Chicken Soup for the Nurse's Soul: Second Dose
While listening to the story, Beth notices Haley still standing closely, almost protectively, by Timmy, who is now glancing at her from underneath the bill of his cap. Just then, Nurse Anne, Haley’s favorite, walks through the room and calls out Haley’s name. Haley reluctantly moves away from the corner while looking back at Timmy. It is as though she can sense his pain. Anne quietly observes this and reaches out her arms to Haley with tears in her eyes. She lifts the little girl from her walker and Haley snuggles her head on Anne’s shoulder as she’s carried into the exam room.
Timmy’s mother explains how Anne has tried everything to reach her son, but in spite of her persistent, loving efforts, he rejects her and everyone else there.
A short while later, Haley and her mom are preparing to leave the clinic and head for the promised visit to the ice cream parlor. Beth turns to the exit door, but Haley is whispering to Anne, who is kneeling face-to-face with her. The two conspirators, the endearing disabled child and the caring nurse, smile at one another, hug, and then part.
“Just a minute, Mommy,” Haley says.
She crosses the room to where Timmy still sits in his solitary corner. She puts her tiny fingers on his tightly closed fist almost hidden in his jacket sleeve. He lifts his eyes to meet hers and does not pull away.
Haley whispers, “I think you are beautiful.”
Tears appear in Timmy’s eyes as Haley continues, “Every night my mommy prays with me and we ask God to take care of me. Tonight we will pray for you.”
The adults in the room who had previously avoided looking at Timmy are now watching and listening. Timmy looks directly at Haley, then holds his arms out to her. She leans away from the safety of her walker and into his embrace.
Barbara Haile
A Sign of Love
The greatest pleasure of life is love.
Sir William Temple
Wandering down the halls of the locked unit of a long-term care facility, you will see many things. People look lost and lonely; they smile at you as if you were family and they walk aimlessly throughout the building, which is both familiar yet strange to them. Today is in a previous time—the year is 1936, when the war just broke out, or 1952, when they gave birth to their first child.
Working in the nursing home you become the residents’ family. In you they see their daughter or son, the one who never visits, and they feel comfortable and happy knowing that someone who cares about them is close by.
Language is lost for them. There are no more utterances of, “I love you,” no more “hellos”—it’s just the silent sound of people who are trapped inside themselves, trapped by a disease called Alzheimer’s.
As a recreation therapist it has been my job to cultivate the incredible creative spirit that lies within these people and provide them a way of having fun and expressing themselves—with or without words.
This is where our story begins.
It was an early morning as I walked around the locked unit. I gave Sheila her good morning kiss and Shirley a hug as we usually did every morning.
The unit was quiet except for the familiar tapping noise. I went into one of the small living rooms to discover Marion tapping the top of her chair. This was a daily occurrence. We knew she was trying to tell us something because she only tapped when she wanted our attention.
I walked over to her and kneeled on the floor beside her. She looked at me with grandmotherly eyes, pursed her lips, and gave me a kiss. Then pointing to me, she tapped on her armchair and smiled.
This event went on every day. I always gave her a kiss and sat with her, as Marion didn’t utter a word. I could tell by her eyes she desperately wanted to tell me something; I just couldn’t figure out what it was.
One day the tapping on her chair was uncontrollable. Every tactic to distract and redirect her was tried, yet nothing seemed to work. I was downstairs doing paperwork when I heard my name on the PA system instructing me to come right away.
I dashed to the elevator thinking something was catastrophically wrong. Did someone fall? Had someone died? My heart pounded. I found the nurse in charge of the unit frantically trying to deal with Marion, who was now very upset and shaking.
I went to her, smiled, put my hand over the hand that was tapping and rubbed it. I looked over to the nurse who was obviously relieved to have someone come to her side.
I said, “What is it, Maid Marion?” as I called her frequently. She frowned a big frown. I kissed her cheek and decided the best thing to do was talk to the nurse and see what had transpired.
On my way out of the small living room area, I turned to Marion and stuck my index finger in the air and bent it several times as if to say, “I will be right back, don’t worry, I love you.” Marion must have thought this was wonderful and mimicked my action immediately.
I spoke with the nurse and after we documented what had happened, I went to check on Marion again. She was mimicking the action I had just performed to the other residents in the room—holding her index finger in the air, bending it up and down, in a little wave.
“What is she doing?” asked the nurse.
“I think she is telling the others that she loves them,” I said smiling.
The very next morning I discovered Marion waiting for me at the door. She smiled and hugged me and then made her finger sign for love. I smiled at her as the tears welled in my eyes. I could tell Marion had finally found a way to communicate what she had been longing to tell me: “I love you and thank you.”
Eventually this sign of love spread throughout the unit like wildfire. All the residents and staff used the sign of love with Marion and with each other.
Marion proved love can be conveyed without words, and that Alzheimer’s disease doesn’t change a person’s ability to share it.
Annisha Asaph
Katie
The wheelchair dwarfed her tiny body as she sat quietly hugging the teddy bear in her lap. Even though her hair was pulled back, soft wisps of rogue curls framed her face. All dressed in pink, Katie was the picture of sweetness.
It was obvious that Katie was a favorite among the nurses as gentle love pats were given each time they passed her chair. But even with the touches of love, she simply sat with her eyes focused on the floor.Well into her nineties, Katie was afflicted with Alzheimer’s.
Sadly, Katie wasn’t the only one in the room who was lost in her own world. There were fifteen others in varying degrees of dementia who had joined her in the activities room of the nursing home. And, for the next hour, this little group would be my “audience.”
As a part of my Touch of Love ministry, I have the privilege of taking my little “sidekick” (dummy), Ezra, for visits in nursing homes, hospitals, and places of special needs. He sits on my lap and with the trickery of ventriloquism, he can say the darnedest things.
The scene was all too familiar . . . wheelchairs, walkers, blank faces, and weary bodies. But what was also familiar was the evidence of loving care given by the nurses and staff. I’d come to the conclusion that “TLC” is a universal, inborn quality in caregivers to the elderly.
As Ezra and I moved from wheelchair to wheelchair, the mood in the room changed. Not only were there sounds of laughter coming from the patients, but they were coming from the nurses as well as they witnessed the delight in the responses to Ezra. It seemed that everyone in the room was connecting with the fun—except for Katie.
She simply sat. Her eyes focused on the floor.
Having started on the opposite side of the room, we reached Katie’s wheelchair. Kneeling in front of her, with Ezra at her eye level, Ezra said, “Hello, Katie. I love you!”
She lifted her sky blue eyes and said, “I love you too!”
It was breathtaking to watch the transformation in Katie’s face as she broke into the most delightful toothless smile. And the “conversation” between Ezra and Katie? It was actually quite comical. The topics changed with every other sentence, and Ezra was having a hard time keeping up! It was obvious that
in her younger days, Katie had a wonderful sense of humor, on full display here.
At first, because I was so focused on Ezra and Katie, I was unaware of the commotion happening behind her. But, gradually, I realized that something was going on. The nurses and staff were hugging one another . . . actually jumping up and down. They were laughing and crying at the same time, beckoning to others in the hallway. I wondered, What good news have they just received?
It wasn’t until I had finished the visit that I learned the “good news” . . . it was Katie. That was the first time that any of them had heard her speak.
“Ezra may be a dummy, but he has accomplished something we haven’t been able to in three years!”
Gail Wenos
Winter’s Story
A mother’s love for her child is like nothing else in the world.
Agatha Christie
December arrived and with it, the usual preparations for the holiday season. Our unit, an NICU, entered our hospital’s holiday decorating contest. Snowflakes and all, my helper elves and I transformed our workplace, abiding by the theme “Peace on Earth and Goodwill to All.”
Here in Scottsdale, Arizona, the daytime temperatures had dropped into the fifties. We had three solid days of rain, our equivalent of a midwestern snowstorm. The locals agreed that the last and coldest season of the year was upon us. Yet little did we know that winter was yet to arrive in our unit.
On December 5 during a scheduled Cesarean section for breech presentation, one of our neonatologists was urgently called to the operating room. All present were astonished by the baby who had just been born. Although crying and screaming, this little baby girl was encased in a thick layer of her own skin . . . her eyes merely narrow slits, her arms and legs flexed and contracted. It was as if this precious little girl had been born in a cocoon.
Our neonatologist immediately recognized this child as a collodion baby. She had seen this condition before and assured us that the yellow tight film, or dried collodion membrane, would undergo desquamation or peeling complete by two to three weeks of life. She assured the parents that although their baby would require special care, chances were that she would be okay.
Instinctively, the mother also knew that all would be fine as she received her child with open arms. Even through narrow slits, their eyes met and so did their hearts. Lovingly she named her new baby Winter.
I met Winter for the first time when she was three days old. When I approached her Isolette, I was shocked. I had never seen a baby like her in my nearly thirty years of experience. After report I had to step away and take time to compose myself. Several deep breaths later, I began my nurse-patient relationship with Winter, an experience I will never forget.
Cracking, leathery skin covered her entire body. She was able to move her arms and legs, yet range of motion was limited by the all-pervasive thick skin that restricted even the digits of her hands and feet. The same thick skin covered her ears, yet the ear canals were open. Winter’s eyes were narrow slits and her face was encased in the thick skin, yet her nares were open and she required no supplemental oxygen. Remarkably, she was able to suck, swallow, and breathe easily.
Needless to say, her condition required special considerations. Initially she was kept in an Isolette with 90 percent humidity, more like Florida than Arizona. Nothing could be attached to her skin, no skin temperature probe or monitor electrodes. No arterial or venous access could be maintained, accept via a single umbilical catheter. Winter’s care included protective isolation, sterile linen, rigorous skin care and diaper care, frequent application of emollients, lubricating eyedrops, and daily baths with gentle debridement.
Winter’s mother breast-fed her around the clock. She participated fully in her care, eagerly making suggestions. After she was discharged, she came to the hospital in the morning and stayed all day despite her C-section and her two children at home. She pumped her milk diligently so that Winter rarely had formula, even during the night. Winter’s dad spent long hours at work but visited in the evening and always told Winter how much he loved her. Grandparents provided support, visiting often and taking care of Winter’s siblings.
After that first day, I became attached to Winter. I took care of her every day that I possibly could. Special babies with special families usually attract an entourage of nurses who insist on taking care of them. Winter had her posse. No outsiders had a chance.
Gradually,Winter started to emerge from her cocoon. She was acclimating to our dry desert environment and moved to a regular crib. Those beautiful dark eyes became larger. A great deal of her leathery skin shed. She had freer movement of her arms and legs. As the thick skin came away, fingers and toes also appeared. She could grasp. Her skin became accustomed to cotton clothing, cute, mostly pink little baby girl clothing. Soon her medical needs would be provided on an outpatient basis. Soon we would say good-bye.
As far as needs, Winter actually was born with everything she would ever need. Sure, her unusual condition required NICU care but she had all the things that any baby needs, all that any of us really needs—a mother who loves her and believes in her and knows that everything will be all right.
Christmas Eve arrived. It was time to go home. Winter was all dressed up in her layette and bonnet, sitting in her car seat and ready to go. Her mother gave me a long hug and thanked me for taking care of Winter, for doing so much for them. Tearfully, I hugged her back, looked into her eyes and told her that they had done so much for me. They had become my inspiration.
Each December we are reminded to think of “the real meaning” and “the true spirit.” When snowflakes appear I will always remember a mother and her remarkable little girl. I will fondly recall Winter’s story, one of love and belief, a story of Madonna and child.
Christine Linton
Serendipity?
Destiny is no matter of chance. It is a matter of choice. It is not a thing to be waited for, it is a thing to be achieved.
William Jennings Bryan
He shouldn’t have been on my unit, but Medical was full and Orthopedics had a bed opening. I shouldn’t have been his nurse, but the R.N. assigned to that wing called in sick for the evening, so the rest of us divided up her patient load. If he had been sick just two weeks later, I would have been gone, since I had already accepted a job at a different hospital in another city.
Our first meeting was a bit unusual; it involved two rather uncommon items: an aspirin suppository and a large hypodermic needle. Not what one would call standard “get to know you” equipment.
During my administration of his nasal douche, I remember saying something like, “I know this is uncomfortable, Mr. Nichols, but it has to be done.” Where’d I get that little tidbit of bedside manner? Not very comforting when someone’s squirting saline up your nose, I’m sure. Most of the time, he hid under the covers in 541-2 and clearly wanted to be left alone.
On any other shift, he would have been the most critical patient on my team, requiring the most attention. But the moon was full and any nurse knows what that can mean. The night was crazy! I had a biker, involved in a motorcycle accident, who had definite attitude issues. He was not adjusting well to the pins in his legs and entering his room meant ducking airborne bedpans. An elderly gentleman, recovering from hip replacement, was a tad disoriented. He hid chewing tobacco and spit it on the walls, the linens, the dresser, the bedside commode . . . and the nurses’ white uniforms. Three units of blood were infusing down Hall #1, which necessitated countless vital signs and checks on the blood warmers. There were complicated dressing changes and one unexpected Code Blue. So, with these situations and the extraheavy patient census, it was impossible to do more than meet basic needs. It was a night of “no frills” patient care—no back rub, no bedtime snack, no teaching, no interaction for psychological assessment, nothing but ordered procedures and meds. High stress is definitely not the best environment under which to recognize and appreciate your future mate.
My shift ended at 11:00 PM
and with patient needs now in the domain of the crew on night duty, my charting began. By 1:00 AM, heading home seemed remotely possible, when a nurse’s aide stood at the desk with bundles of clean linens in her arms and reported that the patient in 541-2 had soaked the bed. I was shocked!
“That young man wet the bed? What happened?”
“Your aspirin suppository is what happened!” she laughed. “His fever finally broke.”
Now the guilt started to set in, gnawing at my conscience for being a basic nurse instead of a good nurse. Since he was awake anyway, and no doubt feeling better now that his temp was normal, I decided to go in and apologize for his less-than-five-star treatment.
Our eyes locked. There was instant electricity, a sense of “something’s happening here.” In that first relaxed moment of a totally insane night my internal voice murmured, “He’s been my patient?” He later admitted to a similar voice that said, “She’s been my nurse?”
Running a hand through his tousled mop of hair, he sighed, “Forgive me, this is the worst I’ve looked in my life.” But somehow I just didn’t notice.