Barbara Allen, 5ET
Bill Banusiewicz, 7WT
Deborah Baron, ECC
Jackie Bland, 7WT
Teressa Ferguson, 6ET
Dawn Oder, Simulation Lab
Robyn Pomykala, Home Care
Barbara Ritchie, Mother Baby
Tina Sweeny, Ortho
Mary Vijayan, 7WT
Joann Deserio, RN
Neonatal Transport Team
Winner of the First Annual NAUTILUS AWARD
When I tried to think of a “caring story”, several sharing moments came into mind. They are as fresh in my mind as if they happened just yesterday. And all had an interesting common thread, they all involved thinking “outside of the box” and doing something unusual and intuitive that would never be done under normal circumstances.
There was a time that I was caring for one of our “graduates”, a twin, who returned one month post discharge with overwhelming beta strep sepsis. We came to a point where our skills were not going to be able to save this baby boy. His parents consented to withdrawal of life support but wanted to hold him in his last moments of life. They were trying to decide who should hold him. I had a bed brought into our NICU so both parents could get into the bed and lie with their dying baby together as a family, loving and supporting each other and their son. At his funeral they expressed how much that really meant to them. THAT was their memory of his short stay with us.
And there was the time that I was caring for another terminally ill baby who was the son of a single dad. His dad was always by his side, and had to face the difficult decision of letting his son die a natural death. He told me his only regret, one that he could never get used to, was that his son never got to breathe outside of a hospital, never felt the warmth of the sun. He had only experienced breathing through tubes and the artificial heat of our machines. I thought about what he said and came up with a plan. I begged the neonatologists to go along with me because it would not change the outcome and I promised I would stay with the baby. I talked with the dad and he started to cry. We disconnected his son from every device, leaving the endotracheal tube for last. I scooped up the baby, and with dad following right behind, I ran out the back NICU door, down the stairs, and outside to a picnic bench across the street. Then I placed the baby in dad’s arms and he sat for a half hour or so talking to his son and describing the world to him. That is a memory that dad would have forever.
And lastly, is my main story, of a sweet deformed baby that his mom did not want because he was not perfect and reminded her of a part of her life she was unable to face. He had a lower limb deformity that cased malformation and fusion of the limbs. He was a DNR at delivery, but survived and I brought him back to be admitted to the NICU. His mom could not deal with his birth, survival and existence. She did not want to see what her past had resulted in. She would not be taking him home. I asked that she be brought to his bedside because he may not live. She came, and I helped her “say hello” to her son, gradually introducing them and ending with her actually holding him and giving him a name. In four days, when we knew he would survive for a while, he left us to go for specialized care he would now need. Mom put him up for adoption, but for a brief time, he was held and loved by his mom, and she had a chance to give love and a name to her son. These events were observed by a peer and were put in a poem, given to me a special and wonderful gift.
We expected the call
but did not want it
NICU needed in LDR9
That’s the DNR someone whispers.
I see Joann volunteer to go
She knows her compassion is needed
and they dress her in the
Strictly Business Gown,
mask, gloves,
She dons her Strictly Business Face.
They don’t take The Box,
him being a DNR
and I find myself praying
she doesn’t have to suffer
helplessness.
It is a quiet wait.
she might return
hands to her side.
Joann returns,
the bundle only half the size
it should be
cradled to her breast.
He keeps looking at me
she says.
I call the chaplain
for her sake, mostly
and she asks if he can have
a temporary name,
Michael, she says,
like the archangel.
He might live
Joann says
and he might not
would you please go get his mother?
The Mother Who Couldn’t Do This comes.
I wish I could take him home
she says.
I will name him Kevin Michael.
I can not hold him
she says
but I will look.
And not at his legs.
Joann’s eyes tell me the Michael part is her reward.
Joann changes the Michael-Child’s diaper
slightly revealing little deformed legs
growing the wrong way
so his mom can see only a little bit
because she is Not Ready To See.
The diaper is not wet
I know.
Joann tells her it’s okay
you don’t have to hold him
she says
and he is slipped into his mother’s arms
in sixty seconds flat.
Very slick, Joann
my heart feels very warm.
With great patience Joann the nurse
introduces Kevin Michael to his mom
a little bit at a time
and they bond.
He may live
she says to me
You know he keeps looking at me.
I will take care of him tomorrow.
And she does.
Third day
the Mother Who Couldn’t Do This
never comes back
but we know their time together was good
Joann made it good.
He has decided to live,
she reports with confidence
we’re sending him away
to where he can get
multidisciplinary care
he can’t get here.
He keeps looking at me
She says.
So powerful is her love,
for a moment the child in me
thinks
maybe if they’d leave him here
with Joann
his legs would turn around
and grow the right way.
I go home
and fall asleep
thinking of the Michael-Child
searching Joann’s soul with his dark eyes.
Fourth day
his bed is empty
she smiles professionally
and says with pride
They fell in love with him up there, too.
The nurses think he is beautiful.
And I wonder how she can share him.
I guess correctly
she took him there herself
Transport Nurse.
Jumped at the chance to ride
I smile.
The little Michael-Child
left with a piece
of this nurse’s heart
She gave it freely
the nurse who volunteered
to go to the delivery
knowing her compassion
was needed.
(Written by Laura Stutzman to honor Joann Deserio)
Pam Mason, RN
Comprehensive Rehab Unit
As nurses, we are very fortunate to have many people cross our paths, and relationships grow. Co-workers, patients, their families, their friends and so on. In February, 2007, those relationships collided.
Working on a TCU unit we had a large turnover in staff. For me it was great opportunity to meet many nurses: Some traveling, some just getting experience and others, like myself, enjoyed working on a Transitional Care Unit. In September 2005, a new nurse arrived-Ann-a fairly new graduate. She had worked at a local smaller hospital so this was an adjustment for her. I was more than willing to help make the transition pleasant. I discovered she lived in my town, and we shared some common interests. We started taking occasional walks on the beach, lunch dates, carpooling to work and always sharing stories about our kids. I always felt as if there was some connection between us. Her dream in nursing was to work on an OB unit. Not long after she came to us, she was given that opportunity and left to follow her dream job. Shortly after, my unit merged with the Comprehensive Rehab Unit. After those changes occurred, our schedules were not conducive to sharing time with each other. We still kept in touch.
On February 12, I was making my local supermarket run and usually passed her house en route. It was early evening and I noticed her house was dark, which was unusually for a home with 3 teenagers. That was the moment that “connection” kicked in. I returned home, and spoke to my husband about it. I made a phone call to her house, and left a message on the answering machine. I didn’t receive a call back by the next day. I started to call mutual friends and no one knew of anything unusual. Again I called and left a message. Two days later at 10:30 at night, I received a call from Ann. I can still hear her on the line. Her older son John had a terrible accident and she was apologizing for not calling sooner. They were in the hospital in Gainesville. The long-term prognosis did not look good. He had a serious brain injury. His injuries would require long term therapy, and being three hours from the family was not an option. I talked to her about transferring him to our facility for rehab. They had considered the move but were not sure how to go about it. I asked her permission to help, and with that, set the wheels in motion, making phone calls to case managers, and spoke to our medical director. On February 18, he was transferred to CRU.
I arrived to work on Monday. The charge nurse approached me and said the family had requested I be John’s nurse that day. Emotionally I didn’t know if I was ready for that. It would be the first time I would see Ann since the accident. We hugged and cried. I knew at that point I was gong to get John and his family through this. In two and a half week he made amazing progress with the support of his family, friend, and the rehab staff of CRU.
It’s been about a year and a half now and John is working at an engineering firm and doing very well. Our schedules still don’t allow us to spend much time together but we always manage a quick hello and hug in the elevator at work and an occasional long phone conversation. I am thankful every day for the wonderful recovery John made and my relationship with Ann as a nurse and a friend.
Connie Caban, RN
Mother-Baby Unit
I have a story to share-it doesn’t relate to any one patient but to a group. I used to be a float nurse and have now been based on MBU for a year and a half. I am bilingual in Spanish but not what I consider fluent. It seemed obvious to me that we were missing an opportunity for teaching an entire population of our patients. Some Hispanic moms register for prenatal classes but I’m told as time goes on, fewer attend in the end. We send our moms home with discharge instructions and a Spanish booklet after they view their video. However, there was no plan of care for them explaining what to expect from us while they were hospitalized. I developed, with the help of Eva Valenzuela, RN, MBU, some Spanish communication tools for bedside use by patients and staff in the hope of enhancing communication, teaching a standard plan of care for vaginal and cesarean deliveries, and improving patient outcomes. Feedback so far seems to be good. It feels good to contribute to the unit. My hope is that both staff and patients benefit as a result.
Sandy Goguen, RN
8 Waldemere
Here is my story of caring! While working on an oncology floor I was very fortunate to meet a wonderful lady, Mrs. S and her 3 daughters. Mrs. S was diagnosed with untreatable cancer and was going to stay with us as a hospice patient. I worked the night shift and am very open with my patients and spend a great deal of time sharing of my family and encouraged them to do the same with theirs. Mrs. S asked many questions about my wife and I and she learned of our being pregnant and soon to be born child. She was very excited for us and every shift would ask how my wife was doing and such.
One day on my schedule days off, I received a call from my floor asking me and my wife to come in as Mrs. S was not doing well and she had asked to see us together. My wife Lynn and I went directly to the hospital to see Mrs. S and her daughters. Upon entering the room, I could tell Mrs. S was very weak and not doing well. How her face lit up when Lynn and I came into the room! She explained she had wanted to meet the woman who her favorite nurse was married to. She was then handed a package from one of her daughters which she presented to my wife and explained that this was a small token of friendship for the special treatment that I had given her (same as I treat all my patients I hope). When Lynn had opened the package, inside was a beautifully handmade crocheted baby blanket that Mrs. S and her daughters had made. Needless to say, my wife and I were both teary eyed at that beautiful and thoughtful gift. All the nurses on the floor were aware of the gift and had kept it a secret!
It was not long after that, that Mrs. S passed away-not knowing if we had a boy or a girl. Once we had our daughter, Sarah, we wrapped her in that blanket and took some photos and hand delivered them to the oldest daughter. Again, our daughter was wrapped in the blanket they had made for her. Once again, the tears flowed and Mrs. S’s daughter could not thank us enough for taking the time to remember a past patient and her family.
My family has been very fortunate to have met many of my patients over my career. It is the small things that make nursing my career choice: the “thank you’s” the “I’m so glad you are on for the next three shifts,” “your co-workers have said so many nice things about you. I’m looking forward to you being my nurse,” but every now and then a special friendship or bond occurs and you can tell you have made a difference in someone’s life.
Elizabeth Cardinale, RN, BSN
Orthopedics
I have always viewed nursing as a team effort, and my view has proven correct on numerous occasions. One particular event that sticks out in my mind occurred during my first year as a nurse as I was caring for a patient suffering from a rare complication following a routine orthopedic operation.
I have worked on the orthopedic unit since graduating nursing school in 2006 and have cared for countless spinal surgical patients and knee and hip replacements patients. At this time, I was a brand new nurse which meant that any high risk patients or patients with high acuity were assigned to the experienced nurses and charge nurses. If at any time I had questions or concerns or wanted another nurse to verify my assessment, all I had to was request so.
The day that this practice-changing event occurred, a nurse was working overtime on our unit from 7am until 3pm. Since we work twelve-hour shifts, every staff nurse had to pitch in to take the nurse’s assignment for the remaining four hours of the shift. I can remember sitting down at the nurses’ station with a report sheet taking report on a 46-year-old woman status post an Anterior Cervical Diskectomy, a common neck surgery where the surgeon repairs the neck vertebrae by making the incision in front of the neck. She had only been on our unit for 2 hours at 3pm.
“OK, Mrs. Smith (name changed to protect the patient’s identity). She is a very needy patient. She has been complaining of discomfort since the minute she arrived. She acts as though everything is an emergency.” The nurse reported to me.
I have never liked the idea of a report starting this way because it sets the oncoming nurse up for a false impression of a patient that is unknown to me. But, I listened to the report and shortly after, went in to assess my new patient.
“Hello Mrs. Smith. My name is Elizabeth and I will be taking care of you for he next four hours”, I said. I immediately began to experience that “gut feeling” that something was not right with this patient which is the same gut feeling that my professors would always talk about.
“I can’t breathe”, she cried. In my assessment, I saw that her oxygen saturations were 100% on 2 liters of oxygen, she was swallowing ice chips well, her skin was warm and dry, her blood pressure was a little on the high side, and her heart rate was in a regular rhythm at a normal rate. Her neck dressing was clean, dry, and intact. Her assessment appeared normal but because of her statement, I reassured her and immediately, but calmly as not to worry the patient, left the room to call a respiratory therapist. I could not even make an educated guess as to what my patient was experiencing, but, from day one you were always told to listen to your patients and mine was complaining that she was unable to breathe.
“Respiratory. I was paged.”
“Hello. This is Elizabeth on ortho. Can you please come and look at my patient in 340B?” I explained the situation briefly. The therapist stated he would come up as soon as possible but did not think the situation was emergent. He suggested to administer pain medication or anti-anxiety medication to bring her pain/anxiety down until he was able to assess her.
Without thinking or planning, I went directly back to my patient’s bedside to see if there were any changes. Her blood pressure has continued to rise along with her heart rate. She was now slightly sweaty and still complaining of an inability to breathe. Still, all I could do was reassure, raise the head of the bed all the way up to help her breathing, and search for someone to help me.
I placed a call to the surgeon over the hospital’s overhead paging system. After a few minutes of no response, I paged again and called the office even though I was sure he was not there as he had just finished a case. At this point, I am beginning to feel overwhelmed and nervous about my patient’s outcome. I called my manager and nurse educator who promptly came to my assistance. The intensity was rising so quickly that every nurse on the floor knew what was going on. And, ever worse, my patient’s roommate was beginning to feel nervous because in her eyes, nothing was being done about a serious situation.
As soon as my manager and educator arrived, we called a Rapid Response.
The surgeon’s office called back and provided my with his cell phone. I had apparently called when he was in route from the hospital to the office. The surgeon picked up the call after the second ring and after explaining the situation, without hesitation, stated he was on his way back to the hospital as he was afraid that the patient was suffering from an anterior cervical hematoma.
The rapid response team was now at the bedside. The patient’s demeanor proved that she was going into shock. Her dressing was taut, her skin was clammy, her heart rate was high, and blood pressure declining. My manager encouraged intubation because she knew the outcome if the patient was experiencing a hematoma. At this point, I was so caught up in the moment and nervous that I do not even remember if the patient was intubated on the floor. It seems as though the minute I turned around, the surgeon was there. He immediately said, “Let’s prep her for surgery.” Then, my nurse manager and the surgeon himself took the patient to surgery.
My educator described to me a few days after how critical our nursing team’s interventions really were. The surgeon evacuated a 150cc hematoma. The patient was taken to the ICU on a ventilator for about 2 days before returning to the orthopedic unit. Apparently, she was minutes away from coding but our tight knit nursing staff saved her life. My educator described the situation as “uncommon, but not that uncommon”. Strangely, that made sense to me.
Had I ignored my gut feeling, the patient would have definitely suffered fatal consequences. It was my nursing assessment skills that activated a strong team effort that eventually lead to a 46 year old woman walking out of the hospital healthy and strong. I have never felt so proud and accomplished towards my career.
I could not have described a cervical hematoma prior to this but now, I feel as though I can handle many life-threatening emergencies even if the pathophysiology could not be described. I strongly believe that instinct has a lot to do with it. This was my first critical situation as a nurse. Since, I cared for patients who experienced severe hypotension, respiratory distress, severe respiratory depression, and a myocardial infarction. I have a new found sense of confidence and my usual nervous feeling that I had always had before going into work, has disappeared.
Amanda Miller, RN, BSN, CCRC
Clinical Research Center
A Special July Celebration
We all recognize the minute a patient walks through the door into the hospital he or she is already looking forward to going home. There is huge trust that the physical body will be safeguarded, and one will leave either cured or with the opportunity to heal. Our duty as professional nurses is to provide a supportive environment for the individual and the family unit, focused the whole being rather than on the disease or pathology. It can be a challenge to balance the science with the art of nursing but sometimes one really ‘gets it’ – a recognition that there is a connection with another spirit and an opportunity to transcend the tasks and create a lifelong memory. Close to my heart are two special moments among many, shared with a unique patient who I’ll call, “Sam.”
Sam was in his 80’s, a retired Colonel of the U.S. military. He was the epitome of a proud, dignified leader. I was sure he maintained very high standards for himself and others. Sam was admitted for ‘redo’ open heart surgery. His surgeon had explained the risks of complications and mortality was much higher with this second surgery. I met them when the surgeon referred him as a potential candidate for a clinical trial. Surrounding Sam were his two daughters. He greeted me with a big smile but the daughters’ expressions revealed their deep fear and dread of the unknown. I immediately felt my presence and purpose was adding to their stress and discomfort. After spending over an hour contemplating the pros and cons of being a research subject and getting an experimental valve implanted, Sam decided to go ahead and participate.
One thing was puzzling me, though. I noticed he had been clutching a piece of paper in his hand during our entire encounter. I didn’t inquire as to what it was but knew it must be very important to him. As the morning went on, Sam was engaged in a lot of preparation for his surgery. I spent this time with his daughters, answering research questions as well as other concerns. The fear in their eyes had lessened and they seemed comforted knowing someone they now knew would be with their father through the entire procedure. Having worked in Open Heart Surgery for many years, it was easy for me to reassure them I was going to be his guardian from start to finish. One daughter asked me if I would do a favor for Sam. “Of course, “I said and out came that little piece of paper. On it was a Bible passage from Luke. The passage reflected the strength and power of belief that one is never alone. She asked if I would read it to Sam as he fell asleep in the operating room. I smiled and was honored to do so even though my spiritual beliefs differed quite a bit. The next thing we knew, Sam, the OR nurse and I were off to the surgical suite. The once reluctant daughters hugged me and appeared to have gained a new level of confidence in Sam’s care and outcome.
Beeps, clangs, cold patches and a small cool narrow table surrounded Sam. The only slightly familiar thing was me! I never left his side and held tight to his hand, keeping eye contact with his big ‘blues.’ When it came time for anesthesia, I asked Sam if he was ready for his scripture reading, and with a huge smile he said, ‘yes.’ I leaned down to his ear and read the verse over and over and over – at least ten times – until I knew for sure he was under deep anesthesia. Then, softly under my mask, I centered myself and blessed Sam with my own mantra. After the procedure, I greeted the daughters who, though tired, now were all smiles. I returned Sam’s paper to their grateful hands. They were so happy to know I had followed through with my promise. Though Sam does not remember my reading the scripture, he knows in his heart that his spirit was as cared for as his body.
The second magical moment with Sam occurred in his post-op phase. He was recovering well but slowly, and his stay was being extended. Sam would be spending the 4th of July in the hospital. I thought, ‘What a shame, a retired Colonel not being able to enjoy the fireworks on such an important national holiday! What can I do? Hmmm…..” While visiting Sam on July 3rd, we talked about the holiday and what it meant to him. He had two friends with him and we all shared our stories. I felt sad he was going to miss out on the festivities but assured him I would light a sparkler in his honor. Sam very much enjoyed the idea and I did too; he seemed to actually glow at the thought.
My niece and I lit many sparklers for Sam the next day and we even took pictures. I presented one of the best photos to him. It was titled, “A Fourth of July, honoring our special Colonel!” Sam did fully recover after a very long convalescence. I like to think and hope he experienced not only nurturing of his physical body during the hospitalization but also sincere nursing of his mind and spirit because of our caring connection. Everyday we touch people’s lives, but I must admit this is one more time a patient has touched mine.
Diane McMahon, RN, MSN, ARNP-C
Director of Nursing,Bayside Center for Behavioral Health
I was going to Vienna Austria on vacation, flying on Lufthansa Airlines. We were half way across the Atlantic Ocean when a flight attendant asked over the speaker if there were any medical personnel on board. There was: an ENT MD and me. The attendant approached me and said there was a male passenger in distress. Could I see him? He was experiencing chest pain and had fainted at one point. The man was seated next to his wife. He was obese and appeared to be having trouble breathing. The ENT MD stood next to me but did not say anything while I asked questions for a brief history. I learned that 13 weeks prior, this man had a double mastectomy for breast cancer. He was also diabetic, grossly overweight and had been immobile for over 4 hours on the plane. I suspected he had thrown a clot.
The attendants helped me evacuate seats in the center portion of the plane, relocating passengers, so I could establish a small medical bay area to further examine my patient. Seat arms were raised to create a “bed“ for him using airline pillows and blankets. I discovered, while this was being done, that there was little in the way of medical equipment on board. A small tank of oxygen had no regulator so I had to control the use by experience of the O2 flow. When I questioned the crew about who knew CPR all of them just starred at me. None of them did.
I did a physical examination of my patient as best I could with my limited equipment. When I auscultated for heart sounds, there were none! How could this be? He was clearly alive and speaking to me. It was only later that I figured out that body posture effected hearing through a stethoscope midair. If I stood akimbo with no part of my body touching any of the aircraft or seat, other than feet on the floor, I could hear the sounds. Otherwise I could not.
I was taken to the cabin to talk with the Captain and reported that I thought our patient had to get to the nearest hospital as soon as possible, that I suspect myocardial infarction. From inside the cabin with my patient, I observed the plane's speed escalate as we headed for an emergency landing in the Canary Islands. This was still over two hours away. I managed to find aspirin onboard with another passenger and, after ascertaining that my patient was not allergic and it was not contraindicated with his other medications, I gave it to him. As time went by, his condition was stable enough for me to be pretty sure that we could continue to Vienna where better medical treatment was available. It was not that much further than the Canary Islands. We landed at the airport in Vienna with me in the cockpit with the pilot and copilot. An ambulance awaited on the runway. The passengers remained on board while an emergency exit was made. The wife did not speak English and I did not speak German but she hugged me with tears running down her face as she disembarked with her husband.
I later learned that my differential diagnosis with little equipment had been correct and that the patient had survived a heart attack. I also learned that the crew, English speaking Germans, did not call CPR the same thing we do. The ENT at one point said to me “You did a great job. I never would have known to ask those questions!“
Some pretty important lessons learned in the air that I needed another time in my career while on a plane.
Kathy Gustafson, RNC
NICU Family Case Coordinator
I have many stories (having worked in the NICU for 23 years) about families and how we have touched their lives as they have touched ours. I do have one story that stands out in my mind and one that I will never forget. We had this baby born around 23-24 weeks gestation 15 years ago. This baby was truly around 23 weeks at birth. Her eyes were fused shut; her skin was so fragile that touching her made her skin peel off. She was bruised from the delivery and her weight was about a pound. This baby had a mom who was young (18 or 19) and no father involved. Mom had a great support with her family. I took care of this baby and bonded instantly with the mom. The baby was not going to make it and lived about 2 weeks, but during that time this mom held on to hope and that a miracle would happen for her little angel.
We all had a very hard time trying to take care of this baby when we knew that hope was slipping away but mom held fast until one day she asked the staff to call me at home to see if I would come in and be with her while her baby was disconnected from ventilator and be able to hold baby while she passed away. I was shocked to get that call that morning but hurried to come in to be with this mom. I sat silently while she held her baby and that baby slipped away to heaven and I kept thinking how privileged I was to be able to experience this moment with this mother. She sat rocking the baby that day for several hours and I was with her when she made her daughters funeral arrangements.
I attended the funeral several days later and all the family knew who I was and thanked me for being part of this mom and baby’s life. That was such an amazing point in my career and it made me realize that nursing was for me and that this mom and baby changed my life as well.
Spence Hudon, RN
Clinical Manager: Cardiac Acute, Heart Failure Unit and Remote Telemetry
Rather than my story, I would like to share with you a story of a caring moment in the nursing career of my colleague, Eric Minkin, RN. First I want to introduce you to Eric, so you can fully appreciate what he did for his patient.
Eric grew up playing sports. In high school and at Davidson College he excelled in basketball. He played with injuries in his senior year at Davidson. His stats were less than stellar because of the injury, but he was still named a First Team Jewish All-American, the best at his position in the United States. He accepted a contract offer in 1972 to play professionally in Israel. He signed with the basketball team and arrived in Israel just two weeks after the Munich Massacre of the Jewish Olympic Team. Eric played under strict security with the Israeli team. At one time, he played in a gym surrounded by 500 sharpshooters, in place to guarantee the safety of his team. In 1977 he was a part of the Israeli team that played the Russian Red Army Team for the first time in Israel’s existence. They defeated the Russians and were greeted on coming home by 1,000,000 Israeli’s, one third of the country. They went on that year to become the European Champions. His experiences while playing in a beleaguered Israel led him to be fiercely Jewish.
After his basketball career was over, Eric returned to the states and got a job selling cars, but found it emotionally dissatisfying. He says he wanted to do something he could be proud of, so he decided to become an RN. He felt it was an honorable profession that gave him an opportunity to help people.
And that leads to the day that Eric was caring for a patient on Cardiac Acute. His patient had not been very religious in his life, but was facing life threatening surgery and felt a need to have the support that prayer and faith can offer. Eric, in talking to him, realized that he had never been baptized and that the lack of that symbolic act was distressing to the patient. Eric asked if he would like to be baptized here, in the hospital, and the patient was enthusiastic about the possibility. Eric contacted the physician, who agreed the patient was well enough to be baptized. Then he contacted the hospital Chaplain on call and they discussed how they could get this done. It was decided that Eric would call rehab and ask about using one of their whirlpools. They readily agreed. Eric went with his patient to rehab and witnessed the baptism in a whirlpool. The patient gained peace and confidence and went on to do well in surgery and was discharged home.
So it was that two cultures touched and a Jewish basketball player who wished to join an honorable profession met his patient’s need and fulfilled his own wish to help people in a way that would make him proud.
Kim Sondey, RN
Intensive Care Unit
When I was a young nurse many moons ago, I had a patient that I think of her till this day. I worked on an ICU and ICU step-down unit and our staff was a very young staff on evenings. We were all in our twenties, so when a young patient of twenty nine was admitted to the ICU from labor and delivery, it hit very close to all our hearts. During labor, Geraldine's blood pressure started to rise and she started to become increasingly more lethargic. At first it was attributed to her long labor, but after delivery, she became unresponsive. She was sent for a CT scan and to the ICU with a cerebral bleed. Her family was devastated and even more so when the neurologist and neurosurgeon gave them the prognosis. The neuro- surgeon, gave her a 1% chance of making it out of the OR and no chance at all if he didn't take her to surgery.
She was taken to the OR and the bleed was identified as a ruptured aneurysm and was clipped. She made it through the night and a few days later, she woke up to all our delights. At first she had some major deficits. She was in the ICU for weeks, but we saw a steady improvement over time. The staff was so attached to her and her lovely family that most went above and beyond the norm. When Geraldine was finally sent to the step down unit, we were thrilled and her progress continued.
About two months into her stay, the family decided that it was time to christen the baby. One Saturday evening the nurses emptied and cleaned our locker room, cooked and baked and watched as the baby was christened over a hospital basin. We all went into the med room then and cried our eyes out, because we were all younger than her and you never know. Geraldine eventually went home with her son. She still had left sided weakness but could be independent. She did need help with the baby. The nurses from the floor were all invited to his first birthday, which we were all happy to attend and she kept us updated on there progress for years to come. As we all moved on to other jobs, we lost track of her , but there are a few of the other staff members that I still keep in touch with and we still talk about her and wonder how she is doing. Her son should be in college by now. There have been other patients and other families that I have connected with over the years, but I don't think anyone hit as close to home as Geraldine.
Dawn Oder-Colletti, RN
Center for Advanced Surgery
Taken too soon
She was one of my patient’s the first year I was a nurse in the Medical ICU. My patient was a 20 year old girl who had been diagnosed with terminal breast cancer. She was in the unit for complications from her treatment and had been weaned off the ventilator. She had a 2 year old daughter. Her mother had been by her side the whole time when she wasn’t taking care of her granddaughter. About a day after she was weaned off the vent, her mother came in to present her daughter with legal papers to give custody of my patient’s daughter upon her death. The family was requesting that I help coordinate this with the support of their pastor. Apparently my patient had been in an abusive relationship with the child’s father, and it would not be in the best interest of the child to be left with him. This was expressed by the patient; and she was scared about what would happen to her daughter. The importance of having this document was apparent, but as we talked to her, with her raspy voice from intubation and tears streaming down her face she demanded that she didn’t want anyone to take care of her daughter, SHE wanted to take care of her. That statement hit me like a brick wall. I was pregnant with my daughter and could not imagine leaving her at such a young age to be taken care of by others, even though it would be family.
I left the room trembling, and went into the nourishment room. I broke down and just cried. I was crying for her pain, for the unfairness of her situation, and for her daughter who would not remember her Mom and how much she loved her. A couple of the nurses working with me that day came in to support me and let me cry. But, I knew I had an obligation to my patient to try to get through this difficult day with her. I pulled myself together and went back in the room with the clipboard that held the documents that needed to be signed. I can’t remember all that I said to her, but I spoke to her as a Mom, knowing we do what is best for our children no matter what the circumstances. This being the worst I could imagine. I told her that what she is going through is not fair, and we were all hurting with her. I also told her I knew in my heart, as well, that her Mom would love and nurture her daughter; and do everything in her power to never let her daughter forget her Mommy that was taken away too early. Her daughter would have an angel always watching over her. With both of our hands trembling as I held the clipboard and she held the pen, she signed those papers. Two days later her Mom came to tell me she was gone.
I was glad we were able to get things in order for her. For several years, I would see her daughter and Mother at church, or around town. They would always come to see me and the Grandmother would thank me again. I watched her daughter grow into a beautiful little girl. I wished my patient was here to see her daughter’s smile.
Deborah Barron, RN, BSN
ECC
MY “CARITAS”
The story or “caritas” that I am about to tell is significant for me because it encompasses many areas and aspects of nursing and because it occurred here, at Sarasota Memorial Hospital, where I work in the Emergency Care Center.
My assignment in the Emergency Care Center (ECC) when I arrived for my 7am shift was room #’s 401-404. The nurses have 4 rooms each and, as you can imagine, things get very busy very quickly. Any extra time we can give to our patients is often a luxury. In room 402 I received a female patient in her mid to late sixties with chest discomfort. She was very attractive and I could see at once that she was independent, intelligent and appeared to take care of herself very well. We introduced ourselves and made a connection right away. I learned that she had a history of atrial fibrillation and she was under the care of a primary physician, a cardiologist and that she was going to have a routine diagnostic colonoscopy the following day. Her chest discomfort was about a 4/10 and had started in the late morning. She described it not as chest pain or even chest pressure, but “just something there”.
Over the years I have heard these typical descriptions of “something is just not right” or “something is there” when they refer to chest discomfort. Of course, I proceeded to put my patient on the cardiac monitor and oxygen, start an IV and draw blood, and perform an EKG; all the while we were talking and I was assessing her. She had gone out for a light breakfast with her friends in the morning and then she gone to the local YMCA (which I had just recently joined) for a pool exercise class. Towards the end of the class she had felt the chest discomfort and decided to drive herself to the ECC. We talked about diet and exercise and medications and how her lifestyle had begun due to the aging process and atrial fibrillation. She told me that she stopped coumadin 4 days earlier in preparation for the colonoscopy and asked me if that had something to do with the chest discomfort she was experiencing. She also shared that one month ago she had stopped the coumadin for the same reason but the colonoscopy had been cancelled and she restarted the coumadin, only to stop it again 4 days ago. We discussed some possibilities and I encouraged her to wait for the test results and then discuss things with our ECC physician. She asked me please, not to speak to her daughters about anything so as not to worry them and of course I complied with her wishes.
The test results came back and her cardiologist decided it would be best, based on the results and the clinical presentation of his patient, that she be admitted overnight as an “observation” admission, for further blood tests and evaluation. My patient was visibly upset about this, mostly because of the colonoscopy scheduled for the next day.
She asked me what I would do if I were in her place. I could not answer the question, and instead I asked to consider the admission as a small event in time that might be helpful and we could monitor her heart, cardiac enzymes and other lab values. My patient did not want to stay. I suggested that she speak to her cardiologist and to this she agreed. I called him and explained the situation and he was happy to talk to her. I arranged the phone call and witnessed it. My patient was discharged with instructions to go home, continue the prep for the colonoscopy and see the cardiologist the day after. She was very pleased with this plan and satisfied and pleased with all the care I had given her. I was still concerned for her and told her not to hesitate for a moment to return to the ECC for any chest discomfort.
I walked her to her car, which was parked in front of the ECC triage area, and we hugged each other.
Two days later, I was working in triage when I received a phone call from a woman asking me if I had cared for her mother, Mrs…..? I replied, “Oh, yes, I did take care of her”, as I recognized the name. “Well, can you tell me what happened to her in the hospital?” “I’m her daughter”. I responded that I was not at liberty to discuss the patient’s care as that would be a breach of patient confidentiality but she cut me off and blurted out, “She’s dead!” I felt like I had been kicked in the stomach. I was silent then I practically stuttered: “I, I’m so sorry. Your mother was a patient here a couple of days ago but she was discharged after talking to her doctor.” The woman said ‘I see…” then silence. I continued, “If you have power of attorney or you are next of kin, you may access the medical record and surely you can talk to her physician. Can you tell me any thing?” She seemed a little more comfortable and told me that it appeared that her mom had died in her sleep in her bed. There was no evidence of a break in or foul play. She never made it to the colonoscopy appointment. They just didn’t expect it. It was a shock. I was still stunned too. I did say that her mom had asked me not to discuss anything with her daughters because she did not want to cause them concern. The daughter replied that “Yes, mom was a very private person, very independent”. I offered that her mother seemed in good spirits, had had a nice morning with her friends and exercise class and that she was satisfied with her plan of care when she left the hospital. She thanked me for my time and I thanked her for letting me know about her mother. I wished her well.
About a week later I received a short, hand written note of thanks from my patient’s daughters. A week after that, the two daughters came to the ECC to thank me personally for caring for their mother. I was overwhelmed by that gesture and by their kind note of thanks. Again, I offered condolences and told them how much I enjoyed their mom, how I thought she had enjoyed her life because she shared so much of herself with me.
