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THE TRUE MEANING OF NURSING
Many persons have the wrong idea about what constitutes true happiness. It is not attained through self-gratification but through fidelity to a worthy purpose.
Working Christmas Day
If a man loves the labor of his trade, apart from any questions of success or fame, the gods have called him.
Robert Louis Stevenson
It was an unusually quiet day in the emergency room on December twenty-fifth. Quiet, that is, except for the nurses who were standing around the nurses' station grumbling about having to work Christmas Day.
I was triage nurse that day and had just been out to the waiting room to clean up. Since there were no patients waiting to be seen at the time, I came back to the nurses' station for a cup of hot cider from the crockpot someone had brought in for Christmas. Just then an admitting clerk came back and told me I had five patients waiting to be evaluated.
I whined, "Five, how did I get five? I was just out there and no one was in the waiting room."
"Well, there are five signed in." So I went straight out and called the first name. Five bodies showed up at my triage desk, a pale petite woman and four small children in somewhat rumpled clothing.
"Are you all sick?" I asked suspiciously.
"Yes," she said weakly and lowered her head.
"Okay," I replied, unconvinced, "who's first?" One by one they sat down, and I asked the usual preliminary questions. When it came to descriptions of their presenting problems, things got a little vague. Two of the children had headaches, but the headaches weren't accompanied by the normal body language of holding the head or trying to keep it still or squinting or grimacing. Two children had earaches, but only one could tell me which ear was affected. The mother complained of a cough but seemed to work to produce it.
Something was wrong with the picture. Our hospital policy, however, was not to turn away any patient, so we would see them. When I explained to the mother that it might be a little while before a doctor saw her because, even though the waiting room was empty, ambulances had brought in several, more critical patients, in the back, she responded, "Take your time; it's warm in here." She turned and, with a smile, guided her brood into the waiting room.
On a hunch (call it nursing judgment), I checked the chart after the admitting clerk had finished registering the family. No address—they were homeless. The waiting room was warm.
I looked out at the family huddled by the Christmas tree. The littlest one was pointing at the television and exclaiming something to her mother. The oldest one was looking at her reflection in an ornament on the Christmas tree.
I went back to the nurses' station and mentioned we had a homeless family in the waiting room—a mother and four children between four and ten years of age. The nurses, grumbling about working Christmas, turned to compassion for a family just trying to get warm on Christmas. The team went into action, much as we do when there's a medical emergency. But this one was a Christmas emergency.
We were all offered a free meal in the hospital cafeteria on Christmas Day, so we claimed that meal and prepared a banquet for our Christmas guests.
We needed presents. We put together oranges and apples in a basket one of our vendors had brought the department for Christmas. We made little goodie bags of stickers we borrowed from the X-ray department, candy that one of the doctors had brought the nurses, crayons the hospital had from a recent coloring contest, nurse bear buttons the hospital had given the nurses at annual training day and little fuzzy bears that nurses clipped onto their stethoscopes. We also found a mug, a package of powdered cocoa and a few other odds and ends. We pulled ribbon and wrapping paper and bells off the department's decorations that we had all contributed to. As seriously as we met the physical needs of the patients that came to us that day, our team worked to meet the needs, and exceed the expectations, of a family who just wanted to be warm on Christmas Day.
We took turns joining the Christmas party in the waiting room. Each nurse took his or her lunch break with the family, choosing to spend his or her "off-duty" time with these people whose laughter and delightful chatter became quite contagious.
When it was my turn, I sat with them at the little banquet table we had created in the waiting room. We talked for a while about dreams. The four children were telling me about what they wanted to be when they grow up. The six-year-old started the conversation. "I want to be a nurse and help people," she declared.
After the four children had shared their dreams, I looked at the mom. She smiled and said, "I just want my family to be safe, warm and content—just like they are right now."
The "party" lasted most of the shift, before we were able to locate a shelter that would take the family in on Christmas Day. The mother had asked that their charts be pulled, so these patients were not seen that day in the emergency department. But they were treated.
As they walked to the door to leave, the four-year-old came running back, gave me a hug and whispered, "Thanks for being our angels today." As she ran back to join her family, they all waved one more time before the door closed. I turned around slowly to get back to work, a little embarrassed for the tears in my eyes. There stood a group of my coworkers, one with a box of tissues, which she passed around to each nurse who worked a Christmas Day she will never forget.
Proud to Be a Nurse
How wonderful it is that nobody need wait a single moment before starting to improve the world.
I just saw another television show where the nurse was portrayed as an overly sexed bimbo. It's obvious the image of the nursing profession still needs some good public relations. Once in a while, we have an unexpected opportunity to educate the public to what nursing is all about.
My chance came on a warm Saturday morning when I had a coveted weekend off from my job in a long-term care facility. My husband and I headed for the Cubs ballpark via the train. Just as the train arrived at the final station, the conductor curtly shouted for all the passengers to immediately leave the car. He hustled us toward the door. On the way, I glimpsed some people huddled around a man lying limply in his seat.
The conductor talked excitedly into his walkie-talkie. I heard fragments of "emergency" and "ambulance." Surprising myself, I approached him and said, "I'm a nurse. Could I be of any help?"
"I don't need a nurse," he rudely snapped back, loud enough for the crowd to hear. "I need a medic!"
His public put-down to nurses was a punch in the stomach. I was incensed. My adrenaline kicked in, and I abruptly elbowed my way through the crowd, past the insulting conductor and back on the train.
Three men were standing like statues staring at a young man crumpled over in the seat. His face was the color of a ripe plum. Fortunately, the ABCs of cardiopulmonary resuscitation clicked into my brain. The man was obviously obstructing his own airway. I was relieved to find a pulse.
"He had a seizure," one man offered.
"Help me sit him up," I instructed the bystanders, as I loosened his collar and tie. We hoisted him to an upright position, and I quickly did a jaw thrust and tilted his head to the side. Mucous and blood oozed out. With a wadded tissue from my pocket I cleared more thick mucous from his mouth and throat. A thump on the shoulder caused him to take in a big breath of air. Within seconds, his color changed to pink and his eyes opened. His tongue was bruised and cut from biting it, but he was breathing well.
I heard the ambulance siren in the background.
Shaking now, I returned to my husband, praying the man didn't have AIDS and searching for something to wipe my sticky hands on.
"Hey, you did a good job," one of the men who had been a bystander called to me.
"Thanks," I replied with a pleased smile, as I stared directly at the conductor who still clutched his walkie-talkie and looked surprised. He stammered, "I guess a nurse is what I needed after all."
Triumphantly, I marched off, hoping at least one person had a new insight into the capabilities of the nursing profession. Because, at that moment, I was especially proud to be a nurse.
Barbara A. Brady
Children are God's apostles sent forth day by day to preach of love, hope and peace.
J. R. Lowell
Nellie was only two years old, the only child of a single mother whose boyfriend walked out when he found out she was pregnant. Not an unusual story in an inner city— but Nellie was unusual. She wrapped your heart around her little finger the moment you met her. Her eyes, huge ovals and black as shiny metal, looked out of a pale, round face. I was told her hair was once dark and curly, but when we met she was bald from chemotherapy.
Nellie had leukemia. During her six months in the hospital, doctors had tried one chemotherapy regimen after another, trying to save her life. I was Nellie's primary nurse at a time when primary nursing was not the norm. We all felt Nellie needed someone constant in her life. Her mother, unable to cope with Nellie's devastating illness, rarely visited. Whenever a care conference was scheduled to discuss the next mode of treatment, Nellie's mother came to be included in decisions. She wanted to make sure everything possible was being done for her daughter. But she just couldn't visit. I always thought she had already said good-bye.
When I first met Nellie she had just started the fifth round of chemotherapy. Her face and body were swollen from steroids. She had a Broviac line in her chest for medications and IV fluids; she had severe stomatitis and was unable to take anything orally; her perirectal area was red and raw from constant diarrhea. Yet she had the most beautiful smile I had ever seen, reaching all the way to her eyes. I wondered when she had decided that pain was just a part of everyday life and decided to smile anyway.
Two things made Nellie happy: being rocked while I sang soft lullabies, and going bye-bye in the red wagon. With a fireman's cap on her head, a face mask on to protect her from anyone else's germs, and the red light flashing on the wagon's front end, we walked around and around the unit saying "hi" to all the "'ick babies." Nellie had a problem with her S's.
And she had a faith in God only a child could have. "Unless you become as little children ..." Nellie bowed her head each time she said his name. She called him "'oly God." H's were a problem, too. When I would finish doing her morning bath and dressing her in a soft fuzzy sleeper, she would snuggle into my lap and ask me about "'oly God."
"Is his 'ouse big?" she would ask with wonder in her voice. "How big is it?" Then, "Tell me again about the 'treets of gold." She remembered all the children's Bible stories her mother had read to her.
One morning she surprised me with the simplicity of her trust. "Pretty soon I go to 'oly God's house."
"Everyone will go to Holy God's house someday," I replied, trying to deny the truth that she had already accepted.
"I know that," she said with all the assurance of a two-year-old who understands the mysteries of the universe, "but I'm going firstest."
"How do you know that?" I asked, choking back tears.
"'Oly God. He told me," she said matter-of-factly. When the fifth series of chemotherapy drugs failed to have the desired effect, the doctors coordinated a care conference. Nellie's mother was coming and the plan was to get permission to try a new set of experimental drugs, not yet approved for use in pediatric patients. I was surprised at my angry response. "When are we going to say that's enough? It's time to let Nellie go." I couldn't believe this was me speaking. I never thought there would come a time when I would think it was not only okay, but the only right thing to do, to stop treatment on a child. I was more pro-life than the Pope, yet in the deepest part of my spirit I knew someone needed to fight for Nellie's right to die.
My worry was needless. When I returned to work the next night, Nellie was off all drugs. The plan was to keep her as comfortable as possible. She was my only patient that night. In the past twenty-four hours, her already swollen body had become even more edematous. I'm not sure why, but for the first time, Nellie didn't want to be held or rocked. I sat alongside her crib and stroked her puffy face. The short stubble of hair on her head was scratchy under my fingers. Nellie laid awake the first part of the night. I never left her side.
Somewhere around three in the morning, she turned and said, "You hold Nellie now. Nellie going bye-bye."
"The wagons are put away for the night, Nellie," I said, clinging to my denial.
"You hold Nellie now," she repeated. "Nellie going bye-bye."
Gently, I lifted her fragile body from the crib and cradled her in my arms. I held her on my chest with her head resting on my shoulder, her warm breath on my neck. We rocked back and forth, back and forth, as I stroked her and sang, "Jesus loves the little children."
After several minutes, Nellie lifted her head, using all the strength she had left and said, "He's here," then lay her head back down on my shoulder. I could no longer feel her soft breath on my neck. I'm not sure exactly how long I held and rocked her as the tears ran down my cheeks. Finally, I put on the call light to let someone know that Nellie had gone bye-bye with 'oly God.
All in a Day's Work
If I can ease one life the
Or cool one pain,
Or help one fainting robin
Unto his nest again,
I shall not live in vain.
Emergency-room personnel transported him to the cardiac floor. Long hair, unshaven, dirty, dangerously obese and a black motorcycle jacket tossed on the bottom shelf of the stretcher—an outsider to this sterile world of shining terrazzo floors, efficient uniformed professionals and strict infection-control procedures.
Definitely an untouchable!
The nurses at the station looked wide-eyed as this mound of humanity was wheeled by—each glancing nervously at my friend Bonnie, the head nurse. "Let this one not be mine to admit, bathe and tend to ..." was the pleading, unspoken message from their inner concern.
One of the true marks of a leader, a consummate professional, is to do the unthinkable. To touch the untouchable. To tackle the impossible. Yes, it was Bonnie who said, "I want this patient myself." Highly unusual for a head nurse—unconventional—but "the stuff" out of which human spirits thrive, heal and soar. As she donned her latex gloves and proceeded to bathe this huge, filthy man, her heart almost broke. Where was his family? Who was his mother? What was he like as a little boy?
She hummed quietly as she worked to ease the fear and embarrassment she knew he must have been feeling. And then on a whim she said, "We don't have time for back rubs much in hospitals these days, but I bet one would really feel good. And, it would help you relax your muscles and start to heal. That is what this place is all about—a place to heal."
All in a day's work. Touching the untouchable.
His thick, scaly, ruddy skin told a story of an abusive lifestyle. Probably lots of addictive behavior, to food, alcohol and drugs. As Bonnie rubbed the taut muscles, she hummed and prayed. Prayed for the soul of a little boy grown up, rejected by life's rudeness and striving for acceptance in a hard, hostile world.
The finale—warmed lotion and baby powder. Almost laughable—such a contrast on this huge, rugged surface. As he rolled over onto his back, tears rolled down his cheek. With amazingly beautiful brown eyes, he smiled and said in a quivering voice, "No one has touched me for years." His chin trembled. "Thank you. I am healing."
In a day when we have increasing concern about the appropriateness of touch, Bonnie taught this hurting world to still dare to touch the untouchable through eye contact, a warm handshake, a concerned voice—or the physical reassurance of warmed lotion and baby powder.
Excerpted from Chicken Soup for the Nurse's Soul by Jack Canfield, Mark Victor Hansen, Nancy Mitchell-Autio, LeAnn Thieman. Copyright © 2012 Chicken Soup for the Soul Publishing, LLC. Excerpted by permission of Chicken Soup for the Soul Publishing, LLC.
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