if that peace for them is anger and hate. These are the moments I cherish and why I love my nursing job.
1. Watermelon....Initially, Ms. C was placed in a NH due to dementia after she was evacuated from LA during the Hurricane Katrina chaos. When it was discovered that the dementia was caused from end stage AIDS, she was admitted to my floor at the state mental institution because the NH couldn't handle her violent behavior. According to them, she tried to bite someone. However, Ms. C never tried to bite me or any of my patients for the year that I took care of her. AIDS had infected her brain so badly that she couldn't tell me her name, the date, where she was from, or where she was. The only thing she could say was "watermelon" . She must have said "watermelon" five-hundred times a day while she rocked back and forth in her chair. Sometimes she yelled "WATERMELON" as loud as she could. Other times, she whispered "watermelon" so quietly that you had to strain to hear it. One afternoon, Ms. C was shuffling back from the bathroom when she collapsed in the floor. I rushed into the hallway and saw that she wasn't breathing. I called a code, but it was too late. Before the crash cart arrived, she had died in my arms.
2. Opal.....Ms Opal worked at the state mental institution for 30 years. Our facility housed the most violent, high acuity, psychiatric patients for our regional area. These were the patients that no other psych facility could take because they were either too violent, to much of a security risk, or too high acuity. For our patients, it was the end of the line. Ms. Opal had seen and cared for the worst of the worst on a daily basis for her entire 30 year career. However, she was the most positive, good-hearted woman that I have ever met. On one particularly bad day, I was ready to give up. With my head in my hands, I asked her, " What can I do for all these people ? " I will never forget what she said to me, it guided my practice, saw me through many hard times, and has stayed with me, always. She said, " Sugar, sometimes all you can do is feed them, clothe them, and give them a soft place to fall..."
3. Sunshine.....Sunshine was my favorite ED tech and my good friend. We had each other's back. We worked as a team. We were alike in a lot of ways. We both loved animals, plants and flowers. We had many long conversations about life, our experiences, our choices, and our dreams during those early morning hours on the night shift...My friend took her own life...I didn't see it coming...
4. Transmitter....This patient came in for abd. pain. When the doc reviewed his CT results with him, he said, " No. You have to do it again, but this time you need to make sure that it has very fine slices because the transmitter is very small..." He thought that the surgeon who removed his gallbladder put a transmitter in him that was broadcasting to the CIA....When we moved him to a secure room to wait for his police escort to a psych facility. He looked at me with this cold, black stare: straight, dead in the eye and said, "I'm not crazy. You're crazy. I'm going to kill you."....He got out of the psych facility 3 days later. He took a cab to the neighboring hospital,and told the driver to wait. He went into the lobby, pulled out a gun, shot 3 people and then he shot himself......
5. . Pain pills and a dinner tray.....One afternoon in the ED, the tech brought a baby back to one of my open rooms for me to triage. Right away, I noticed that he was dirty, unkept, listless and pale. I called another nurse in get a second opinion when his eyes rolled into the back of his head, went limp as a dishrag, and he stopped breathing. We coded this baby for 45 minutes before we got him back...The 2 RTs and myself started to run towards CT with this critically-ill baby on a stretcher, pushing an IV pole c: multiple drips, and the vent, one of my other patients tried to stop me in the hallway and started screaming at me because she hadn't gotten her prn pain pill and her dinner tray.....
Her selfish, self-centered attitude has become so typical for the majority of patients and their families. Her arrogance, inflated ego, and total disregard for that dying child became the catalyst for the decision that I made that day, at that very moment to not only leave the ED but the bedside, as well.....
"...How do you pick up the threads of an old life. How do you go on. When in your heart you begin to understand there is no going back. There are some things that time cannot mend. Some hurts that go too deep ...That have taken hold..."
What a lovely post This made me stop and think about my past years of nursing and many things I haven't thought of in ages. Thank you for sharing with us.
What I carry with me, well one of many is the patient that came into our rehab unit after having a CVA. She wasn't able to walk, talk feed, dress or bathe herself when she came in. With a lot of hard work and determination on the rehab team and the patients part, when she left she was walking, talking and could perform all ADL's herself. I'll never forget this lady, she holds a special place in my heart et memories and always will.
tntrn, ASN, RN
1,340 Posts
I carry the memory of a 13 year old in labor. My gut told me then and still that her own father was the baby's father. During her long labor, which resulted in a c/section, he verbally abused the staff and before 24 hours was up, he was banned from the facility. She had a long recovery, including an ileus that required a second surgery. She had no visitors for two weeks, was afraid of her baby, thought she wouldn't get to take the baby home with her. The staff started "mothering" her....we bought fun gowns for her and grannie panties to wear over two incisions instead of the ugly mesh ones, decent shampoo, hair clips. I personally got into the shower with her to help her shampoo her hair and then I braided her hair. This was a kid you couldn't touch on the shoulder without her recoiling. We did 1-1 care as much as staffing would allow. I carry the memory of the night before her discharge. Before I went home, she said "I am going home tomorrow and you won't be here yet". I said that was correct. I will hold in my heart forever what she said next to me: "will you give me a hug before you go home tonight?" That was at least 15 years ago and every second I spent with her for those two weeks is etched in my very soul.