Ruby's Marbles

Having been a nurse for almost thirty years, I remember the days when we had time to sit and interact with our patients. In today's world of JCAHO, HIPPA, PYXIS medication dispensing systems, computerized charting, and bottom lines, I fear that our patients lose out on those special moments of nurse/patient bonding. Nurses Announcements Archive Article

Ruby's Marbles

In the early 90's I was working as a travel nurse in a small town in Wyoming in a 75-bed hospital that was just embarking on the world of computerized charting. I was frustrated as I was used to charting long-hand on paper...hmmmmm, those were the days. This particular system used a care plan-type system where we did our documentation to address every aspect of each patients plan of care.

I'm sure my frustration was showing when I entered ruby's room for the first time. She was one of those 80+-year-old, tiny little ladies who scarcely made a lump in the bed covers. She had old lady blue hair and lots of pink rouge on her cheeks. The skin on her hands was paper thin and covered with age spots. Her knuckles were large with arthritis, but she still managed to polish her nails, hot pink. She had come in to have her esophagus dilated as she was having difficulty swallowing. She was a "frequent flyer" to this particular hospital and knew her way around medical terminology and was in touch with her body.

She asked me if I had time to sit with her for a few minutes. Sure, I thought, why not? I'm only two hours behind on my charting. I did, however, sit down and we got acquainted. Getting to know Ruby that day made an impact on my life that I have never regretted.

The next time Ruby came in, I made sure I was her nurse and was anxious to continue our bonding. This time, however, she came in with a T.I.A. She recognized me but was unable to verbalize what she was trying to tell me. So when I could break away from the computer I made sure to just go and sit with her and hold her hand, and even read her some articles from the newspaper.

The next day when I came in she had regained her speech but I could tell that she was frustrated as things weren't back to normal for her and she was trying to piece every sentence together before she spoke.

"Well, I feel like I've lost my marbles," she muttered. A tear slipped from the corner of her eye and slid down her cheek.

I gave her a hug and sat a few minutes holding her hand.

The next day on my way to work, I stopped at a discount store and bought a small mesh bag of marbles. When I got to work she was asleep in her room and I sat the marbles on her over-bed table and stepped out of the room.

Later that afternoon I stepped into her doorway and found her awake and smiling from ear to ear.

"Look," she exclaimed. "I've found my marbles."

I walked over and gave her a hug and we both had tears in our eyes.

"That's wonderful," I said. "I wonder where they were."

From that day forward we were true friends. We actually wrote to each other for several years. We shared the death of her grandchild, the divorce of her daughter, and some things from my life, both good and bad. We were close friends. She never failed to mention her marbles, and how my gesture had helped in her healing process. In one letter she said that she had examined her marbles and they were all round.

When I didn't hear from her for a few months, I called her house and her husband told me she had died. He told me how much she had enjoyed my letters and cards; that her face would light up when he gave her a letter from me. I had always been happy to hear from her as well.

I know that the new era of nursing has made things more "professional," more protective of hospitals and staff should a lawsuit arise, more sophisticated. But I see nurses today spending hours behind a computer, frustrated at PYXIS machines as they spend so much time trying to access medications for their patients, having to call pharmacy or the House Supervisor to get drugs that could have been taken from a drawer in a fraction of the time it takes to get it from the machine. Nurses now sit behind a computer hours after their shift is over trying to catch up...tired and emotionally drained, sometimes not having had lunch or a bathroom break. We are asked to do twice the work in the same amount of time and with the same patient load.

Routinely, I see patients complain that they haven't seen their nurse for hours, that their medications are late, that nobody seems to care or have time to explain procedures to them. They feel like a number, lost in the "system."

When will the madness end? Patient in-hospital stays keep getting shorter and shorter. Nursing today is like fast food; next people will drive up to a computer, punch in their "complaint," get a vacuum sealed pill, insert a credit card, and drive away without ever seeing a nurse. It saddens me to think that the "Rubys" in the world no longer get the special attention they need and deserve.

Patients should get the TLC they need to hasten the healing process. I urge you as nurses to take a few minutes with your patients on a personal level. Hold a hand. Cry with a patient. Laugh with a patient. Go out and help Ruby find her marbles. You and your patients will be glad for it.


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Wonderful!! I want you to be my Nurse. And bring your marbles too, 'cause mine seem to be slip sliding away.

Specializes in LTC/hospital, home health (VNA).

Thank you for sharing...this is exactly why I am in home health!!

I may be 2 hours behind in my charting, etc., (like yourself) -- but spending a few minutes with a favorite patient is good therapy for ME. It makes a difference in how I feel going home after work. Thanks for the sweet read.

Specializes in EMS, ER, GI, PCU/Telemetry.

you sound like a wonderful, thoughtful nurse.

i do wish instead of backing out the door to run to the computer or the chart rack that we had more time to sit and truly get to know our patients.

a good friend of mine who works in our pharmacy said to me once at 0200, "i just went to mcdonald's to get a big mac, and they have more people working overnight shift at mcdonald's than they do nurses on the ICU step down floor." and he was right, which is really, really sad.

anyways, thank you for sharing this awesome story :)

Specializes in kidney transplantation.

If only there were more nurses like you, thank you for everything:heartbeat

Wonderful is indeed a shame that "progress" has brought us to the point that this type of interaction nearly impossible,,,

This is exactly why i left hospital nursing & now work for managed care after 31+ years of nursing!!! What a shame the way things are today!!!

Specializes in school RN, CNA Instructor, M/S.

That's why I left too!! Now I am a school nurse witrh special needs kidsd and I get hugs every day!!!!

Thank you so much for sharing this story. Not actually having time to spend with patients is a major concern of mine. I am finishing my last few weeks of clinicals before starting Preceptorship and I believe that the only thing I will miss about nursing school is that I will lose the luxury of spending real time with and getting to know my patients. I'm hoping to figure out a way to be able to spend longer than it takes to assess or pass meds with each of my patients, but I'm afraid it's just wishful thinking. Any suggestions?

Specializes in ccu, med surg, ltc, home health.

Not knocking timeliness or time managment, but while working a small ccu a very good nurse told me that pt care is paramount. charting can wait.

if only the charge nurse wasn't looming in the background checking your time clock punch out time...