I had a special connection to this patient since she was only two years younger than I and shared the same interest in nursing.
About two weeks into the ordeal, she began to flutter her eyelashes and make what appeared to be purposeful movements. We were amazed and cautiously hopeful that perhaps her mom was right. I left for the day and began my hour-long drive home. Halfway home I realized that there was still a “do not resuscitate” order on the chart. I immediately turned around and drove back to the hospital to remove the DNR order. When I returned the next morning, in report I learned that she had arrested during the night and was successfully resuscitated. The gratitude in the eyes of her mom when I came in to begin my daily care was enough satisfaction to last a lifetime and validate that I was where I needed to be in my life.
I also began to believe in miracles, because after a rather long period in rehab, my patient went back to nursing school and finished her studies.
I have since moved on in my career, through various leadership positions, to become the vice president/chief nursing officer of one of the largest hospitals in the country. I have made it my goal in life to make sure that all nurses realize how valuable they are to the lives of others, and that they will experience their own stories that sustain them and make them feel that they, too, are where they need to be in life.
There are a privileged few who can say, “I am a nurse.”
It’s the greatest performance of my life.
Val Gokenbach
2
HEART OF A NURSE
Wheresoever you go, go with all your heart.
Confucius
The Exchange
Thy purpose firm is equal to the deed. Who does the best his circumstance allows, does well, acts nobly; angels could do no more.
Edward Young
My feet hurt and I was ready to go home. Discouragement filled me as I helplessly watched my favorite ICU patient, Mr. Nunley, slowly slipping away. His old flabby heart was failing him by the minute, and time was running out for a transplant. I gazed into the dimly lit room and said a hushed good-bye to his daughters, assuring them that I would be back tomorrow. We exchanged forced smiles of fading hope.
As I prepared to leave, my head nurse came up to me and asked if I would like to go watch a heart transplant: Mr. Nunley’s! I ran back into his room to share the good news. Hope and sadness filled his eyes as I told him that I was going to another local hospital to observe the harvesting of his new heart and then come back for his transplant. I hugged his daughters and called my husband to let him know I wouldn’t be coming home until late.
The organ donor was a gentleman in his thirties who wasn’t wearing a helmet when his motorcycle crashed. This father of three small children was giving one last gift of life to five or six other people before the machines were turned off. I choked back tears as I pondered his wife and children. How would she tell them that Daddy would never be coming home again? I marveled at her courage to share the life of her loved one with others.
As we entered the OR, a beautiful but beastly thought kept invading my mind: today one must die in order for another to live.
That is when I looked up and saw her. The nurse on the other end of this story shuffled into the OR with bloodshot, tired eyes that spoke volumes. She came in and out of the operating room to provide updates to the donor’s grieving family. With awkwardness, the two of us talked about the families. We each knew what our purpose was on that day. Her role was to stand in the gap for the grieving family. She took on grief and passed on hope as she hugged them. My role was to stand in the gap for Mr. Nunley’s family. I passed on the joy and absorbed their guilt through my support. She left the OR quietly and respectfully once his heart was removed and placed in the cooler.
The heart was quickly escorted by ambulance to the surgical suite of Mr. Nunley. Artificial life support took over as the gray, oversized, flabby muscle was removed. I was overcome with fear and hope when, for a few minutes, his chest was completely empty. There was no turning back. Then, the new, firm, pink heart was presented and stitch by stitch it became one with Mr. Nunley’s body. We all held our breath and watched the EKG monitor as a defibrillator shock started his new life. Shouts of joy and victory rang out on this side of the exchange.
I ran down the hall to the waiting room to share the news with his family. It was finished! Life prevailed even in the face of death. Tears flowed as they expressed gratitude for the donor and his family. A new life and new hope filled all of our eyes as the exchange of life was completed.
As I drove home in the dark early-morning hours, I was overcome with emotion. I thought of the widowed wife, the grieving children alone in bed, and the nurse who became a stitch in their lives on the day that their hearts broke. Because of their pain and loss, my patient would have life and joy. Then I realized my purpose as a nurse even more clearly. Nurses stand in the gap, like the heart bypass machine, in the lives of their patients. One nurse may hold the hand of death, while another holds the hand of life.
Our eyes tell their specific stories and our hugs uphold one another, and each day the exchange continues in the lives of nurses and their patients.
Cyndi S. Schatzman
Christmas in July
Children are God’s apostles, sent forth, day by day, to preach of love, and hope and peace.
J. R. Lowell
A drop of sweat trickled down the side of my face. As I walked through the door into the building, a blast of cool air enveloped me.
“Thank goodness for air-conditioning!” I said loudly to the receptionist in the lobby. She nodded in agreement as she answered a call and I got onto the elevator.
“What number?” asked a little boy in a red wagon being pulled by his mom.
I looked at him and smiled. “Number five.”
He pushed the button as he smiled back at me with blue eyes that sparkled. He had no hair, and his mouth was covered with a paper mask. He wasn’t from my floor . . . the masks on my floor were oxygen masks, and they still had their own hair. As a pediatric nurse in a pediatric hospital these sights were a common and accepted part of my job.
It was July 24, a sweltering summer day. But when the elevator doors opened to the fifth floor, it was like a scene from a winter wonderland. There was a lighted Christmas tree in the corner and paper snowflakes hanging from every ceiling tile. Red ribbons adorned all the doorknobs of the patient rooms, and snowmen were pasted on every other available open space. The Christmas carol “We Wish You a Merry Christmas” played in the background, harmonized by Alvin and the Chipmunks. The playroom was filled with children with oxygen tanks and IV poles in tow. There was much laughter and giggling going on as the “play lady” turned to me and said, “Merry Christmas! We are celebrating Christmas in July . . . so that makes today Christmas Eve! Hope you’ve got your shopping done!”
I smiled at her inventiveness and said, “What a great idea, Betsy! Two Christmases in one year. These kids must have been really good!”
As my afternoon shift began and I started my assignment, I saw each of Santa’s “July elves” I was assigned to, all gathered in the playroom, still giggling and listening to the Chipmunks. I did a quick check to make sure everyone was okay, and let them get back to the fun.
After playtime was finished and IV poles and oxygen tanks with kids attached were returned to their rooms, I began my rounds.
I saved Stacey for last so I could spend more time with her as needed. She was waiting for me, with that slightly lopsided grin and those huge brown eyes. I had been caring for her for many months.
Her voice sounded far away with the oxygen mask pulled tightly over her cheeks. “Kathy, what do you like best about Christmas?”
I didn’t really think about my answer, I just said, “I love decorating the tree. I have some special ornaments that remind me of people I love.”
While doing her treatments we talked about Christmas, and I told her part of a story I remembered from when I was her
age, about a mouse that ate Santa’s cake. I couldn’t remember the end and what happened to the mouse, but I said I would try to find out.
I could see she was really tired when her treatment to clear her lungs was finished. She fell asleep during dinner while watching TV; she didn’t have the energy of most other eight-year-olds. I was conscious of the subtle changes, and I knew her treatment options were limited. I understood that she was slipping away. No matter how much I loved her, I could not change that.
Stacey slept much of the evening. As usual, she awakened when I came to say goodnight. It was a ritual we had started when I first started caring for her. Whenever my shift was almost over, I would come to tell her a story, she would brush her teeth and say her prayers, and I would hug and kiss her and tuck her in her bed for the night.
Since it was Christmas Eve in July, I recited “The Night Before Christmas” for her. Just as I was about to leave, she handed me a small package wrapped in white tissue paper and tied with a red ribbon. I was touched and surprised. “Can I open it now since it is after midnight and it is Christmas . . . in July?”
“No, I want you to wait for the real Christmas, with snow, and trees, and Santa . . . in December.”
I gave her another gentle squeeze, and said, “You are so special to me. I love you. I can’t wait till Christmas to see what it is!”
She smiled from beneath her oxygen mask and said, “You have to promise you will wait.”
I assured her I would wait, just as she asked.
The dog days of summer turned into the cool, crisp days of fall. Stacey and I watched from her hospital room as the children played in the park across the street. Soon the brilliant crimson and yellow of the leaves heralded the arrival of October. Stacey’s breathing was becoming increasingly difficult and she required more oxygen to keep her comfortable. Her usually sallow complexion was now a bluish hue, and she chose her words carefully whenever she spoke. It required most of her energy to talk, and when she said, “I’m tired,” it wasn’t just tired. She was tired of fighting for every breath.
Stacey wrote a note to me that afternoon to ask if I would “Pleeeese find out what happened to that mouse that ate Santa’s cake. I want to know how the story ends.”
I had forgotten about telling her that tale until she reminded me about our Christmas in July party. The next morning before work, I called the family friend who had told me the story when I was young. I told him the circumstances and all about Stacey, and that she was waiting for the end of the story. He gladly told the story again, and this time, I wrote it down.
During Stacey’s treatment the next afternoon, I recited the rest of the tale about the mouse that ate Santa’s cake. She smiled when I finished, and with great effort said, “Thank you. Now I know what happens at the end.”
When her grandmother arrived that evening, as the sunset glowed pink and purple in the sky, Stacey closed her eyes and died peacefully in her grandma’s arms.
Now her story was completed too.
I was with her when she died, as I had been on many afternoons and evenings of her young life. I missed her terribly. I missed her big brown eyes and her lopsided smile that drew me eagerly back to work every day. I missed the faraway sound of her voice behind her oxygen mask, and the hugs and kisses she gave me at the beginning and end of my workdays on my first job as a pediatric nurse. I felt her absence every day from that day on.
But time passed, as it does. We celebrated Thanksgiving with a feast together at work, and the holiday rush began. Soon it was the real Christmas Eve.
I returned home from work that evening and as the clock struck midnight, I took out the package Stacey had given me in July. On the tag in her childish scrawl, she’d written, “To Kathy. I love you. Do not open until December 25.” I slowly unwound the red ribbon and removed the crinkled tissue paper. Inside the package was a white snowman with big green polka dots. He wore a black felt hat, had blue button eyes, and a red, lopsided grin. A loop of green yarn wrapped as a scarf around his neck, and another loop was glued to his back so he was ready to hang on the tree. As my tears fell on the snowman, I recalled the words I said to her when she asked what I liked best about Christmas . . . decorating the tree with special ornaments that remind me of people I love.
Each Christmas as I unwrap the ornament, the tissue paper becomes more fragile and yellowed with age. I reread Stacey’s simple declaration of love and caress the polka-dot snowman. His lopsided grin is a legacy of the little girl that I loved.
Kathleen E. Jones
Sacred Moments
Ritual is the way you carry the presence of the sacred. Ritual is the spark that must not go out.
Christina Baldwin
It was a typical day in the emergency department— busy.We are always busy; in fact, we are the busiest ED in the state. I was assigned the float position, meaning it was my job to circulate and help nurses assigned to specific stations when needed.
A call came over the radio from emergency medical services saying they were bringing in a nine-week-old female baby in respiratory arrest. The nurse working the trauma assignment received the infant. Tragically, in spite of every effort possible, the baby did not survive.
Not long after, the ED nurse liaison approached me. One of her many jobs was to care for the families of loved ones in critical situations. “I heard you have some experience in art. Do you know anything about casting in plaster?”
I told her I did. She handed me the materials she had gathered and instructed me to go to the trauma room and make a cast of the infant’s foot for the family.
I entered the room and instantly felt palpable grief. Dad and Mom stood over the gurney staring at a tiny bundle wrapped in blankets. Grandma was holding their other child, who appeared to be around two years old. They barely spoke and when they did, it was in hushed tones. Everyone seemed stunned, unable to move, not sure of their next step.
I quietly introduced myself and said I had come to help make foot imprints of their baby girl. They all stared at me, eyes red and glazed. I looked at Dad and figured he would be best to invest in the mechanical part of our project. I quickly got him involved in mixing the plaster material and putting it into the molds.He seemed grateful for something to do at a time when he couldn’t possibly know what to do next. His voice, hushed at first, became fuller.
“Press her little hand here,” I said softly as we made impressions, first of her hands, then of her feet.
It was time to get the women involved. “Here are buttons, bows, glitter, beads, and other decorations for the molds.”
They began to pick through these items, each making suggestions, discussing how to decorate the molded impressions. Their voices became stronger as they focused on the project at hand. I stood back watching them and realized the energy of the room had changed from grief and despair to focused creativity.
As they completed their creation, they began to talk about what they should do next, who they would call, where they would go. They stared at the molds, eyes gleaming, each understanding they had created a treasure that would always be cherished: the remembrance of a life lived, too short but so very sweet.
One after another, they gathered their things. Slowly, each held the precious baby girl one last time, softly saying their good-byes to their beloved bundled in a blanket.
Then Dad handed her to me.
Mom was the last one to exit. She turned with a hint of a smile and mouthed, “Thank you.”
I held her child; she held their treasured creation.
One of the tasks we nurses are called to do is to assist in the death process. What happened in those shared moments with that young family was something much deeper and richer . . . a sacred ritual in nursing.
Jude L. Fleming
Nurse, Heal Thyself
Her ways are ways of pleasantness, and all her paths are peace.
Proverbs 3:17
I recognized the legal-sized envelope resting inside my mailbox: my nursing lice
nse renewal form. Two years before I had filled out the paperwork to renew my license, hopeful I could resume my career, despite my obvious injuries. It was a hope I had clung to for ten years.
I’d been an impossibly naive young woman, ready to save my little piece of the world at my new job at a downtown Atlanta hospital. With my crisply ironed nursing whites and my freshly printed diploma, I felt ready to fulfill the plans God had laid out for my life.
The post-op patient in bed 419 didn’t mean to hurt me. Although we were not a surgical floor, the man had been assigned to a room at the end of my hall as a favor to one of the doctors on staff. No one expected him to have a drug-induced psychotic episode, least of all a novice nurse like me. With an unnatural scream, he kicked me into the wall. The blow seared a trail of unbelievable pain across my buttocks and down my right leg, ending behind my knee. My toes and the bottom of my foot went numb and cold.
Like a dutiful nurse, I continued working throughout the rest of the night, dragging my right foot a bit as I dispensed medication and attended patients for surgery. Only morning and a visit to the emergency room would reveal the force of the attack on my body. A series of discs in my lower back had been ruptured, putting pressure on my sciatic nerve. The doctors reacted conservatively, treating me with rest, drugs, and traction, but soon it became apparent that surgery was my only option.
Chicken Soup for the Nurse's Soul: Second Dose Page 3