I tried to feed her soup, but she splattered it over us both with her wild head jerks. She chewed paper straws I put to her lips, then sprayed the chewed paper like spit wads. When her father came that evening, I unsuccessfully tried to cover her nakedness, apologizing with crimson embarrassment at her disheveled state. I muttered helplessly to him as I hurried out of the room. He shook his head sadly, more familiar with his daughter’s behavior than I cared to imagine.
When her father left later, she yelled, “You’re stupid! Stupid!”
I fumbled for another hour attempting to reach past her fury. I inquired about her unopened gifts. I freshened her flowers. I tempted her with candy, and offered to read her stories and to watch television shows. Nothing worked.
After two hours of frustration, she changed her mantra just a bit, “You don’t know anything. Nobody knows anything. But I do. I know!” She finally screamed, “Tell me!”
Scared and shaken, I sat two feet in front of her and asked, “Tell you what?”
She eyed me through her tangled, teary mop, then yelled, “You’re just like the rest of them. You’ll just say the same thing!”
“What? What do you want to know?” I pleaded softly.
For the first time in six hours, she stopped struggling and cursing. She was so quiet I thought she had fallen asleep. Then a small whimper rose from the sheets, and I heard her muffled question, “Is my mother dead?”
The charge nurse’s warning flashed in my mind. I didn’t know how to answer without disobeying orders and possibly scarring the child for good if I answered truthfully. I remained silent, but the deadly quiet urged me to risk a tentative compromise. Steeling against her next wave of outrage, I asked quietly, “What do you think?”
“I think she is,” she said in a low monotone. “I think my mommy is dead. I can’t feel her anymore. She’s been dead for a long time.” I let her words hang in the air. She knew, without a trace of doubt.
I took a deep breath, prayed for forgiveness, and said, “You’re right, Hon. Your mommy is dead.”
At that, a loud wail rose from the rumpled sheets, a helpless, lonely one that swelled and dropped without fury, without resistance, without hope. I cried for her loss, then for my loss of any hope of becoming a nurse. When they found out I told her, I’d be fired and barred from any nursing school anywhere.
Her wails finally shuddered to hiccups. “My father kept sa-saying she was in hea-heaven. Whenever I asked where she was, everyone said she’s in a be-better place.” Her voice trailed off into soft sobbing again, and then she added miserably, “I need a bra and I don’t want my father to get me one. I want my mommy to. . . .” Her sorrow rose again, breaking both our hearts.
Slowly, over the last two hours of the shift, I undid her restraints, bathed her, changed her sheets and dressed her in one of her new nighties. We opened her gifts and she wrote thank-you cards to her family. We cried now and then, and she let me hold her whenever a new wave of sorrow swelled through her.
Before settling in for her first night of unrestrained sleep in weeks, she read to me the words she had just written on the front page of her new diary, “My mother is in my heart and Virginia is going to be a nurse. She will be a very good nurse.”
I fiercely prayed she was right.
When I finished my detailed report that night, the charge nurse patted my hand and said, “Well done, Virginia. Well done.”
The child went home the next day.
Two years later, I graduated as a registered nurse— hopefully, “a very good nurse.”
Virginia L. Clark
Finding Your Easter Sunrise
The longer I live, the more convincing proof I see of this truth, that God governs the affairs of man.
Benjamin Franklin
There is a stopping point in the North Carolina mountains called Pretty Place. Pull off the main road and follow a dirt one to a clearing, and there stands an open-air chapel on the side of the mountain. Simple concrete benches encompass a stone pulpit. The area is open on all sides so you can see the breathtaking beauty of the scenery. A feeling of reverence permeates the place. People talk quietly, as though in church, in this wonderful place of solitary reflection.
At Easter time about twenty years ago, a group of friends and I decided to attend the sunrise service at Pretty Place. I had always wanted to go but never managed. I was an emergency-room nurse and had to work on this particular Easter Sunday, too, but worked it out to go to the service, and then go to work my shift. We got up about 2:00 A.M. to make the drive to Pretty Place. We arrived in the dark, parked and proceeded toward the chapel. A huge gathering of people collected in and around the chapel. In darkness, a simple nondenominational church service was held including a hymn, a prayer and a short message.
I was content just to sit and enjoy the tranquility, the smell of earth and pine, and feel the coolness of the morning air on my skin. I heard the birds and the sounds of the woods around us and enjoyed the pleasure of being with my friends. The sky lightened as the day broke and a glowing orange ball began to appear as if it was rising out of the earth. One minute there was a gray canvas and the next, a glowing sphere of orange, yellow and pink rose, filling the sky. Then, more quickly than they had come, the crowd took their leave to return to the real world. I headed for work.
I arrived feeling peaceful and ready for the day. The ER was quiet, too. Since there were no patients, I began cleaning and restocking.
I heard the familiar announcement, “patient in the hall,” and then the sound of a male voice calling for help in desperation and panic. I entered the hallway to see a man carrying a small, limp, breathless child. Traces of blood and discoloration smeared one side of her pale face. No other wounds were visible. The man handed me the little girl, dressed in a frilly dress, lace-trimmed socks, patentleather shoes and a crushed Easter bonnet. His words spilled out. He couldn’t see her when he backed the family van out of the driveway. She was dressed and ready for church. She saw her daddy leaving. She ran behind him. She only wanted to go with her daddy.
I rushed her into critical care, leaving the father in the hallway. Someone would come shortly to get him to fill out the paperwork and show him to the family waiting room—not the usual waiting room, but the small, softly lit, private waiting room where families and friends await bad news and pray desperate prayers for the lives of their loved ones.
As the call of Code Blue went out over the hospital loudspeaker, a team gathered to do all that was possible to save this child. Her Easter clothes were cut away and she was intubated. We began CPR, started an IV, and gave her drugs to attempt to restart her heart and lungs. It soon became obvious her neck was broken. We continued to resuscitate her, doing everything within the power of man and medicine. We couldn’t give up the life of this small child. Often a knowing, an intellectual process, says there is nothing to do, but the heart pushes us beyond this knowledge to try anyway. So try we did.
After the hopeless resuscitation ceased, I slowly removed the tubes with tears in my eyes, a huge lump in my throat and heaviness in my chest. We took care of the details of preparing her body for death and for her family to see her. The emergency-room doctor went to the family room. His words to the father started with, “Your little girl is dead. There really was nothing we could do, but we tried.” He talked, trying to explain what had happened. He listened for a little while to give the father a chance to respond.
The cry we heard coming from this man as he was given the news still touches me at the core of my very being. Some of us have experienced the misfortunes in life that enable us to understand the pain and loss this man must have felt.
It’s been twenty years since that Easter Sunday. I am married now and have four children of my own. I traded in the job of being a nurse for that of being a full-time mother and homemaker. Not an Easter has passed since that I do not remember that little girl in the arms of her father on that Easter Sunday. I can always recall the pain and agony of that fat
her’s cry at the news of the death of his daughter. Now, as a parent, I understand that cry in a way that I couldn’t at that time.
Medical personnel must learn to deal with the pain and suffering of others in order to do their job. We witness human misery, loss of limb and life, loss of family and, at times, the horrible unspeakable things that people do to each other. My saving grace is always that when I remember that little girl dying, I also remember the profound experience of being at the Easter sunrise service. I’m glad that on that morning I made the effort to go. I remember the magnificence of that sunrise there on the side of a mountain and the awe I felt taking it all in.
I experienced two opposite ends of the spectrum of human emotion that day—wonder and despair, life and death, joy and suffering, breathtaking beauty and profound sadness. I wrap the beautiful memory of the sunrise service around me to protect me from the hurt I felt at the death of that little girl. That memory of the sunrise was the armor I carried into battle that day as I went to do my duty in the ER.
As a nurse or a doctor or anyone who deals with pain and suffering, we must care for ourselves in order to serve others. We cannot give water to others from an empty well. We must take time to refill the well—to find our Easter sunrise.
Cindy Bollinger
The Old Woman
What one has, one ought to use; and whatever he does, he should do with all his might.
Marcus Tullius Cicero
As a student nurse, I was assigned to give my first bed bath to an elderly woman with emphysema and heart failure. I was told she went in and out of consciousness, and not to worry too much about communicating with her.
I gathered the bath supplies, but the woman didn’t move, open her eyes or acknowledge I was there. I thought giving her a bed bath would be like working on a mannequin, as we had often done in class. While I ran the washcloth over her resting face, the warmth of her skin and little ringlets of hair on her forehead made me keenly aware that, although we might not be able to communicate verbally, she was still a human being. I bathed her gently as I would have bathed a baby.
I had almost completed my task when a whisper came from her lips. “You care,” she said, barely audibly. I bent down near her face, touched her cheek and asked what she had said.
She repeated, “You care.” Her eyes were open. Her voice was crackly and breathing labored, but she had something she wanted to say. “Most of the nurses don’t think I notice, but I do.”
By then, her face was animated and she went on to tell of events in her childhood and the antics of her grandchildren. She seemed to be having so much pleasure talking and remembering as I finished bathing her. She gave me advice about life, then patted my hand and finally said, “I’m tired now.”
I gathered up the bath supplies and looked at her resting, smiling face. The conversation ended as quietly as it had started.
Mitzi Chandler
Communication Is the Key
I like the laughter that opens the lips and the heart, that shows at the same time pearls and the soul.
Victor Hugo
Communicating with our patients can be a real challenge. Do they really understand what we’re asking them?
Consider the new patient at the clinic who finished filling out his health history form. The nurse noticed that under “sex” he checked both “M” and “F”—then wrote in “and if I’m feeling strong enough, sometimes on Wednesday, too!”
Then there was the man who was terribly overweight, so his doctor put him on a diet. “I want you to eat regularly for two days, then skip a day, and repeat this procedure for two weeks. The next time I see you, you will have lost five pounds.”
When the man returned the doctor was shocked to see he’d lost nearly twenty pounds. “Why that’s amazing!” the doctor exclaimed. “Did you follow my instructions?”
The man nodded. “I’ll tell you, though, I thought I was going to drop dead on that third day.”
“From hunger?” asked the doctor.
“No, from skipping!”
Another young man called the hospital shouting, “You gotta help! My wife is going into labor!”
The nurse said, “Stay calm. Is this her first child?”
“No!” he cried urgently. “This is her husband!”
Maybe to communicate more clearly, we simply need to ask for what we need.
A patient’s wife passed the nurse’s station carrying a large, heavy cardboard box. A few moments later, the patient’s call light went on. When the nurse entered, the patient asked if she would give the box to his doctor. The nurse was puzzled to see it loaded with old phonograph records. The patient explained, “The doctor said to have my wife bring in all my old records.”
Maybe patients just can’t hear us.
One man boasted, “I have a new hearing aid.”
“What kind is it?”
“One o’clock.”
Karyn Buxman
Reprinted by permission of John Wise, R.N.
Meeting Her Needs
What we have here is a failure to communicate.
Cool Hand Luke
In 1994, our health department began serving as the primary care provider for thousands of patients who had previously only received public-health type services in our clinics. This switch to a “medical model” in our neighborhood clinics was quite a change not only for the patients but also for the staff who were more accustomed to providing chronic disease follow-up and preventive care, and now were being asked to provide acute care/primary care as well.
Because of this change, I was now a public health nurse in a primary care setting, working with the physician who was trying to meet the women’s health needs as best he could. Not having done a lot of women’s health previously, he was somewhat disorganized in his visit sequence but usually covered all aspects of care in a thorough, professional manner.
This particular day, the physician was completing a visit with a new, elderly patient. In his usual quiet way, as the patient was preparing to leave the examining room, he said offhandedly, “Oh, Ms. R., would you like to have a Pap smear today?”
Ms. R. appeared surprised and a bit confused because she was already dressed, had received her prescriptions, and thought her appointment was over.
“Why, yes, Doctor, that would be nice,” the patient said.
I realized immediately that a communication error had just been made.
“Ms. R., the Doctor is asking if you want your PAP SMEAR done today—your test for cancer of the womb. You would need to get undressed again for that test,” I tried to explain.
Ms. R. looked embarrassed and replied, “Oh, Doctor, I’m sorry. I thought you said PABST BEER! No, I don’t want a PAP SMEAR today, thank you.”
Judy B. Smith
Rose
True teaching is only achieved by example.
Plato
Rose had been a resident of the nursing home for quite some time before I began to work there. With curly gray hair and a smile that never quit, she wandered the halls in her own Alzheimer’s-induced world, oblivious to the tension and swirl of activity that frequented her home. Up and down, back and forth she went—sometimes looking for her coat or her mother or a ride to Mass. Rose’s happy-go-lucky demeanor was a treat and we relished her sweetness.
Rose had a knack for lifting our mood at just the right time, even though she had no idea she was doing it. One particularly hectic night when everything seemed to go wrong, Rose came out of her room and sat in the chair across from the nurses’ station where I was furiously documenting a fall that had just occurred. I heard her sigh, and without looking up I asked her what was the matter.
Rose lamented, “Did you ever have one of those days where nothing goes right?”
Oh, yes, I thought, then looked up to see that Rose had taken a pair of underwear and put them on over her head, with one arm through a leg hole. It took all I had not to burst out laughing. She did wonders for my mood.
Another evenin
g while we were preparing the residents for supper, I noticed Rose seemed sad. Putting my arm around her shoulders, I asked what was bothering her.
“I have no money,” she said.
Thinking Rose was concerned about paying for her meal, as some of our residents are, I explained that everything was paid for.
“But I have no money to put in the collection plate,” she said, her head hanging.
She thought she was at Mass, so I tried to orient Rose to the here and now, but soon realized that she didn’t understand. Taking a coin out of my pocket, I directed her to the medication cart with all its recessed spaces to hold supplies. “Here you go, Rose, put your money there—in the box.”
Plunk went the coin. The smile on her face was priceless. You would have thought she had won the lottery. Of course, I was also grinning from ear to ear as she hugged me and called me her angel. That was Rose’s name for us. We were her angels.
Later that night, I administered her bedtime meds and handed her the apple juice. She exclaimed, “Oh, my highball! Thank you. I love a drink before bed.” Again, Rose blessed me with a smile and a hug.
The next evening at the start of my shift, I heard Rose was gone. She had died that morning on her way to attend her great-grandson’s high-school graduation. It was a bittersweet time. We were glad for her, but sad for ourselves.
In the hall outside the room where Rose once lived is a collage of pictures taken at Christmas. There in the middle is our Rose. Her sweet smile and the loving look in her eyes leap from the wall and draw us in as we still hear her say, “You are my angel.”
Little did she know she was our angel, sent to slow us down and help us see that life’s little detours are only temporary. There is always something to smile about.