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Topics About 'Compassion'.

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  1. Carol Ebert

    Need a Compassion Tuneup?

    Accused of Not Having Any Compassion? My husband always accuses me of not having any compassion, especially toward him when he gets sick! I’m not sure where that comes from but in my early nursing career in the US Navy I was required to get any patients who could stand up to get out of bed, make their beds and stand at attention every Friday morning when the hospital wards were inspected to see which one would be awarded the E flag for excellence that week. So I learned that you can’t slough off even when you are a patient. Talk about squelching my compassion gene! Another factor that came into play was managing a large number of patients and not being able to give them the personal attention I wanted to give, and they needed to have. Never being able to just sit next to a patient and hear their story and listen for clues that might give insights on how better to care for them. It was a setup for the appearance of being a nurse who lacks compassion. I consequently became disillusioned with my clinical nursing role and decided to pursue the role of school nurse and health educator. That experience of working with “well” students and staff and educating them on how to stay well, started awakening my compassion gene once more. I finally had time to go deeper with finding out their needs and locating resources to meet those needs. And this propelled me into the world of becoming a Wellness Coach. Talk about really awakening my compassion – this was what I had been looking for all along. A chance to sit and listen, to allow them to express their inner wisdom and guiding them as they crafted their next moves toward creating a healthier and more meaningful lifestyle. How to Rejuvenate Your Compassion Which brings me back to you who might want to rejuvenate your compassion gene but might not know the best way to proceed. I personally use a strategy called the Loving-Kindness Meditation that has several benefits you might appreciate. Increases compassion A recent review of mindfulness-based interventions (MBIs) concludes that Loving-Kindness Meditation may be the most effective practice for increasing compassion (Boellinghaus, Jones & Hutton, 2012). Increases empathy Klimecki, Leiberg, Lamm, and Singer (2013) found that Loving-Kindness Meditation training increased participants’ empathic responses to the distress of others, but also increased positive affective experiences, even in response to witnessing others in distress. Decreases your bias towards others A recent study (Kang, Gray & Dovido, 2014) found that compared to a closely matched active control condition, six weeks of Loving-Kindness Meditation training decreased implicit bias against minorities. But wait - there are even more benefits. Research shows that Loving-Kindness Meditation has tremendous benefits from greater well-being to providing relief from illness and improving emotional intelligence. Increases positive emotions and decreases negative emotions Decreases migraines. Decreases chronic pain Decreases PTSD Activates empathy and emotional processing in the brain Increases gray matter volume Slows biological aging Makes you a more helpful person Increases social connection Self-Love Curbs self-criticism Since Loving-Kindness Meditation appears to be powerful “medicine” we could all use right now, I made a video of the strategy so you can practice along with it to start receiving some of those benefits. Did you know the music you play helps to relax your mind, takes away stress, and replaces resentment and frustration with empathy and compassion? That's why I am sharing a musical version of Loving-Kindness Meditation from Karen Drucker to further deepen your experience. Have you felt depleted of compassion lately? What strategies are you using to enhance your capacity for compassion toward others, even those you disagree with! References: Science-Backed Reasons to Try Loving-Kindness Meditation What is Loving-Kindness Meditation? Loving-Kindness Meditation 5 Ways How Music Increases Empathy In Listeners
  2. Erica McNary

    The Power of Passionate Care

    Nurses are the most visible care providers in a hospital. They are usually the first caregiver a patient sees upon admission, the caregiver patients encounter most during their hospital stay, and the last caregiver a patient sees at discharge. Nurses are trusted, nurses are visible, nurses are the ones getting things done for their patients. They worry about their patients after their shift has ended and they go home evaluating their care, wondering if they did all they could for their patients that day. A healthcare facility thrives on the hard work of nurses. The constant forward momentum of a hospital is propelled by: Nursing assessment Nursing prioritization Compassion of care Assessment It is a nurse’s detailed assessment and their input to the care team that shapes the plan of care for a patient’s day. Whether a nurse starts with a formal head-to-toe nursing assessment or an informal once-over of a patient’s surroundings, their assessment begins when they enter a patient’s space. Their assessments are a large part of what the care team uses to ensure patients receive the exact care they need when they need it. This is the nursing process at its finest! A nurse is continuously using their skills of assessment, diagnosis, planning, implementation, and evaluation they learned as the foundation of their schooling. During every shift, nurses rely on the processes that make them experts in the field of nursing. Prioritization Nursing school begins with learning the ins and outs of prioritizing a single patient and shifts to prioritizing multiple patients' toward the end of school and into their career. The better a nurse is at prioritization, the better the patient’s outcome. Dr. Cody Legler, Adjunct Nursing Faculty at Marymount University states, “For a long-time, nurses have been at the forefront and center of patient care delivery. In both direct and indirect patient care roles, nurses function across hospitals and institutions in a wide variety of capacities. Nurses provide the unique contribution of not only clinical expertise but patient and family emotional support systems. As has been seen throughout the COVID-19 pandemic, nurses continue to be at the bedside with great resilience, dedication and flexibility. Nurses on the front-line of family practice will need to expand their skill sets in caring for patients with more complex health issues and change how they integrate treatments and manage care.” Compassion Nurses are drawn to a career of providing care out of compassion. They are driven by their need to guide a patient and their family through their healthcare experience. Whether a patient is experiencing a traumatic event, a new diagnosis, or routine care, a nurse is prepared to provide support. Although a nurse’s compassion can lead them down the road of compassion fatigue and burnout, this is an invaluable skill needed for providing the type of care everybody wants for their loved ones. Dr. Legler mentions that “Nurses, like many healthcare providers, often experience compassion fatigue. Frequently, nurses extend their expertise and commitment beyond their job, taking a sense of responsibility and dedication to personal life at home. Nurses need to be reminded frequently to take time out and care for themselves so that they can continue to be healthy in order to care for others. Caregiver support programs, dedicated space for respite and supporting work-life balance, are several mechanisms in which employers can mitigate compassion fatigue for nurses.” Nurses are the lifeblood of the hospital. They do amazing things within the scope of their practice and go above and beyond the call of duty in so many ways. They master clinical skills within the scope of their practice. They safeguard the dignity of every patient they care for. Nurses understand when their patients are in pain or afraid. They comfort them if they are lonely or sad. They support patients' family members and help them understand the complexities of a loved one’s illness. Nurses are infection control warriors and amazing advocates for their patients. Patients and families trust nurses. For eighteen years, nursing has ranked as the most honest profession. This is because a nurse doesn’t just provide patient care during their shift, but they take the time to build relationships. Not only with patients, but with other healthcare providers, and the patient’s family members. At the heart of a good nurse lies a person who is driven by compassion and fueled by a desire to make a difference. References The True Nursing Epidemic: Getting Nurses to Stay at the Bedside Nurses are the Most Trusted Profession Dr. Cody D. Legler, DNP, APRN, NP-BC, RN-BC, NEA-BC, CNL, is an Adjunct Nursing Faculty at the Malek School of Health Professions from Marymount University which offers online MSN-FNP and DNP-FNP degree program.
  3. jeastridge

    Nurses: Compassion Experts

    Below are three instances where a dose of compassion resulted in good medicine. Case 1: “I feel like my body is betraying me. I’m only 55 and everything seems to be falling apart,” the patient I was sitting with cried as she spoke with the nurse that was getting her admitted. The nurse paused her typing, turned her body slightly to face the patient, and with genuine compassion in her voice said, “I’m sorry you are having to go through this. All this testing can’t be fun.” The patient visibly relaxed and the tears that threatened seemed to dissipate. Case 2: The patient was all set to go to surgery. I was there with her pastor to pray for this major procedure to remove cancer from her colon. Her husband hovered nearby and as they started to roll her stretcher out, he clung to her hand. The intake nurse was there, and he gently slowed the gurney and spoke to the husband, touching his arm, “We will take good care of her. If you will go through those double doors to the waiting area, we will be in regular contact with you throughout the surgery.” His manner and calm demeanor spoke volumes. The husband released the stretcher and kissed two fingers before touching them gently to his wife’s lips and mouthing the words, “I love you.” Case 3: The patient had been in the ICU on life support for several days. The situation looked grim and the prognosis was not good. As the Parish Nurse, I visited daily and tried to help the family as it became clearer that we were looking at considering end-of-life issues with this wife, mother, and grandmother in her early 70’s. The bedside nurse was so helpful! She was competent and busily tended to the patient’s multiple lines, continuous dialysis and ventilator. Her manner was simply reassuring. She talked in low tones and did her best to answer questions that the family expressed. They sat anxiously by, and some of them stood in the hall. No doubt crowd control had to be trying this nurse’s patience, but she did not let it show. She steered the family away from the bedside and into the waiting area so that she could have more space to provide the necessary care, but even in doing so, she communicated volumes about her empathy toward this tight-knit family and their grief. As the Parish Nurse, I tried to help transition the family to a better space and continued to provide a listening ear and to help in interpreting what was going on. The American Nurses Association’s broad definition of nursing states: There is a lot to love in this definition because nursing is truly about so much: the stated and unstated. Compassion may not be part of the official description, but it is often part of the force that draws people into nursing and certainly one of the motivators for staying there even when times are tough professionally. So being a compassionate nurse is a good thing. We all get that. But if we are not particularly bent that way, how do we cultivate that characteristic? Also, if we are just plain worn out and tired, how do we stay compassionate? Isn’t it “fake” to pretend that we feel something we don’t? If we really want to be authentic people, shouldn’t we be honest with our patients when we are not having a good day? Compassion is an action more than an emotion. When we are professionals, we can act with compassion even when we are having a difficult day and do that without “faking it” or lying or trying to muster up some artificial warm and fuzzy feelings. Professionalism simply means that we understand the scope of our work and that part of it is trying to make a better day for our patients. We do that best, when we act with compassion—in some small way seeking out a position of empathy. This can be trying with our difficult patients, but part of being a consummate professional is knowing how to make that happen even when we don’t feel so inclined. Compassion rises from a well that can run dry. We have all been around the nurses that have run out of steam professionally: they have had to work too long and too hard and under undesirable circumstances. Let’s be honest and name it: Nursing really stinks sometimes. But as professionals, we keep trying to support each other and encourage one another to be our best selves. No, we will not succeed every day—no one does—but we can prod each other on and help each other seek ways to refill that well of compassion when it threatens to hit bottom. Genuine compassion sometimes means not communicating your own personal issues. In our own lives, we have struggles so it is easy to forget that the patient is not there to hear about them. They are in their own time of trial and often cannot cope with hearing about someone else’s—even if it’s as simple as your flat tire on the way to work this morning. Really, our patients need our professionalism to trump our own need to share. Listening and caring about their needs is what we are trained to do. Whether brand new or benefitting from long years of experience, nurses can have uniquely helpful perspectives in their area of expertise. Whether in the hospital or out; whether corporate or private; facility or outpatient—in any and all settings nurses who show compassion offer true help.
  4. "Please tell us your name, hometown, reason for joining the nursing program and clinical experience. Maria, let's start with you." "Maria Sanchez, Milwaukee, WI, I joined because my mother was a nurse and I respect her so much for the job she does, and I am currently a CNA at UW Hospital on the transplant unit." "Very nice, Tait go ahead" Gulp. "I am Tait, hometown Little Town, WI, I joined the nursing program because something in my soul told me it was the right thing to do, and I have no clinical experience outside of school. I am a waitress." A gentle murmur. A hawty snort. A surprisingly approving look from an instructor. "I have to say Ms. Tait" steeling her gaze against the class. "I have known a lot of very successful nurses who were waitresses first, it gives you a very similar look on nursing, balancing a section, being responsible, and learning how to deal with customers." BAM. Did she say customers? As we coast leisurely through the new millienia, life moves along beside us, changing, flowing, and dying. Like constellations born of the fiery inferno of our mothers loins we move along a genetic pathway affected by our training, habits, and lack of discipline or foresight. Each life intricately touching those around us in ways that we aren't even aware of, making a difference in the energies of others simply by passing down the street near them. Nursing, as a profession, is a long and steady history of men and women driven to offer something more to society. To take the hand of those deemed unworthy, due to sickness and grief. To nourish those who have fallen to the unknown. To comfort those who sit beside and watch as the light of the cosmos flickers, dies and takes a massive piece of their hearts back to a higher plane. Nursing is about protection, knowledge, compassion, empathy and the ability to stand closest to the fragile line of existence than most people will let themselves admit exists. In and amongst all the expectations of nursing, there is also a special part of each person that is there to make the person feel well, protected, cared for and safe. "Ding" "Ding" "Ding" "Ugh is that Ms. Norris in 25 again? I swear that woman has been up to the bathroom fifty times tonight! Where is Mary, I am not going in there again, every time I do her daughter just wants to yack and yack about how to find a nursing home, how to find a caregiver, and she never wants to help clean her mother up when wets the bed." Patients can be frustrating. They don't understand their bodies, they don't want to understand that eating well and taking their insulin will help prevent them immense pain from an amputated leg. They have families that are crying, needy, questioning and overprotective. They question the medications you have to administer, they ask one million questions about the future, even if you have answered them all, ten times. They request you wash your hands over and over because they fear being here. Yes, FEAR. As you look at your patient load each day, what do you see. Three people who need a bath, five people who have to have insulin four times a day, two foley catheters and a ostomy in a pear tree. However, when we take the time to turn around and look from a different location, what do we see? Four walls and a tv with a bad remote. A plastic commode that a stranger must help you up to each time. The open door as that person walks out leaving your exposed to the nurses station and a hundred other people you don't know. The empty plastic cup on your nightstand without any ice in it, ice that at this point is the only, precious bit of happiness you have. A rubber mattress with a sheet stained from the sweat of a fever two days ago. A body that needs a "doctor's order" to be allowed to feel the refreshing flow of water cascade down it. A different person, coming into your room, a different doctor than the one you normally see each and every day, a different person at three am to poke and prod your tender skin for blood, a different person walking in over and over judging you, questioning you, demanding of YOU. Take a breath my patient. Relax your heart. Relax your mind. As nurses we offer a unique experience. Not only are we educated in the ways of healing and technical skill, we are also afforded a very special place in our patient's heart. We have the ability to walk into a room, and have a person trust us with some of the most harrowing, painful and embarrassing situations, of possibly, their entire life. So, the question is, are we making the best experience for our patients? Most of us believe we don't have time for customer service. We have many tasks to do, many iv's to check, many patients to reposition every two hours, many families to placate. Customer service isn't something that may even come into our daily vocabulary. However, customer service isn't something your do, it is something we are. Imagine the person from the above scenario of worries. How much effort would it really take to make this person just a little more comfortable? New batteries in the remote or a quick call to maintenance for a new one. Helping consistently with the patient getting up to the commode and then giving them the dignity to leave the room and closing the door. Even if that person has dementia, it only takes one small second to shut the door and stand outside the room and listen to make sure that person is safe. Promptly filling that cup with ice, two seconds to you, may seem like an eternity to someone with nothing else to focus on. A quick change of bedding while that person is up, and after they have finished their natural business. How lovely the feel of crisp linen on tired skin! A moment to help a patient sponge down the areas that can't be showered just yet, and to offer them a bit of lotion to that dry area in the middle of their back. However, this situation isn't just about tiny changes to patient care, but also to nursing care. Customer service and patient care are not just about what we are doing for our patients, but how we take care of ourselves. Helping each other out, answering call lights when the CNA/Tech is busy toileting someone, sitting with a dementia patient when you have downtime and helping soothe their mind, and simply promoting a workplace of care and compassion. For your patients, and for each other. Yes, I fully understand there are days when you just don't have it in you, when you are overtired and feel too much is being demanded of you. However these days are most important. The days when someone else can step up, for you, and make your day a better experience. When you notice that overwhelmed nurse, take the time to offer them a few of your precious seconds. Changing an iv bag can sometimes be a extremely productive customer service act. Not only are you silencing the wretched, repetitive beeping inside the four walls of a patient's existence, you are taking one tiny thing off a fellow nurses plate. A tiny space that might give that nurse a few more seconds to answer one more question from a family member about post open heart surgery infection prevention. That tiny space becomes a reinforced piece of knowledge in the mind of that family. Who later sees a reddened area around their incision they wouldn't have otherwise noticed. Which brings them back to the hospital mere days before a vicious osteomyelitis sets in. Management and staff alike need to realize that nursing is more than just pushing medications and making sure a patient has had a bowel movement before going home. This is a career of compassion and care, of hospitality and service. In an age where people can pick and choose their hospital, as easily as the steak house next door, we must take the time to ensure our practice, our patient well being, and our own mental state by looking for the little things that make an experience just that much better. No, we won't make everyone happy, there will be the vegetarians, the angry couples that should have stayed home and went to bed instead of coming out for steak, the people that are late for their movie because the kitchen ran out of lettuce. However, and over all small change, can sometimes have the biggest impact. In conclusion I offer the following challenge. Look for opportunity. To give a person a little something extra. Close the door when you leave the room. Look to the nurses around you and see if they need a little extra care as well, ask for help when you need it, push your management to deal with issues that lower patient and staff satisfaction. In the end, never forget and always enjoy the fact that you hold a place dear in each patients heart, whether they realize it or not. Without the nurses, phlebotomists, technicians, cooks, maintenance and supervisors these people would suffer, wither and die without feeling the warm touch of compassion and hope.
  5. vineyard

    Transcultural Nursing Experience

    My instructor said, Mr. Fernando...And I said who was that again ma'am? She repeated it, Mr. Fernando. The only thing I said to my instructor was "thank you so much and remember with a crocodile smile..." The moment I looked at the patient's chart, I was thinking like the patient's case was just okay and that everything will just be very fine of him, me and the significant others... Well, well, well, when I get into my patient's room, I was so shocked at the back of my mind because there were many bottles hanging on both sides of my patient. Not only one, two or three but there were four bottles hanging beside him. I said to myself while looking at the patient, oh-oh this is gonna be a very exciting yet tiresome job. I told my American classmate to really help me because I am anticipating that there will be a lot of calculations then and there will be a bunch of things to do. And so yes! Lots and lots of things to do. One day during my shift, I didn't notice that my patient deposited a bulk of smelly feces on his diaper and her daughter told me that the patient defecated a day before my shift. It was a very disgusting smell when I entered the room. And Ummm, of course, I don't have a choice but to clean it up because he was my patient. And Because my patient was so big, my clinical instructor called up four (4 ) other student nurses to help me. There was one guy on my right side near the patient's head (left side). One American female on my left side and there were two other student nurses in front of me. When we turn the patient on his right side, the smell went out and the guy on my right side was crying. I asked him why he was crying. I thought he was thinking like he can't make it but then he said because of the smell. He said it was the most disgusting smell he ever inhales in his life. And because at that time, we were not using any disposable towels or wipes. Everybody was asking on what are we going to wipe them. Suddenly our clinical instructor said, we can use a face towel. Yes, a face towel!!!! A face towel that my American classmate who was on my left side was used to clean up the patient's anal area. Would you believe that the towel used was the same towel being used the whole time until the patient's private part was clean?!? Meaning the towel has been squeezed with water just to make it clean 'til it has been finished. I can't believe it! After which, I removed the diaper but then because the patient was very heavy my hand slipped away and was able to touch the patient's feces! Eeeewwwwww! Yes, that was the only word that everybody was able to say right after I placed my hand on it. The patient's daughter was laughing while looking at me and said am so sorry about that. And after we saw the patient's daughter laughin' everybody smiled and said it's ok because I am used to touching feces.LOL...Yeah, it was okay because I had no choice, hehe! Furthermore, my clinical instructor asked us on who will put the ointment on the patient's butt, the guy who cried turned his head away and was smiling, said in a whisper "no, not me please..." Our clinical instructor noticed and call him with a big smile and said Yes you will ... hehe! He had no choice but to get the ointment to avoid sore. If only the patient was conscious, for sure he will laugh at us and with us. Seeing our different faces with the smile but with meaning would really make him smile too. The patient's daughter and wife were smiling that time during the procedure and they said a "warm thank you" to us because they said they can't do it by themselves because they are not used of cleaning up the patient. With it, I was bearing a crocodile smile when I heard the word "thank you..." Indeed, it was of great honor and privilege to help patients even in a very small way. That experience really helped me a lot and motivates me with regards to my patience, endurance and of being a good healthcare giver. I believe it did also test me of how much I care for my patient in any setting and cases. I am a nurse now in my country (Philippines) and hopefully work in the US soon with a true heart of giving care to my patients. I believe I could sincerely serve my future patients because life is important as how God treasure and value life. I hope that this article would enlighten all healthcare givers. May this article reminds us always that we are given a very good privilege to serve, care and above all love our patients no matter what race and which country he or she from. Have a nice day to all!!
  6. awongaemtcc

    In My Prayers

    We do the best for our patients and then we don't try not to take the job home or let it bother us. But I give credit for those floor nurses who are busy taking care of our grandma's, grandpa's, mom's, dad's, siblings and friends because in a way, they become their own family. Their work family. For the most part, they see them every day, day by day. All the things nursing school focuses on care plans and stuff actually matter up there. In the ER not so much. But today, I felt like I connected with a patient. It wasn't a bad night in the ER. We had my first cardiac arrest at Crouse tonight which was definitely different the way it is run at the Brook. But that's a whole other story. I was working at the Acute end of the ER tonight but I thought I'd go help one of the nurses who was drowning with patients. I went to go check on her patient who was hypotensive. I walked into the room and the small frail lady in her 80's sat there in her bed with her son and her daughter at her bedside. I took her BP and asked her how she felt. She said I feel like "crap". Laughing I looked at her BP and it was 70/40. Low. Her son made a comment about saying mom you could've said you felt like ****. And the woman laughed and yelled at her son for cursing in my presence. So we bolused her and I went on my merry way. About 20 minutes later they rush her to the Acute end. Apparently, she went into rapid A-Fib and her pressure kept dropping. She had a positive troponin. Pretty much whatever was bothering her was becoming systemic. The doctor wanted to cardiovert her. All the sudden this frail old lady who laughed and joked looked like a scared child. She kept saying how scared she was. She told me one of her grandson's names were Andrew and that he didn't like being called Andy. I told her she could call me whatever she wanted. We tried to calm her down, had the family step out and gave her some propofol. Once she went out we cardioverted her 3 times. We couldn't get her back into a sinus rhythm. She slowly came around and looked at me and said to me. "Andrew I'm scared. You see, I didn't call you Andy." I felt horrible for the poor old lady who was being shocked over and over. I kneeled on her side and held her hand. I told her exactly what the doctor was doing through each step of the central line. She squeezed my hand and said "I trust you, Andrew. I'm scared... but I trust you." I kept reassuring her that it was going to be ok, we did the central line and I explained each step telling her how great of a job she was doing. I tried to talk to her about her family to get her mind off things. She was a mother of 8 children oldest in his 50's and youngest in his 40's. She had 15 grandchildren and 3 great-grandchildren. She just kept smiling when we talked about them. We started her on pressors to bring her BP up. When the doctor was done, I left the room to attend to another patient. A few minutes later I figured I needed to get something from the room and check on her and she's in the room and the doctor is doing chest compressions and intubating her. I don't know what it was. I've been doing this for so long and I've seen people crash before but I felt like I was connected to her. As if that was a family member on that stretcher. We got her back and she started waking up from the sedation. She had an ET tube in and she just looked at me and tried to mouth words. I just tried to comfort her and tell her it would be ok. She looked at me and I could tell she recognized me. So tonight I pray for her. I hope she gets better. I try not to get too attached but I am only human. So even though I don't know her and probably will never see her again, I hope that I've made all the difference in my hour with her.
  7. BookishBelle

    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.
  8. She Was Waiting for an Angel to Guide Her Her name was Norma and she was from Rhode Island. It was a hot July day when she came to spend her last days in the hospice unit. I remember so vividly the machines that she was hooked up to, the machines that would not guarantee a longer life, just enough time for her loved ones to gather and say their final goodbyes. She was a beautiful woman and only sixty eight years young. I continuously thought why does she have to leave this world? Why her? I am not ready for this! There was a nurse on duty that day and when she entered the room I felt an overwhelming peace come over me. She had strawberry blonde hair and a pale complexion. She looked at me and smiled as she walked over to the bed where Norma would spend her final hours. I instinctively knew this nurse had the compassion that Norma needed and deserved. As I approached her, I felt as if this stranger would help me through the most difficult time of my life. How could a stranger be so powerful? In that room, every moment is precious, every detail is important and every sound is amplified. On this day, the morphine drip was mesmerizing to the point that for a moment it was as if it was in sync with the beating of my heart. I soon realized every drop of morphine that fell was like a countdown to the last breaths that she would take. I looked up and there she was, the strawberry blonde haired nurse. She was just smiling at me, not a happy smile but a very comforting smile. I needn't speak a word to her because my thoughts she already understood. She quietly said it was time for her to re-position Norma. I told her that I would gladly help her but you see she couldn't have me there. Not because of rules in the hospital but because she wanted to preserve my memories. She did not want me to see what would happen. She cared about how I would forever visualize such event should I have stayed. As I walked out of the room I found myself counting the beeps on the monitor, one, two, three, four, five... Scared but appreciative, I walked out of the room and went down the hall until the beeping faded and then stopped as if it was never heard. As I sat and waited, other family members had arrived. I told them we had to wait outside the room for a little while. I didn't tell anyone how the nurse had spared my memories, or how she comforted me beyond words; I wanted that to be mine. After what seemed like hours, we were allowed back into the room and when I entered I felt something was different. Norma looked so peaceful and comfortable. An overwhelming feeling of sadness came over me. The nurse looked at me in such a way that I knew it was time to prepare to say goodbye. I did not want to! I was not ready for this; she just got comfortable again she is fine, but she was not fine. Cyanosis started at her toes and eventually up her legs and so on. The nurse told me that this is normal symptomatic behavior for a hospice patient in her condition. My focus was now on this because I knew that the more observable color, the sooner her last breath would be taken. Time was of the essence. We all gathered around her bedside and sang a song that she loved, a song that she wrote for all of us. The moment the last word was sung, her last breath was taken at 7:24 p.m. I relive this moment as if it were yesterday, I see the room, the bed, hear the noises from the machines, the crying and even the silence was deafening. Everything is so vividly painful in my mind, all the memories that I had would be all that I had for the rest of my life. I would never hug her, talk with her or laugh with her again. It was over and it was final. But she, the strawberry blonde headed nurse is the most vivid memory of all. Not her face but her compassion, her empathy and most of all her giving Norma, my beloved mother, the dignity and respect that she so deserved during her last hours of her precious life. My mother went to a hospice unit on a hot July day when she was sixty eight years young. She took the most important journey in her life. She waited for the moment when an angel would come and guide her home. She was respected, loved, cared for and her dignity was preserved by the hands of one nurse. Who is she? I do not know. I do not remember her name, yet she is not faceless; I will remember her face for the rest of my life and I will never forget her. A nurse is defined as a person trained to care for the sick, to give medical attention and prevent illness and injury. To me, nursing goes beyond that. God Bless all nurses everywhere; you never know what an impact you will make in the lives of others. Thank you for your service. Lori Modert
  9. meg.sullivan

    Comfort in a Cup of Tea

    Self-Assurance Each of us, regardless of our role on the healthcare team, develops a rhythm we become comfortable with that gradually allows us to acquire a level of ease. In my seventh week of medical surgical nursing clinical, I was starting to feel that assurance. I began the day by stuffing my pockets with the essentials - a couple black pens, a pair of bandage scissors, a pen light, and enough alcohol wipes to scrub every IV hub on the unit. After hanging my stethoscope around my neck, I tiptoed out from the break room to the nurses' station, not wanting to be the one to break the peace of night with the flurry of activity of days. I scanned the patient list to select my two patients for the day. One was an 82-year-old woman recovering from a pulmonary embolism. Broken Heart Syndrome After checking lab results and reviewing the patient's medications, I began to read the history and physical. It began like a familiar jingle. The patient was pleasant, but presented to the ER with chest pain. After a series of tests, labs, and assessments, it was determined she had a pulmonary embolism secondary to a deep vein thrombosis. Furthermore, there was dissonance; she also experienced broken heart syndrome, believed to be the conductor of all her problems. Broken heart syndrome had never been covered in a classroom lecture, much less a textbook. I pictured a fracture between the left and right atrium of the heart, the sapium no longer serving as the bond between the two. My professor remarked, "how sad," as she pointed to the broken heart syndrome diagnosis. As I continued to read the patient's history, it all began to fall into place. For me, broken heart syndrome meant a good cry, a bowl of ice cream (read: pint of Ben & Jerry's), and a Nicholas Sparks movie. However, this woman had enjoyed over a half-century of marriage, five kids, and a lifetime of wonderful memories. The loss of love had left this widow bed stricken. Following weeks of confinement to her house, a clot dislodged and formed the pulmonary embolism. It is said, "true love leaves you breathless," but Hallmark never designs anniversary cards featuring someone gasping and wheezing. What Can I Do to Help? In all my initial interactions with the patient, she was sweet, but short. Her voice professed she was fine, but her eyes echoed back that she really was not. She insisted she did not want to be a burden, but also conceded she needed some help with her activities of daily living. As I entered her room for a late morning round, I noticed her staring down at her leg, which appeared a bit swollen. Despite my assessment that the inflammation was only minimal and my explanation that it was an expected finding due to the DVT, I recognized much more was bothering her than the fluid build up in her leg. I felt as helpless as she did - how could I possibly console a woman struggling to cope with the finality of the loss of a love like no other, when I had barely experienced true love myself? There was no medication or treatment I could provide, nor words to ease the pain she felt. All I could offer her was a cup of tea. Success! Somehow, the eight-ounce Styrofoam cup filled with the finest generic brand of decaffeinated tea was just the elixir this patient needed. The warmth of the cup radiated from her petite hands, relaxing her whole body. All the worries, the hesitations, and apprehension dissipated with the rising steam. With each sip, she revealed more about herself, and each story conveyed brought forth a new sense of assurance. While her husband's passing seemed like a tragic conclusion to the life she had known, she discovered that perhaps he was still a part of her life, as an angel watching over her new beginning. I Made a Difference The patient reached for my hand as I got up from the chair, and a smile spread from cheek to cheek on her timeworn face. I realized that I had not said much while she sipped her tea - however, I did not need to. After my brief, but sincere time with her, I understood that although the job may sometimes have more cacophony than harmony, it is in the vocation that I will always be able to find the melody. While the tempo may be fast-paced and the rhythm precise, as a nurse I must recognize that sometimes more is revealed in the muteness of time. That day, I learned that being a nurse goes far beyond writing care plans, hanging IV fluids, and measuring vital signs. While it may not be elaborated in a textbook, this patient helped me to understand the most meaningful and important nursing intervention I will ever be able to perform is taking the time to listen. Medications and machines cannot replace the comfort found in a conversation over a cup of tea.
  10. Julie Reyes

    The Fine Line

    The fine line between being a professional with compassion and empathy with CLEAR boundaries versus being, well - me, runs a bit blurry. I remember this being pounded into my brain in nursing school - and I have never really learned the lesson. Sometimes it wears me thin, and at other times, I am glad that I chose to give a little extra. I have many friends from work and when I talk to them, I know I am not alone in my feelings. I wonder if the reason we sometimes get more attached is because we work with children. I have never worked in a hospital setting with adults, so I have no foundation for my thoughts, and I have no reason to believe that this is actually true. Yet, I still wonder. I admitted my infant patient into the PICU from a simple procedure - a heart cath. However, the news that the parents received from the cardiologist was not good, and the baby would be going into surgery the next day. I explained what the cardiologist said many times throughout the day. When you are hit with a bomb, sometimes things don't make sense. I see this over and over - you have to explain things to parents many times for them to understand, especially if the illness was not expected. The morning of the surgery, the parents were anxious. Mom and dad held their precious baby throughout the night, rarely putting her down. Strong in their faith, I asked them if they wanted me to pray with them in case the chaplain they asked for did not arrive before the baby was taken to OR. They did, so I did. I cared for their precious one many times, over several admissions into the PICU. I became close to the parents - and they trusted me with every aspect of care for their baby. The family moved to a new town, and one day, I got a text message from the mother saying they lost the battle, and the baby passed away, the funeral would be nearby, and could I come? Of course, I would. Another child was admitted into our care for an illness that eventually left her without any brain activity. Over the days and weeks we spent fighting for her life, it was hard to get through to her mother, who seemed very aloof. One day as I was talking to the mother about withdrawing life support, she finally let me in to her private world. We talked about the life her daughter had lived, and who she was. Mom sent photos of her daughter from her phone to my work email, and I printed out the photos to hang in the room. Mom opened up about many details, including the fact that her daughter loved to straighten her hair and paint her nails. On the day the mother chose to withdraw life support, I brought a hair straightener to work, and another nurse brought pink fingernail polish. Mom painted her daughters nails, and I straightened her hair. She looked more like "her old self", mom said. And mom hugged me and wept. When we withdrew support, my lovely patient was surrounded by her friends and family. I received an email from the mother several weeks later, telling me thank you. A beautiful baby was in our care for months. His parents were very young, and the entire staff became attached to the young mother, who was there the majority of the time, and our patient. She doted over her son, and she had to make some very grown up decisions for the plan of care presented to her. The parents never wanted to give up fighting for their son. I talked to the mom for hours over the course of her baby's stay with us. I learned her hopes and dreams, her fears, her plans. I listened - as did the other providers - and we supported. We admired her tenacity and hope. In the end, the parents both realized their precious baby was suffering immensely, and decided to withdraw support. The bravery they showed and love of their child more than their own desires to keep him alive another painful day was nothing short of courageous. The young mother still keeps in contact with me, and I know she is now expecting another baby. I have cried more tears being a nurse than in almost any other aspect of my life put together. It pains me to see parents cry, a child die, and to fight and not win. I doubt I will ever learn the lesson or clearly define that fine, blurry line. I'm not sure I will ever want to.
  11. TiaKay

    Till We Meet Again

    It seemed like it was going to be just another usual Sunday night on our med/surg floor where I work as a tech prior to starting nursing school in the fall. A 3-11 shift doesn't include baths, but if the patient is incontinent of the bowel, there's a good chance that a tech will change the sheets, bath the patient, provide a clean gown several times in the course of the night. This can be an unpleasant task; let's face it, being up to your elbows in someone else's bowel movement isn't very delightful, especially if it is the liquid, odiferous, potentially C-diff bearing stool that was the case with this particular patient on this particular night. However, I do my darndest not to shy away from these situations, as I can only imagine how difficult it is for the patient to be so limited and to need that sort of personal care repeatedly. As I was getting the linens ready and running some warm water in the sink while preparing to clean up the patient, I began humming a tune. I'm a singer in my out-of-the-hospital world, and I frequently get tunes in my head, which I sing or hum. As I came from the bathroom, the patient this night heard me humming, and began to sing the words with me. I asked him if he knew the whole song, and he said he did, so we started off together at the beginning. He knew me only by my voice, as he was quite elderly and blind as well. We started talking about songs we knew and loved, and before I knew it, we started singing some of our favorite numbers from the musical "South Pacific." I was joking how, now that I was older, I was going to be too old to play Nellie Forbush, but instead would have to play Bloody Mary. That naturally led me into the song made famous by that character in the show, and we were laughing by the end of the bedding change. He had no control over the illness that was ravishing his GI system, so I was in the room several times that night. We sang songs from "Carousel", from "Oklahoma", from "The Music Man", "The Sound of Music", all of those oldie-but-goodie Broadway shows. There was a 45 year age difference between us, but we both had loved all those songs and had them tucked away in our memories. What could have been a distasteful and smelly task instead became, for both of us, a delightful break in the monotony of the long shift? When at shift's end I came to get his final set of vitals and to help him settle in for the night, I told him I'd thought of the perfect song to end the night's songfest, a lovely tune from the World War One era entitled "Till We Meet Again". Now, while the song's lyrics are written for sweethearts, and that wasn't our case, it was still a lovely thought to wish each other well until we were to meet again. We sang it together, and I wished him a pleasant good evening. Two days later, I had to come into the hospital for an educational meeting for techs. I wasn't scheduled to work again until the weekend, and I usually exit out the back door to the employee parking lot. As I was completing a cell phone call, I stayed on the main floor planning to exit using the door by the ICU (I never go out that door on a normal basis.) Glancing into the ICU waiting room, I saw his family, whom I'd met earlier that Sunday night when they came for a visit. Going to them, they told me how he'd slipped downhill rapidly on Monday, and things did not look good. I had their permission to visit their dad, so I went into his room. He was on a respirator and was completely unresponsive. It was evident from looking at the vitals and other info on the machines at the bedside that he was very critical. I held his hand and quietly sang to him "Till We Meet Again" one last time, and left. It seemed a very fortuitous choice of exits to me; otherwise, I'd never have known he was in the ICU. The next day, his obituary notice appeared in our local paper. I cried a little, and yet, it was a comforting thought to know that on his last aware night of his 88+ years on this earth, he sang the old songs he loved so well, had talked about his beloved deceased wife of 60+ years, and knew that while he was in a difficult care situation with the diarrhea he was suffering, that he'd given ME the gift of his music as well. Rest in peace, Mr. W.; until we meet again.
  12. kaylie1

    Through the back door

    We had just finished our Monday morning hospice report. As a group, we routinely meet for 30 minutes on Monday morning to share admissions and deaths over the weekend. I was preparing my schedule for the day, still thinking of a patient that had just passed away over the weekend. I thought to myself, its pretty cool to be able to help others make the transition through death. It is often nursing care at its most basic-comfort care. This is when the call came into the office to my supervisor-"Sue." She was a bit distraught saying that the caller was the daughter of a patient screaming in the background with pain. Sue had assured me that as soon as the order for the morphine was signed off by the attending, that I would be able to pick it, and the rest of the comfort kit, up from the pharmacy. Quickly, I hurried out the door and into my car. I was on my way. I entered the address on the GPS and wasn't really sure how far away it was. I knew that the patient was to be admitted for Cancer, although I wasn't sure what type of Cancer or about the source of pain. I assumed she was dying as any other patient on hospice, but for the pain to be this severe, maybe it was more terminal. I just didn't know how I would be able to help, especially without the comfort kit and/or the morphine. About 10 minutes down the road, I received a call from Sue. She wanted to know if I was almost there. She said if the Dr. could hear the patient screaming on the phone, then he would be more likely to sign the order. The Dr. was still working on it. Sue was getting ready to follow up once again with him. Arriving at the home, the daughter "Lisa" met me in the driveway. "Did you bring the morphine?" I responded, "No ..I'm sorry, we are still working on that. Is it OK if I go ahead and see her?" She said, " Sure go up these stairs into the back door." So I ran up the stairs and entered the room of a screaming woman lying in bed. Looking directly into her eyes, I said, "where is your pain?" The patient motioned with her eyes and said in a weak voice, "down there," only to start screaming again. I asked the daughter if she was constipated to which she said "maybe." I replied, "Would you mind if I just check, I mean I know we just met?" With the daughter's assistance, I turned the patient to the side and with rectal check started disimpacting the patient. After a few balls of hard stool, the patient stopped screaming. The daughter's response was, "You really came in the back door more than once, didn't you?" Not sure she ever used the morphine or comfort kit, but I had later picked it up at the pharmacy and brought it back to her in case she needed it. I phoned the office to speak directly with Sue and said, "The pain is gone. It turned out she was impacted, and I just disimpacted her." Sue's response was, "Thank God!" The patient died the next morning. She just needed to be comfortable. As a nurse I had the unique opportunity to relieve the suffering of another person that I had just met. Entering the back door in more ways than one says something pretty special about their confidence in me as a nurse. I am proud to say that I directly relieved her suffering and helped her make it along her journey.
  13. andre

    Lather, Rinse, Repeat

    So my usual morning routine goes like this: print my report sheet, and start putting in my little boxes for med times, assessments, etc (yes, I'm the OCD nurse), while I wait for the night nurses to be ready for report. Get a face-to-face report from the off-going nurse(s). Then we do walking rounds, so we can meet the patients....and make sure they're still breathing (true story: not long ago in walking rounds we discovered a palliative patient had just died...imagine if we had skipped rounds and I hadn't gone to assess her first?). As soon as I've met my patients and made sure there's nothing that needs my immediate response--patient crashing, in pain, etc--then I go back to my computer. At this point, I take a good 20 minutes to look at the last set of vital signs, any a.m. labs that are back, and the last nursing note. By this time I feel "ready" to decide who I need to see first and start passing my meds. And it's probably 8 am by now. Generally, I find it helpful to have looked at vitals and labs before pulling meds, so that I know if the patient's BP is low enough to hold meds, for example. Or I know what their K+ is before I pull out a big dose of Lasix. So anyway, I pull my first patient's meds, and do my first assessment when I go to give them. Lather, rinse, repeat. I usually pass all my morning meds and cover fingersticks before sitting down to document any assessments. Of course, by this time docs are rounding and writing new orders, too... So. Back to my patient. After hearing in the report that he's full of cancer, we go to see him first and he needs pain meds. So right away I pulled his Oxy and gave it. He said to me, "you girls are soooooooooooo nice". About a half hour later, after seeing my next patient, I went to re-assess his pain, and he was much more comfortable. I asked him if he needed anything, and he said, "oh just a few ice chips if that's ok". I said, "Of course" and then suggested some ice cream. His whole face lit up, and he asked, "I can have ice cream?" Oh lordy, you can have anything you want. As far as I'm concerned, when you're dying of cancer, ice cream for breakfast is not only ok, it's medicinal. So I went to see all my other patients, gave meds, sent folks for Xrays, talked with some docs. Then I went to see him again. With an ice cream in hand. He beamed from ear to ear. All day he kept thanking me for being so nice. Honestly, he was an easy guy to like, grateful for the most trivial of things. One of the things I like most about palliative patients is that the focus really is on the small things--fluffing pillows, backrubs, clean sheets, cool cloths. Pain meds. Ice cream. Lather, rinse, repeat.
  14. angiebaci

    Thank you, Eileen

    Four years ago, my father died. We were all expecting him to die since he was a terminal cancer patient, however, when his life began to end we were in complete shock. Chalk it up to denial or hope, we were completely surprised when the time actually came. If it wasn't for the bravery of one nurse, the last days of his life would have been filled with a great deal of confusion for our family. This nurse completely changed our ability to filter information and make a decision while dealing with a dying family member. She gave us strength and clarity, two things which we were severely lacking before her intervention. When my father received his stage IV cancer diagnosis, the Oncologist gave him three years to live because he was relatively young and healthy. One year into that three-year timeline, he started to deteriorate slightly. He became less happy, ate less, and experienced more pain on a daily basis. Nevertheless, he was still carrying on his life, driving about town, going to doctor's appointments and running errands. He had just returned from a road trip from San Francisco to Los Angeles to consult with another Oncologist when he started to experience extreme pain. The pain became so unbearable that he went to the hospital. He was given Morphine to ease the pain. He fell asleep and he never woke up. In between falling asleep and dying, there were a handful of days. He went to the ER on a Sunday and died on Friday. When he initially fell asleep, he would have brief periods of consciousness and be able to semi-interact with us in a coherent fashion. He made slurred requests to not let visitors see him in his current state and asked me to rearrange plans he had made with friends. Eventually, his periods of semi-consciousness turned into delirium. He would open his eyes and make eye contact with us but would speak about something that wasn't happening in the room. He was happy and jovial but not with us. Even in his delirium, he still embarrassed me in front of any and all hospital staff by telling them I was a nurse, one of his favorite things to do. My father's sudden decline in functioning left my family and I in a state of total confusion. He had doctors and staff from every department pay him a visit and they would each clear him from their standpoint. The hospitalist suggested we decrease his pain medication to bring back more lucid behavior. Infectious disease ensured us he did not have an underlying infection. The discharge planner encouraged us to decide on a local skilled nursing facility for him to be transferred to until he regained his normal level of functioning. My family and I were running in circles, both mentally and physically, trying to reconcile what the doctors and staff were telling us with the shell of a person we saw laying the bed. Even though I was a nurse, I felt useless to my family as a source of guidance. I was out of my realm and dealing with death for the first time. On Tuesday, the day shift nurse, Eileen, pulled my mother outside of the room to speak to her outside of my father's earshot. She told my mother point blank, "He is dying. I have been an Oncology nurse for many years and this is what happens. The organs shut down and the mind starts to slip away." These words were hard to hear, but they were what we needed to hear. Eileen could sense that we knew this was the reality of the situation, although we needed validation from someone. No one had even brought up the words "death" or "dying" up until this point. Her words were the most logical and easy to understand we had heard since the beginning of his cancer diagnosis. She wasn't speaking in medical jargon or down from a pedestal. She was a human, talking to another human, in a hallway. The bravery of Eileen's actions helped our family come together and get through the worst part of that week, Wednesday through Friday. We made the heart wrenching decision to pursue palliative care and he died two days later on the same day his daughter gave birth to his only granddaughter. He died two years before we were expecting and decades before we were ready to let him go, however, it was his time. Eileen led with her heart in a moment of need and the impact of her actions will never fade from our memory. From one nurse to another, thank you.
  15. In choosing a career as noble and honorable as nursing, having the responsibility of being trusted to care for those who are stricken with illness should always be considered the core of our profession. However, we sometimes overlook the feelings of patients as individuals in our role as caregivers. It is imperative that we, by whatever means necessary, take the time to remember that the duty of the nurse is the pinnacle of patient care. While physicians diagnose and treat illness, nurses are responsible for the care and wellbeing of the patient as a fellow human being. Far too often nurses become caught up in the institution of a hospital, and by that, fail to remember it is we who are the very heart and soul of that institution. We are the believers. Every once in a while there comes a situation that reminds us what it really means to be the patient. This is usually a rare time when someone else is responsible for caring for us. I have one such example which offered me an opportunity to take a step back and realize just how frightening medical care can be for the patient. I would like the opportunity to share it with you. I had a perplexing reaction in a doctor's office during an appointment to start the course of vaccinations required for my nursing career. Mind you, I have always had an uneasy feeling of the doctor's office stemming from my association of the white-coated doctor and paper covered examination table equating to something being wrong. My blood pressure skyrockets concurrently with an elevation in pulse but this is the extent of my reaction. That is until this day. As the nurse came into the room with a clipboard serving as a tray to five syringes I sat quietly without the slightest inkling that my calm condition was to change in the very near future. I watched the nurse as he prepared the first of the syringes, the tuberculosis test is given just under the surface of the skin, and offered my forearm up for the injection. As he inserted the needle I felt fine. It wasn't until I saw the bubble rise on the surface of the skin that things went downhill fast. Instantly, I went white with sweat running profusely from my face. I removed myself from the table and sank to the floor as my vision spotted white. I was terrified and I had no clue as to why this was happening. After reassurance from the nurse that there was no danger, I lifted myself into a chair knowing there were four more shots still to come. I closed my eyes, the sweat now making watermarks on both my pants and shirt and prepared myself as much as possible for the next shot. With each additional shot came the same terror. When it was over I was required to sit and collect myself for twenty minutes so I did not faint. It was one of the most traumatic personal events I remember in my adult life. After leaving the clinic I half racked my brain for explanations and half tried to think of how I could make it through the last two series of vaccinations I still had to complete my immunity. At this point, I had no answers. The next time I went I had my wife accompany me to see if that would alleviate the problem. It did nothing. During the span of the six months from start to finish I searched and searched for an explanation with no real answers. On the last visit, I only had one shot to get this time and willed myself to finish, I decided to ask the nurse why this could be happening to me. I told her I had not been afraid of needles since I was a child, having no trouble with even a shot in the eye a few years ago, but was all of a sudden deathly afraid of them again. I ended by telling her that I was quite embarrassed that I was going to be a nurse who was afraid of shots. This made her laugh. It was in her taking the time to sit with me and explain this both being a common occurrence and a manifestation drummed up from childhood that I found my answer. She said I was afraid of shots as a child, grew out of it as I got older, and something since the last peaceful injection resurfaced my fear of shots being unsafe. As I thought for a moment it became clear what triggered the fear reaction. Microbiology class! She was right. She gave me some exercises to do before the shot, talked me through the safety of what she was putting in my body, and calmed me by allowing me to face my fears and work through them. My shot was a breeze. I've had another since and still no reaction what-so-ever. Today I am still astounded that something I was afraid of as a child could surface so profoundly out of the clear blue as an adult but it has helped me to realize that we truly are a product of experience. I had a revelation from my experience which I will carry with me for the rest of my life. I learned the value of a nurse as a caregiver. In other words, within the care of two nurses, I was given insight into the difference between a "good nurse" and an "average nurse". I realized the profound effect that a "good" nurse can have far beyond the walls of a hospital in a patient's life. The nurse who continued to administer shots during my anxiety without taking the time to "care for me" made me feel as though I was being rushed through an assembly line while the nurse who was interested in helping me beyond the scope of the requirement for employment saved me from a considerable hardship in life which I may not have ever sorted out without her. In her taking the time to comfort me and help me to the best of her ability she alleviated my stress and helped me to solve a problem; both of which I will always remember and love her for doing. In retrospect, I can see that her actions were selfless and had benefits for me which she was never aware. Let me explain. Before going in for my last shot I made a decision that if the situation dictated the same result in anxiety as the previous ones, I was going to speak to a physician concerning the prescribing of something to help me cope with injections in the future. It was this nurse that helped me to circumvent this course of action and allow me to face a fear rather than just treat the symptoms of that same fear. I can only believe that each of us is blessed with the desire to go above and beyond what is required to do all we can for our patients. In the monotony of our work days that give them the illusion of running together at times, there are things which we must remind ourselves at all times are by no means monotonous. These "things" are not really "things" at all. They are people. They are individuals, each patient unique, which make them different from any other as well as from us. No matter if you have an example of your own that you use to remember what it means to be in their position or your welcome use of mine, try to remember the next time you see a face as you enter a room that it belongs to a human being and that human being is in dire need of all that you have to give.
  16. I missed the phone calls, yet again. I don't know how many times I have given my brothers and mom my new cell phone number, but no one seems to write it down or remember it. So, at the end of a long day of nursing, I head home with a throbbing headache and take two Tylenol PMs, and sit down to write an article. My phone rings and I smile - it is my daughter. I answer the phone, "Hey Princess!" "MOM! Have you checked your phone? Have you got any texts from your brothers?" "No, I didn't get any, why?" "Mom, Grandad is in the hospital - call Granny!" I hung up on her and dialed my mom. I hang up the phone with my mom promising to drive the 4 hours to where they live in the morning. With the medicine I just took, I will crash, so I am not safe to drive. First thing in the morning, I head out. I have talked to my brothers, and they assure me that dad is fine but they are running more tests. I cannot helped but be stressed out. He's my dad. My dad is 90. He has lived a very full life, and I am very blessed to have both of my parents - I know this. My dad has had several strokes, hundreds of falls, but really, these are his only health issues. His medical history is remarkably healthy, except for the stroke, and possibly, undiagnosed depression. I remember when he was 84, he started to become a lot more quiet. One day he made the remark to me that caught me totally off guard. He said he would die when he turns 85. I asked him why he would say that. He answered, "because my dad died when he was 85". I replied, "Dad, grandma died when she was 106, and you are more stubborn than she was." He winked at me and nodded. He had his first major stroke at 85. Now, here we sit in the hospital. My dad is having a really hard time with his speech, and I can see his frustration in trying to be understood. His blood pressure is low, his GFR and creatinine are high, he is dehydrated. I can tell he is getting a little frustrated with my mom's chattering. I have heard "the story" about the 9-1-1 call already about 50 times. I don't stop her from retelling the story - someday I will miss her voice. I just nod and try to tell mom to be patient, we will get answers when the doctor rounds. No, mom, he is busy, he will be here when he can. No, he is not putting us off, he is doing his job with all of his patients here - answering questions from other scared families. I try to keep an eye on what I can - his IV site, his repositioning, here dad, try to take a drink. His hand is puffy at the iv site, but the site does not appear infiltrated. The line is flowing at a high rate to flush his kidneys (per my brother who talked to the doctor yesterday). I elevate his hand on a pillow. I feel like I did SOMETHING. Sitting. Waiting. Hoping. Praying. It is monotonous. It is incredibly stressful. I feel incredibly useless. And then, she walks in, glowing sunshine. This patient care tech (PCT) had a huge smile on her face and I could not believe what a breath of fresh air she brought into the room. The way she talked to my dad, the way she beamed confidence, displayed cheer! She checked every aspect of my dad to make sure he was safe and comfortable. She took all of his vitals and offered reassurance to my mom on his ranges. She teased my dad (very respectfully) and brought a beautiful, handsome smile to his face. I didn't want her to ever leave. I just thought she was amazing. I appreciated her so much. I will never forget her. I know that may sound really crazy, but, for me sitting on the other side of the bed, I have a whole new perspective. I can only hope that all nurses everywhere make their families feel as good as she made my family feel. I know - that is a tall order....she did set that bar pretty high.
  17. marshmallownurse

    Compassion is a Commodity

    After five days off, I drive to work singing. I'm a little off-key, but the windows are up, and my favorite songs are all queued up in preparation for the forty or so minutes my car will take to weave through 1740 traffic on my way to a place that I used to call my sanctuary. I grew up in hospitals, I used to tell anyone who asked why I would ever want to be in this profession. This is my natural habitat. But I digress.. The point is that I've been away for five days, and I was, for once, happy to be going to work. Or, more appropriately, I was very, very hopeful that I will not feel the oppressive depression that work has been inducing lately. I want to love my profession. I employ so much conscious effort in staving off the negativity that overwhelms me when I remember that I don't know how to be anything else other than a nurse. When positive thinking, meditation, deep relaxation, venting, and all the other internet suggestions didn't work, I even sought out a therapist who might be able help me come up with other ways to start loving patient care again. That's how much I want to embrace this profession. But, again, I digress. I am always cheerful when I walk through those double doors. I smile, I greet everyone appropriately, I take report, I assess my patients. It's the usual routine, bolstered by all the repetitive positive self-talk ringing inside my head. This will be a good day. I love my job. I love the people I work with. I make a difference. Then one patient's CIWA rises to 28 while he's cussing at me. He swings at the staff and hurls misogynistic derogatory remarks while we empty his urinal and try to keep his trembling legs from sending him face down to the unforgiving floor. He doesn't show an ounce of decency until first the security guard then the doctor walks in. They barely say anything to him but he's suddenly reasonable. He gets back to bed. Even in his poor mental state, he respects them, these gentlemen who were kind enough to grace his presence for exactly two minutes. But the nurses who struggle to keep him safe, who rearrange the entire unit so that we can put him in a room closer to the station because he's at such high risk of falling, who get yelled at by the doctor for calling for the nth time because he had no withdrawal medications onboard, who change his linens because, once again, this grown man has soiled himself, the bed, and the floor-we're just female dogs and prostitutes who need to shut the hell up or we'll get what's coming to us. This is Day 1. It ended with a CNA sitting beside me at the station waiting to give report to the oncoming shift. She was pulled from the floor and had to stay at the patient's bedside for the latter end of our shift. For the sake of my patient's safety, nurses with full patient loads willingly surrendered their aide. "You must not have been doing this for very long," she says, exhaustion apparent in her voice. She spoke with no hint of mocking or irony. "You still have a lot of compassion. Patient's like that-- they make it so hard to care."
  18. thywillbedone_

    Nursing as a Human Experience

    I'm writing this article on my bed, wiping my tears away and making sure that this article makes sense to those who are reading it. I just finished a 13-hour shift yesterday night at the CVICU. I am in my final semester of nursing school and I am so excited to be on this amazing floor for my preceptorship. For the past three shifts that I have been on this floor, I have been so happy that this floor opened up so many avenues and opportunities for learning. Things I have only read in nursing textbooks (when I do read them) are now being applied in the real setting. Machines, pumps and other alarms consistently needed my attention & care. And the patients that I have are "critical," which means that I get to do a lot for the patients and learn and apply many nursing skills. So, I finished getting my report from the night nurse, and my preceptor asked me, "What is your plan of action for today and are you ready for it?" It was a Saturday shift, and it seemed that the floor was quiet (the quietest I've seen it). I answered my preceptor, "I'm ready, it seems that we're gonna have an easy and good day." I shouldn't have said this (which I learned to never ever say this again), or maybe I'm glad I did (because I learned a great lesson). Throughout the day, there were two code blues, one stroke alert, and 3 code ices; all to which one of the CVICU nurses must run and respond. (Trying to keep this short & sweet & maybe sour - from crying.) Truth be told, I thought I was ready, but I wasn't. I was not ready for the tears that the wife of my patient would shed, as she left her husband - who was intubated and required continuous dialysis - to travel 6 hours away to go back home. I was not ready to see a grandchild who would give up the comfort of sleeping and eating, just so that his grandmother could rest well. I was not ready to respond to a stroke alert, in which I chose to comfort the crying daughter who tried to be strong, as 5 nurses were assessing her father. I was not ready for the physician to say, "There's no hope for my patient" in the break room just as I was grabbing my first sip of water for the day. I was not ready for one of the nurses to tell me, "The patient died," as I was too focused in her telling me that she had to perform chest compressions with one hand, for the patient was vomiting and expelling secretions from all places in his body. I was not ready. Being in the healthcare field (I can say this for myself), you forget that people who come to the hospital are really sick; some are more critical than others. You forget that there are so many hospitals in the world, and so many people waiting to be cured. You forget that there are so many more sick and dying people who are not in a hospital bed. You forget that you are in the middle of pain & suffering, as well as faith & hope. During hand-off reports, I became too focused on how many CABGs does the patient have, any lines or drainage, feeding pumps, etc. and charting. You forget that in that chart you only have one line for something, social support. You forget that your own patients are mothers, fathers, grandparents, and children. You forget that you are part of the first line of care for these patients. You forget that whatever you do for these patients directly affects them, whether it is all the medications you give, all the heavy turning & lifting you do, or all the assessments you perform. You also forget the last meal or water break you had, when you last peed or sat down. You forget all of the aching calves and back because you have to hang this med up or cover for a nurse that just ran to the sixth floor to respond to a code blue. You forget that you, yourself, are important. Being in the CVICU, I learned that there are so many patients in the world, from being discharged to dying. Nursing is not just "work" that we have to get through, it is also a human experience. Call it "therapeutic touch," call it "supportive," or call it "active listening." Don't forget that we are human and that there are human experiences to be recognized every time you step on that floor. I now know the importance of the saying, "treat the patient, not the machine." So when you walk into your work, or clinical rotation or preceptorship, ask yourself, "Am I ready?"
  19. The best nurses are compassionate and empathetic by nature, so it's no surprise that emotional exhaustion is one of the primary causes of "nurse burnout" - a term used to encompass the physical, mental and emotional fatigue nurses can experience after hardships on the job. This can cause some nurses to disengage, dulling their emotional responses to traumatic encounters.* "The loss of a patient, no matter the circumstances, never gets easier," shares Angela Puleo, clinical director of Home Health Services at Always Best Care Home Health Cleveland South. "You may feel a sense of relief for the individual who you watched suffering before death, you may experience shock because you just assisted the person to the restroom and had a pleasant conversation, or it may be disbelief because the patient just arrived on your unit and you were not even given a chance to care for them." As varied as the experiences of losing a patient can be, so too are the recovery processes, which can look different for every nurse. With that in mind, we spoke with a handful of nursing professionals to learn their best tips for overcoming the grief that accompanies such loss. Their advice may help you determine the best coping strategy for you. 6 ways to help you deal with a patient's death 1. Resist the urge to bottle your emotions "Like many clinicians, I find that I detach myself from the situation at hand within the moment and later process it privately," says Kathy Kump, director of nursing at Ottawa University. For some, however, detaching from the moment can lead to unwanted disengagement. "Parents and families want to know that you're human," suggests Trish Ringley, neonatal ICU nurse. "I have had parents say it brings them so much comfort, not feeling as if they're all alone in their grief when the people caring for their dying baby are tender and caring, when they are clearly saddened by the grief." She warns against keeping your human emotions locked in, adding that some may actually find it cathartic to express them in the moment. 2. Focus on the patient's loved ones If you, like Kump, are more productive in grieving on your own after the fact, it can be helpful to turn your focus to the patient's loved ones. "Supporting the family in their time of need gives the nurse a sense of purpose," explains Susan Tromp, practicing BSN in the Medical Intensive Care Unit at Good Samaritan Hospital Medical Center in New York. One of the cornerstones of holistic nursing practice is looking at the whole person, not just their illness or disease, according to Dr. Julie Anderson, dean of nursing at The College of St. Scholastica in Duluth, Minn. This includes considering the patient's loved ones every step of the way - especially in the event of a patient death. 3. Consider professional or spiritual guidance "Having pastoral care involved can help the family and the RNs feel a sense of peace that their loved ones are no longer suffering," Tromp offers. But it's important to note that seeking spiritual guidance doesn't always have to translate to inviting a religious leader to offer assistance. While this may be the most effective option for some, there are other avenues to explore. Kump, for example, has at times wandered into the hospital chapel to simply sit alone and cry. "Personally, I find meditation during the experience and after the patient's death helps me get a calm sense of perspective about the bigger picture - of life, of my job, of my family and of the families I work with," Ringley says. If the patient death is unexpected or unusual, nurses may be left with feelings of inadequacy or guilt, Anderson adds. In cases like these, she suggests utilizing the resources made available to you on the job, including a Critical Incident Debriefing Team, nursing peers, the facility's social work department, and chaplaincy. 4. Lean on your coworkers If anyone can truly identify with the tough emotions of losing a patient, your coworkers can. Not only do they know you personally, but they know the ins and outs of your job. "Turning to coworkers for emotional support is most important because of the mutual understanding of loss that RNs feel," Tromp explains. Discussing a tough patient loss with your peers can help you externally process the emotions you're feeling - especially if you're not comfortable expressing such emotions in front of a patient's loved ones. "It's incredibly difficult to face death repeatedly while at the same time remaining open to grief and sadness," Ringley adds, touching on the complexity of these emotions and the importance of expressing them to a close confidante. Grief that is suppressed, she says, can end up creating distance between the nurse and future patients. "Providing nurses with the ability to reflect with their peers after the loss of a patient can not only provide the emotional support necessary to go home and get the needed rest after a tragic loss, but also the ability to clock in for another shift," Puleo says. 5. Find ways to honor the patient in memoriam For some, simply processing the grief isn't enough. If you're the type who feels the need to do something, it can be helpful to identify ways to physically honor the patient's life. "Find time to respect the memory of the patient," suggests Sara Mosher, owner of Patient+Family Care. Mosher offers a few ideas: take a moment of silence, find time to be alone and pray, make a donation to a charity in the patient's name or, if invited by the family, opt to attend the patient's memorial services. "One 'living' tribute to someone who has passed is to plant a tree in a place that is meaningful for the individual," Anderson suggests, "such as a favorite park or school." 6. Remind yourself of the passion that drives your profession One of the most helpful antidotes to the deep levels of grief that can accompany the death of a patient is to remind yourself of the reason you chose to become a nurse in the first place. Focusing on the passion that fuels your professional life each day can help you pick yourself up and move forward. "One of the most beautiful rewards of being a nurse is to witness the sheer rawness and true vulnerability of the human experience," Kump says. "Each individual has their own unique journey and having the privilege to participate in these incredible moments in a patient's life, from birth to death, is without a doubt one of the most humbling wonderments in a nurse's own life." "It is truly an honor to provide care to a dying patient. Each experience is unique and changes you as a nurse and an individual in meaningful and positive ways," Anderson adds. How do you pick yourself back up? There is no cure-all when it comes to grieving a patient's death. But these tips from veteran nurses may help you cope next time you encounter a tough loss on the job. The most important thing is to figure out what works for you so you can pick yourself back up and continue doing the job you love. "I think it's safe to say that any person who deals with the delicacy of human life in their career has found that the only way to get through it is to continue to go on and have hope that the next case, the next patient, the next victim they care for will not yield the same results," Kump says. Do you have your own coping strategies to add to this list? How do you allow yourself time to grieve while still going on to pursue the true passion that drives your nursing career? Share your experiences in the comments below to help build up and strengthen your nursing community! *Source: National Nurses United article: "Beating the burnout: Nurses struggle with physical, mental and emotional exhaustion at work"
  20. ........A little effort can go a long, long way. Investing five or ten minutes in a needy patient at the very beginning of the shift sets the tone for the entire day, and pays dividends in decreased anxiety for them (and less call-light use for you). This principle also works for nightmare-plagued toddlers, frustrated spouses, and picky in-laws. ........Age has its advantages. Having been orphaned at thirty-one, I didn't know how much wisdom and life education I'd missed out on until I began working with the elderly. Through their stories of the past, I've discovered much about where I came from, who I want to be, and the legacy I want to leave my own children and grandchildren. I only wish I could bottle whatever these people are made of because our generation and those coming after us could certainly use a dose or two. ........No situation has ever been made better by panicking. ........If it weren't for drugs, alcohol, fatty foods, and human stupidity, we'd all have to go out and get REAL jobs. ........The longer you're a nurse, the more warped your sense of humor becomes. And a warped sense of humor can get you through almost anything...even the worst code brown in history. ........No matter how crazy your shift has been, there will always come a time when you get to hand over the keys and let someone else take care of the patients, put up with the families, fight with management over staffing, and deal with the paperwork when the 😂 in room 205 is found on the floor for the third time today. Remembering this is the only way I can maintain my sanity and still keep coming back, day after day, to do it all over again. ........Teamwork is a great idea in theory, but rarely practiced in everyday life........and that failure to "jell" as a team is not merely a nursing issue or a female issue. If anything, it's the American way---we're raised from the cradle to value individual achievement and make the attainment of personal goals our driving force. Group-think isn't natural to us---especially Baby Boomers---so I hope we can be forgiven for taking a little while to adjust. ........I finally understand what the expression "thinking outside the box" means. I don't care what the powers that be say---I'm not going to force a 90-year-old nursing home resident to eat his meat and vegetables before he can have his dessert, or put him in a nightgown when he wants to wear pajamas. I'm OK with bending rules, and I've taken my share of "verbal counseling" for doing so, but I'm simply not going to let anything so petty as facility policy trump my patients' rights to determine: a) what they may eat, drink, wear, sleep in, listen to, watch on TV, or read; b) how late they may stay up; c) whether or not they will take a shower on a given day; d) who may visit them; and e) which activities they want to be involved in (or whether they will participate at all). .......People will generally live up---or down---to your expectations. This includes nursing assistants and MDs. .......And yes, I've found that the Golden Rule is applicable to every possible situation, whether in nursing or in life: Treat everyone you encounter with the same respect you would want for yourself or your loved ones. Everyone who ever lived is, or was, someone's parent, someone's sibling, someone's child, someone's friend. What's more, we are all members of the human race---including the three-hundred-pound diabetic who smokes like a chimney and doesn't take her insulin and the homeless alcoholic who hasn't changed his socks in six weeks. We judge them only because we fear, deep inside, that "they" could just as easily be "us...but for the grace of God and perhaps a few strokes of plain good luck. So many lessons...so many opportunities to grow in compassion and wisdom. Thank you, Nursing!
  21. tnbutterfly - Mary

    When Nurses Cry

    Although it's been more than 30 years ago, I remember the occasion very clearly. My first death on Peds as the charge nurse. It was horrible. A four-month old with a congenital heart defect was to be discharged that afternoon. He was to go home and grow a bit more before undergoing a surgery that would correct his heart anomaly. I had just come from the room not 5 minutes earlier and the baby was laughing and playing on his father's lap. So cute..... The frantic father suddenly appeared in the hallway with the baby in his arms. He was no longer laughing but his little body was lifeless, his face very pale. We rushed him to the treatment room as the code was called and the baby's physician was notified. Any code is unpleasant, but a code blue on a Peds floor is a dreadful experience. The tiny treatment room was alive with a high level of anxiety and activity as the many responders crowded around the tiny pale body. Many were unsure of dosages for one so small, but were willing to help in what ever way they could. The baby's pediatrician arrived and took charge. Despite the long and valiant efforts of many, the baby did not survive. We were all exhausted......emotionally and physically. The family was devastated as was the entire medical team, tears streaming down the faces of many. There were so many tears. Even the pediatrician was crying. So very sad.......... The parents were holding onto one another, sobbing quietly, as the doctor and nurses tried to offer their support. In the face of such an overwhelming and painful crisis, nurses were able to make a difference that day as they provided tender and compassionate care to the mother, father, and extended family....through their tears. Because of the very nature of our work, nurses encounter many situations of grief, death, sorrow, and crisis. While we frequently witness others crying around us, we try to maintain a "level of professionalism", keeping our emotions in check, especially in front of the patient and/or the family, or other staff. Some people view a display of emotion as weakness, and will suppress their feelings, remaining controlled at all times. As a nurse, it is certainly necessary to control your emotions so you can handle a situation and provide safe and appropriate physical care for the patient. But periodically, not showing our emotions.....our humanness......is viewed as cold and unfeeling. In certain situations, expressing genuine emotion can be a sincere way to provide emotional support. Nurses work very closely with their patients, providing intimate care to the whole person on a daily basis. We see their struggles against their disease; we hear their cries of pain. As we share intimate and intense conversations with patients regarding their care as well as their fears and concerns, we get to know more about them as a person. Because we get to know them and their families so well, we end up caring for them. It is easy to become attached, even though we try to put up our professional boundaries. Patient suffering and death does affect us as nurses. How we respond is different for each of us. As nurses, we strive to provide compassionate care, sharing in the grief, loss, and fear experienced by patients and their families. We want to do more than just go through the motions, becoming numb to the pain of others. Seeing that doctor cry openly after the death of that infant so many years ago, made a profound impact on a very young nurse who was just embarking on her career. My level of respect for him as a doctor and a person grew. Since that time, I have seen many nurses and doctors shed tears in the presence of the patient and/or family. These days, I more often care for people on the other end of the life cycle. I am often called upon to stand alongside someone as they take their last breath. I still get tears in my eyes, but I don't even try to hide them. To read more articles, go to my AN blog: Body, Mind, and Soul Be the Nurse You Would Want as a Patient From the Other Side of the Bed Rails - When the Nurse Becomes the Patient when-nurses-cry.pdf
  22. Nursing, a caring profession or is this a lame description? Caring is such a mild description of what nurses are about. I believe the word care or caring are no longer adequate to describe what we as nurses do as a profession. I really do think you have to be a special kind of person to be a nurse, over the years I have worked with Nurses from all walks of life, different cultures, beliefs and back grounds. Did all of them care....What does that mean to you 'Care' So what do we all have in common? What a difficult question, because I honestly think not many of us have much in common. Is our common ground caring? No I do not believe that is our common ground. We are all bound together because we wanted to be nurses for one reason or another. Another question which springs to mind 'is the reason we came into nursing the same reason we stay in nursing?' Why did we come into nursing? Again there are many different reasons why we become nurses. One of the main reason nurses state they came into the profession is 'I want to care for people' Really! I don't think that holds much merit anymore, nursing is a lot more than caring for people. Caring ... Nurse ... what do the words mean? In the dictionary caring (adj) feeling or showing care and compassion a caring attitude (Social Welfare) of or relating to professional social or medical care nursing is a caring job nurse (n) A person educated and trained to care for the sick or disabled. During many interviews over the years I have heard when asking the question 'tell me about yourself'. Responses will often include 'I care about people'. I do take that into consideration when selecting the right candidate but caring, is just not enough to be a good nurse. Care or caring are the first descriptive words which come to mind when the public think of the word 'Nurse', I don't really think that many seasoned nurses would say I am a nurse because 'I like caring for people'. Do we think that this is an old fashioned attitude which stems back from the era of Florence Nightingale? Do we really think that we as a nursing profession consider 'caring' as definitive description of what we do or what we stand for? I believe nursing has evolved so much from the core values, that caring is no longer a good description of what nursing is all about. It is too simplified a description of what we do. How many of you have heard an aide saying, 'the nurse doesn't care, I could do the nurses job all they do is give out medications, and talk on the phone? I know as a manager I have aides and technicians coming to me saying that they do all the work because the nurse is always on the phone or writing notes in the computer. This is what people we work with on a daily basis see nurses doing, and think it is easy. Are they playing games on the computer, or socializing on the phone-I doubt it! They are spending their time documenting, to cover themselves just in case they go to court 5 years from now. Caring who has time to care these days? Remember if you didn't document you didn't do it! Seriously, you can document anything you want to it doesn't mean you did it, it just means on paper you said you did it! It always makes me scratch my head in wonder, because we have all met the nurse who documented something you know she never did. I know where I work the nurses run round like headless chickens, trying to complete a 100 tasks at once, and if they do get 5 mins to breathe, are they sat in the patients room caring? Not many, they are trying to run down to the break room to stuff their lunch and a drink down their throats as quickly as possible just in case it might be their last food of the shift. I know I go to a restaurant and eat a meal faster than anybody else at the table, because I can. After a couple of decades on the job, I no longer notice that I eat my food fast, not pausing for breathe because it is normal for me. Another thing I am fast at, showering! I kid you not I can shower, wash all my body, shampoo and condition my hair in under 5 minutes, grab a cup of coffee and be out of the door in 15 minutes from alarm to car. Caring? No I do not think that is what we are all about, we are so much more than a caring profession. Yes we do care! We care very much-we care that we cannot spend as much time with our patients as we would like. We care that if we don't document the conversation with the Dr, then we didn't have the conversation. We care that we didn't have a drink or lunch that day. We care that others are judging us on a daily basis. We care that we have a heavy workload than anybody else. We care because the reason we became nurses is no longer valid, we know we have different reasons we stay in the profession. We care because in order for us 'to care for a patient', we have to be experts not in caring but in being efficient at managing the disease process, policies and procedures, up-to-date information about the day to day management of their 'plan of care'. We care ...
  23. Having been a nurse of some type over the last 30 years. I have had many patients who have endeared my heart to further my education in nursing. I have two particular patients to whom I owe my education in life and nursing. The first patient was a woman who had worked hard her whole life for her family. She was sick most of her life, genuinely sick, yet she was up and at them every day working and carrying on what she needed to get done. Each time I would see her I wondered how she got through each day. When she would come into the hospital she always carried a bag of yarn and crochet hooks. She would have baby blankets or coverlets made before discharge. Often she would give these to the nurses who took care of her. She was quite strong in her faith but did not force it on anyone. You could see it in her eyes and she would often comfort the nursing staff, more often than they her. This dear lady taught me to grow in my faith in a higher power to get me through my shifts. She gave me remembrances of her life to keep with me when the stress of patient care was too heavy. She taught me that it was OK to pray, cry, and hold someone close when they are dying. This was her way of easing everyone's pain. My second patient was a gentleman who had a smile and a good word for anyone who was in his presence. He also was a very hard worker all of his life whose health was great until he was 82 years old. He was a widower who loved the nurses who took care of him. He always was holding their hands or giving a wink. He had open heart surgery at the age of 82; he really did not want to have it, but he wasn't ready to die either. I was fortunate to be able to take care of this man in the last 6 years of his life. I was with him the night he coded; he later woke up and wondered who had been banging on his chest so hard, he ended up with 7 fractured ribs. His strength was unbelievable and he would often overdo so he could get back to work and finish what needed to be done. This man retired about 4 times before his death. He always had the smile on his face, even when it was not the best. His strength was always there for all that took care of him. He taught me not to be afraid of anything and do what is needed, provide for those who can't for themselves. He never let someone be in need. These two patients have made my nursing career grow through allowing me to learn to love, cry and hold a patients hand. That caring is sometimes what is needed instead of medication. I have become a much better person and nurse in the last 30 years because of these two persons who came into my life for a short time. Because I was a nurse I was allowed to care for them. These patients were my Parents. I was privileged to work where I could also care for them when they were sick. Susan, RN BSN Clinical Instructor
  24. One day, as I walked in to my workplace after my long leave, I noticed a new patient in my ward. Actually, she is not new to the hospital, this lady has been staying in another unit for nearly a month due to non healing wound. I was deployed to that unit earlier on and the nurses there had labeled the patient "fussy". This patient's fussiness is notorious over the other unit. 2 hourly positioning for her is a nightmare for most of the nurses, her groaning haunted me throughout the shift. Besides, she's grumpy, if anything went wrong in her nursing care, she'll start yelling. It was my first day of my night duties that I saw her in my unit. "Oh God, she's here now! What a..." I said to myself, groaning underneath my breath. My colleague passed over to me that this lady had been crying for one whole day when she was transferred to my unit. What has been passed over to me sounds nothing different from what she was known as in the other unit. What a "fantastic" beginning for the night. It is our routine that we check our patient's vital signs in the beginning of every shift, when I went to her, she told me that she is scared. Happen to be new to my unit, she feels lonely. She claimed to be closed to the nurses in the unit where she came from because she has been staying there for more than a month. Suddenly I feel sorry for her. I feel guilty for labeling her as "fussy" without really trying to know what happened in her. She can't sit up on the bed and her body is weak, this means that she requires full nursing care. She has a bedsore at the back, two hourly positioning for her was not only nightmare for the nurses, it is her nightmare of all. She claimed that the nurses in the other unit did a very good job. Instead of dragging or pulling her, they eventually lifted her every time she slide down towards the end of the bed. She doubted our ability to do that because there were only 3 of us working during the night and back in the other unit where she stayed, there were always 4 to 5 of them. I assured her that she'll receive the same quality of care in my unit. I was told that she has involuntary movement on her legs every time when my colleagues tried to change her position in the bed. I saw her suffering the pain caused by the involuntary movement. Me and my colleague decided to stay in her room massaging the legs until the pain is relief before we reposition her to another position. After a few days repetitively doing the same thing for her, she begin to know us by our names. She praised us for treating her well and complimented us. Her husband came and told us that she was anxious on the day when she was transferred to my unit, yet now she feels relief.
  25. mother/babyRN

    The Sweet Old Man in Room 724...

    One can forever discuss the unmistakable magnificence of mountains or sunsets, or millions of other unforgettable miraculous occurrences. So many moments we take for granted, assuming other such moments will follow with scarcely a thought as to how fleeting they really are...Life is not a promise, but a gift...Not everyone can "see" the subtle nuances we are so fortunate to experience as time carries on. Vast sky, awash in color in early gray dawn; vivid palettes of rich oranges and pinks seeping silently toward the city like perfectly tinted paint on some ghostly artists' easel...This is what I see as the days old night retreats... Today I was humbled...I'm not certain why the feeling occurred today as it was, until then, a day not unlike any other. I wanted so badly to reach out and stroke your forehead, all the while imagining if I were you I would need to know that someone cared. Odd, you can't see or hear me, cannot comprehend...those tired eyes, which are absolutely the most beautiful shade of light powder blue, just like my gramma's, tell me as much...Or do they? I never knew you. Then, suddenly, you were my newest patient-Mr. A, the CVA in 724. Massive stroke with little hope of recovery. Until then, that is exactly how I thought of you...Until today...Until this very moment.... You must have been a grand gentleman. Stories regaled by the fire in the cool briskness of late autumn. I suspect bold gregarious yarns accompanied by rounds of barreling laughter and peals of delight from scads of grandchildren gathered gleefully at your feet, mesmerized in rapt attention as grampa spun tales by the fire under a dark blue velvet, flawless star flecked sky....Sparkling, dancing eyes and work roughened gentle hands, wisps of white hair ruffled in the face of a breeze on the open sea. I think you must have sung songs too..I can't explain but somehow I'm sure of it. Sad that you may never again know anything of the world, at least as YOU knew it...I don't know you, but somehow I already miss you. I grieve for you, your life and what might have been but can now most probably never be. I remember my own grampa and the way he smelled-pipe smoke and rootbeer....I memorized every little wrinkle when he laughed...You remind me of him...... Can it be that you are no longer even aware of your own existence? I pray not. I think not, for somehow you have connected with me and touched my heart. Your tortuous, labored breathing makes my own drawn and painful, and as I caress your weathered face, I see no tears in your eyes but in my heart I know that they are there. Mine have joined them... I wonder, God, what if the man inside can hear me? What if everything is understood? How frustrating, no, how absolutely terrifying not to be able to reach out, but to merely exist. To move, to be alive, yet not... So, I will touch and comfort you, feed and bathe you, keep you warm and manintain your dignity, and even if you never again stir, we will know, you and I, that we are somehow responsible for each other, for you have touched my heart without uttering a single word...You have made me a better nurse and are an unforgettable immortal lesson on my journey to the future.... Go on dreaming Mr. Al, for I am here for you... I will always care... Written by : Martha RN