Ready for Christmas

nfriddle, RN

"Any change today?" I asked the nurse at her bedside.

"Not really," she replied. "She has been unresponsive like this ever since she came back from the O.R. on Friday."

"What happened to her last week? I didn't get the whole story."

"They brought her in with a fractured shoulder and she coded in surgery. It took a long time to get her back, and if you ask me, she would be better off if they hadn't succeeded."

I looked outside at the snow clouds forming, and tried not to think about the Christmas shopping and decorating i had planned to do before the phone call that morning.

"I know you have family coming tomorrow, but there is an ICU patient who needs a dialysis treatment and I don't have anyone else to send." The Charge Nurse knew I would be torn between the need for a day off and the lure of overtime pay so close to Christmas.

Seeing the inert body of my patient, I could not help thinking, "Maybe she and I would both have benefitted from me taking the day off."

Cheri and I had become aquainted back in the summer, when she was hospitalized after experiencing a hypoglycemic seizure at her outpatient dialysis clinic. A brittle diabetic since the age of eight, Cheri's unstable blood sugars had not only eroded her kidney function, but had diminished her mental function as well. Poor judgment led to poor lifestyle choices, and eventually to alienation from family and friends. Now homeless, her meager resources were used to purchase cigarettes rather than insulin. She showed up for dialysis when she felt like it, and adhering to a special diet was out of the question.

Her easy smile and childlike demeanor had made her a favorite of the dialysis staff. Still, experience taught us that as one of our so called "noncompliant" patients, Cheri would have a short and difficult life.

Setting up for dialysis was a familiar routine. I hooked up to water, power and monitoring equipment. I primed and tested the machine, and gathered the supplies that were needed. All the while I was unconsciously humming the tune to "Away in a Manger." That was when I realized that Cheri was looking at me. Really looking. Eyes wide open, she was watching me as I moved from one side of her bed to the other. Impulsively, I reached for her hand.

" Cheri, do you know this song?"

I was sure I saw a faint smile, an almost imperceptible nod. Feeling self-conscious, and a little silly, I held her hand and sang all three verses of that Christmas lullaby, moved by the realization that there really was somebody still "in there." I finished with the last line:

"Bless all the dear children in thy tender care, and take us to heaven to live with thee there."

Our gaze broke and so did the spell. I went back to work and Cheri slipped back into semiconsciousness. She died the next day, and the Charge Nurse apologized for having wasted my time, depriving me of the opportunity to get ready for Christmas. I never told him just how wrong he was.