I Hope you...

I Hope you… Lie on the hospital floor

Laura G.

Ventura, CA

ICU

IG: Fitasgluck

I’ve heard a heart break.

I’ve looked someone in the eyes while watching their world change forever.

I had the honor of taking care of Mr. M, a 40 something year old husband and father, who recently suffered a cardiac arrest at home. His son did CPR while his wife called 911. EMS revived him. The ER stabilized him, and then he was brought to us, the ICU, to be cooled and cared for before finding out what damage had occurred. His course of events, while traumatic, were timely and executed flawlessly. He had every reasonable chance going for him. But, after rewarming him, Mr. M wasn’t responding. The tests results, along with his neurological exam were suggesting brain death had occurred.

The day I took care of Mr. M we were preparing for brain death testing, a series of procedures and tests that are used to determine brain function. Mrs. M sat, limp and twisted at his bedside, her face swollen with tear stains. She looked up at me trying to force a smile of acknowledgement. I asked her if I could get her anything or help her in any way. She stared at me and then, losing focus, seemed to stare through me, whispering “I don’t know… I don’t know what I need… I don’t understand what’s happening now. The doctors have told me, but I don’t understand.” I took a seat next to her answering questions and carefully explaining the plan for the day. I told her to ask me as many times as she needed to help her understand what we were doing and why, while reminding her that she’s allowed to feel flustered and forgetful.

We went through the day like this. Slow. On repeat. Going from procedure to procedure. From cold caloric testing to apnea testing. Moving his family in and out of the room, explaining and over explaining. Carefully preparing them for the news. Trying to explain how all of his vital signs could be perfect while his brain was in question.  And why two sets of doctors would be needed to assess for brain death. Every day life doesn’t prepare people for moments like these.

Finally, the doctors asked for the family to come to the patient's bedside to discuss the findings. Mr. M’s children and wife moved from the waiting lounge through the hall as one unit, holding each other closely. As they came into the room I closed the door behind them. The doctors began to speak “Mrs. M, I’m sorry…” The rest of his sentence was drowned out by breathless weeping. Mrs. M fell to the floor, and laid there, body pulsating with heavy sobs. Her son ran out of the room and her daughter was crouched down in the corner. The doctor said again “I’m so sorry, I'll give you time” and turned to leave the room. I tearfully knelled down next to Mrs. M and looked her in the eyes. Her pain was evident. She reached out to me and I laid down next to her while hugging her closely, her wet face in my neck.

As a nurse, we learn to compartmentalize things in order to get our job done effectively. But we must never forget to be human. So, friends, I hope you slow down. I hope that you repeat yourself as many times as they need to understand. I hope you hold their hands. And, if the time comes, I hope you lie down on the hospital floor and hold a widow close while she morns the loss of her husband.

I hope you always choose to love.

 

 

 

I hope you... smile.

Lauren M

West New York, NJ

CVICU RN

IG: lemon_drop__

I'll never forget being a new nurse. I was nervous, anxious, scared, and excited all at the same time to make a difference in patient's lives. When I was hired for my first job out of nursing school, I started a Nurse Residency Program and was promised a job on a Cardiac Telemetry unit. Cardiac nursing was something that I was always interested in and it felt like the right fit for me. 

However, during first week of orientation, I was told that myself and another nurse resident were being moved to work on another unit due to staffing issues. This unit in particular was an Oncology unit. It was a Med Surg and Telemetry floor that primarily took care of various patients who suffered from cancer as well as hospice patients.

As a brand new nurse, the idea of cancer, hospice, and death scared me. Sadly, I have watched family and friends suffer from this horrible disease, and be taken away from this world way too soon. 

When I found out that I was being moved to work on this floor so many thoughts and fears, ran through my head. Am I strong enough to be able to care for these patients? I had never witnessed a code during my clinicals in nursing school, nor had I ever seen someone pass away. I thought to myself can I do this? 

It turns out I could, but it definitely wasn't easy. I got to celebrate the triumphs of those who kicked cancers ass, witness the strength and courage of patients in the midst of their battles with cancer, and sadly be there to hold their hand as they took their last breath. 

I'll never forgot one interaction that I had with one of my first hospice patients. One night during my shift I took care of a middle aged man who fought a long and hard battle with cancer. His loving wife of many years refused to leave his bedside afraid she would miss her chance to say goodbye. I came into the room with the PCT to turn him and make sure that he was comfortable.

After we had turned him, I wiped his face and cleaned him up a bit. His mouth looked dry, so I dipped a mouth swab in water and wiped his lips and inside of his mouth, shortly after doing this, the biggest smile spread across this mans face, and for a moment he looked so happy and at peace. However, little did I know that this would be the last time that this man would ever smile, because moments later this man took his last breath. 

I'll never forget his wife giving me the biggest hug, thanking me for allowing her to see her husband smile one last time and giving her that last memory of her husband. 

Nursing school may give you the skills and the knowledge to be the best nurse you can be, but what it doesn't teach you is kindness, compassion, strength, and courage. Just remember you are strong enough and you can make a difference. Although there will be tough times, it can also be very rewarding. All you can do is put your best foot forward, work hard, and just remember that you are strong enough, and in the end I hope you smile. 

 

I hope you... have the courage to stand up for yourself.

B.B

Sarasota, FL

Medical Surgical 

IG: beccarayeofsunshine

I was not one of those people that was thrilled to take off my orientation training wheels.  Admittedly, I was the one in nursing school that would panic every time I thought about working solo and holding my own license.  I remember studying for the NCLEX and when the question “how do you handle inappropriate patient comments” popped up, I’d stare blankly, paralyzed with the fear of what I actually would say.

How on earth would I approach that in real life? I adore the precious geriatric population I get to work with and the little spark in their eyes when they see a young nurse, but I felt ill prepared for the less than desirable patients that would inevitably come my way. 

At 3am one morning my new admit came rolling through the halls and the stench of alcohol was already permeating the unitWe frequently get drunk patients, but this one sounded rough in the ER docs note, “pt unable to hold a coherent conversation.”  Perfect challenge.  I started the admission, and the inappropriate comments started almost immediately. 

“So, are you single?” followed by “you have the most beautiful blue eyes I’ve ever seen”.  I glanced over at his bag that was literally containing the stench of his clothes and the previously two bottles of vodka that I confiscated, when I noticed a suit. 

“Where were you coming from wearing a suit?” I asked, wanting desperately to ward off the bizarre smattering of remarks. 

“Oh”, he continued in between violently vomiting up the contents of his stomach and me pushing a dose of Zofran, “I just bought it for my 7 year old son.” 

My heart sank a little bit.  We can never forget that these sickly and often messy patients are someone’s mother, father, child.  I hope you remember that no matter how unpleasant an encounter, you’re still caring for someone’s love.  An hour later, we started noticing bigeminy and trigeminy PVC’s every other beat and extreme tachy into the 170’s on the monitor.  I ran into the room half expecting the patient to be unresponsive.  Instead, he was calmly lying in bed and rolled over to look at me, pleased that I was giving him more attention.  Gross.   

“Becca”, he started sleepily, “I just want to say something before you leave, because I know that you won’t be here during the day and there’s just something I need to ask you…” 

My heart lurched.  I felt like I was spiraling face first into an NCLEX question, except it was real life and I was standing in front of a miserably drunk, incredibly suggestive man more than double my age that was trying to make a pass at me.  All of a sudden, my tone changed and confidence took over. 

I looked him right in the eye, took a deep breath and started in the most sharp, stern voice I’ve ever used with a patient. “No sir, you are going to stop where you are.  I am your nurse, in a professional role and you are acting beyond inappropriately towards me right now and you are NOT about to ask me what we both know you are about to ask me.” 

His eyes got wide for a minute and he fumbled on his words, clearly thrown that I had caught him and said something. “Oh no wait oh what I wasn’t going to say anything!” 

“Mhmm, that’s what I thought,” my voice still cold as I turned to leave the room for the last time before we contacted the doctor and stat transferred him to a cardiac unit. 

Oh baby nurses, I hope you know how competent and self-assured you'll be and how wonderful it’s going to feel when you face your own personal nursing fears.   I hope you have all the strength to stand up for yourself when the time comes. 

Love to all of you beautiful nursing souls, best of luck! 

 

I hope you... let your heart break.

Stephanie O.

Chicago, IL U.S.A.

Pediatric Intensive Care Unit 

IG: stephanie.odie

I hope dying makes the living closer. One of my patients I took care of passed yesterday morning. I walked into work with his family standing outside the hospital holding one another crying. I knew exactly what had happened. His mom managed to smile at me, her eyes thankful despite what she had seen, what no mother should see.

He had such a difficult road, at only 16 years old grappling with his own mortality. His kindness was never lost, but his innocence left him too soon. The slowness of his demise tortured not only him, but also his entire support system. His mother so strong and protective, yelling at me when I pronounced his name wrong the first time I cared for him.

He loved her so much he engraved it on his arm in the form of a tattoo. Their love transcends this world, his strength beyond the grave. His death process slow, like many things in life, but too soon for him. He experienced a gradual system shut down: going blind, losing hearing, movement, the ability to speak.

I deal with death on a daily basis, yet it’s all hitting me now. He was one of the great ones. I wonder if you learn to know which patients will take your love and tear your heart out. I wonder if it gets any easier to see an amazing, creative, wonderful child leave this earth with their parents surrounding them with love… probably not.

As a nurse, we learn to compartmentalize some patients to prevent their tragedies from hindering our work, our lives. While at other times, we grow to love a child, a family, so much so that we are sad to have a day off. What if that was the last time we see them? What if their parents needed us? It’s a delicate balance when our lives are fulfilled through providing for others. We sometimes forget the value of caring for ourselves because it feels so good to be needed. 

 

I hope you... raise your right hand when she can't

Briana R.

@BeachLifeOrganic

Los Angeles, California

Emergency Room Nurse, RN, BSN since 2010

Nursing Experience at the time of this event - 3 years
 

Let's call her Grace - because to me, she still had everything to live for. & Yet, if it was up to the doctor (she wouldn't have ever lived again) ...  these words that follow were his:  

"There's nothing we can do. She has a bleed in her brain and she'll never walk again ... she'll be stuck in a bed for the rest of her life"

... and he walked out of the room.

I'll never forget her. She rolled in to ER room 4 straight from the beach, the ambulance brought her, still in her swimsuit, still wet with saltwater. She was playing in the ocean with her husband just before the symptoms started. The next thing he knew, she fell under the waves, & when she came out ... she couldn't move anything on her right side. 

Grace suffered a traumatic head injury that day causing a left sided bleed in her brain. By time she arrived in the hospital she was experiencing what they refer to as right-sided neglect. It's as if her brain suddenly forgot that half of her body existed. She couldn't speak either, but you better believe she would hit you with her left hand if you talked about her as if she wasn't in the room.

I had 20 minutes left in my 12-hour shift and it had been an incredibly busy day - but the moment she arrived, I gave her my full attention. She was 60+ years old and the room went still when the doctor told her husband and her daughter standing at her bedside there was nothing he could do. I knew in my gut there had to be a better way.

I can still hear his words as if he's standing next to me today "She has a bleed in her brain, it may get worse or it may stop here - either way, this is what the rest of her life is going to look like at best". 

He left the room, and I told them I would do everything in my power to make sure she still had a chance. I called the stroke coordinator at home while she was eating dinner with her family on a Saturday night and told her the story, I told my charge nurse we needed a second opinion and I called the hospital supervisor tell him that I needed to transfer my patient to a different hospital if our neurosurgeon wasn't willing to give her a chance. 

The ER doctor was too busy to round on her again when I asked for him to call for a second consult "I've already handed her case off to the ICU hospitalist ... call him if you want a second opinion" 

No matter which way I turned, everyone kept telling me ‘NO’. I did everything in my power; I fought hard for Grace and her family because Grace wasn't your typical hospitalized patient. She had no medical history other than borderline high cholesterol. She wasn't sick or overweight or being close to being bed bound by any means. 

She still had years in her life to enjoy and this bleed in her brain was from a trauma that happened while playing at the beach. I was determined to give her a second chance. This wasn't supposed to be the end of her life, not that day.

Words can't explain how powerless I felt, and it was the worst feeling in the world when I walked back into the room, feeling defeated, about to tell her family that I had tried my best but this bleed in her brain was going to be her fate.

It was 745pm, I had just handed off report to the nightshift and was saying goodbye as I heard my name on the overhead pager. I picked up line 2 - it was the Neurosurgeon - "Briana, I've heard you've made a few phone calls and there's no need to transfer our patient out - I've reviewed her chart with my colleagues - I'm ready to take Grace to surgery - I'll be waiting in OR 3." He hung up. 

I dropped the phone, grabbed her chart and pushed her to surgery myself. Grace still had a chance and I wasn't going to miss this window.

3 weeks later, Grace went home. 

& as far as I know, she's sitting at the beach with her husband holding his hand with her toes in the sand as we speak.

This is my best way of showing you how important it is to get to know our patients and our families and advocate for them when they can't. Most importantly, when they can't raise their right hand to speak up for themselves, I hope you do the talking and even stay a few minutes late. It may literally change their life.

Since this day there have been many more 'Grace's' in my career ... but I can only hope her story will help you find your own grace and motivation to speak up when the time is right. 

**If this story resonates with you or you have any questions, at all, please don’t hesitate to reach out.**

xo, Bri

 

I Hope You... Say Happy Birthday

Devon H.

Ventura, CA

Labor and Delivery Clinical Nurse II BSN

IG: @hi_devon

I remember my first month as a new graduate in Labor and Delivery at one of the busiest Los Angeles Hospitals.  I was always nauseous driving into work, I was a deer in a headlight and we all called it the Wild, Wild, West.  Every room was always occupied, patients were delivering in the parking lots, in the elevators, and we never got lunch breaks.  It was pure chaos and the best exposure to labor and delivery I will ever get.

That first month, I cried at every birth I saw.  Mind you, I had seen plenty of births during nursing school.  But, there is something so special in that moment between the parents and their newborn when they see their child for the first time.  There is a brief interaction between the parents and their newborn during that you might miss if you’re not paying close attention.  After the mother has just exerted every once of energy pushing the baby out and they place the baby on her chest with the father right at her side, that’s when the magic moment happens.  You have to see it to believe me.  There is that stupid little ball that creeps up into the back of your throat as you watch that moment unfold before you.  You can feel the love raidiating off them.  And you have to look away and pretend to attend to something really important so no one sees the tears trickling down.  I made it my goal to wish every baby their first “Happy Birthday” as I dried them off, took their vitals, their weight and length and swaddled them back up.

It took a good month for me to get my emotions under control and the initial excitement of births to wear off.  Two years later, I have found myself still telling babies “Happy Birthday” and will tear up only every now and then.  Don’t forget that even though this may be the 417th birth you’ve seen, it’s the first one for that mother, father and baby.  I hope long into your career, you still say “Happy Birthday."

 


I hope you... sing them lullabies

Kendra M.

Norfolk, Virginia
Pediatric Nurse at Portsmouth Naval Hospital
@healthwithkendramik
 

I have only been a nurse since last June, yet I feel like I have learned more about what compassion means over this one short year than I have over all of the other years of my life combined. Nursing is a profession that means more than simply doing what it takes to get by and make it through the day; I have learned that to be the best nurse possible, your heart needs to be in it every step of the way.
 

Working on a pediatric unit, I see the sickest of kids, yet I also see the happiest of kids and families once they heal; this what makes my job worth it. A few months ago, I took care of a former NICU baby girl who was unable to eat without putting her at risk of aspiration due to a congenital malformation of her esophagus that needed a serious procedure to fix. This sweet girl had been in the hospital since her birth in March until about a week ago- from her NICU stay to her pediatric unit stay to her operation to another NICU stay to the PICU, from which she was ultimately discharged, she and her family knew no other life than the life of the hospital up to that point.

I grew exceptionally fond of this patient and her family, yet I found myself remorseful to the parents when, at times, they would not stay overnight with her, as many patients on our unit do. I thought, "how could parents leave their sick child in the hospital alone?" One night, the baby was crying and screaming and fussy to no end; I could not figure out how to calm her. Finally, I decided to do what my mom used to do when I was upset...I began singing "Twinkle Twinkle Little Star" softly as I rocked her in my arms. Much to my surprise, this worked. As she gazed into my eyes, I could feel the bond I was forming with a three month old baby who I could tell had finally come to trust me. 
 

I rethought my preconceived beliefs about the parents not being present...after weeks and weeks of being in the hospital, I understood that they needed a break, and having the nurses care for their daughter when they could not be present was a blessing for them. I have never been hospitalized, nor do I know what it is like to have a child who is. As I sang to her, I was overcome with joy and gratitude that I could serve as a mother figure to this sweet child. Every day, I looked forward to caring for her. She was just one of the babies with whom I so easily connected. It may sound silly, but babies are much smarter than we think; they are humans with their own needs and thoughts and personalities! I have learned that compassion makes the job much easier; while my interactions aren't always verbal, as I spend days with only infants sometimes, I have learned how to connect and channel my emotions with my patients. Sometimes, nursing care does not mean solely administering medications and changing linens, but instead singing lullabies. Nursing requires creativity and stepping out of comfort zones to appeal to each patient's needs; at the base of that, I have learned what compassion truly means. 

We give up countless hours of our time and sleep to those who need us, but we do it for our patients, and they're what keep us going. If you ever have a bad day (because they are bound to happen) remind yourself of the good ones; they make it 100% worth it!

 

Love, 
Kendra

 

I hope you... walk the halls at 2am. 

Andie

Spokane, WA 

Medical Surgical/Tele Float RN 

@andietimesthree 

I spent the first six to eight months of my nursing career striving to be a go-getter. I was never a fan of being labeled a new grad, and I wanted to prove that title wrong. I wanted my new co-workers, charge nurses, and assistant nurse managers to have no idea I was a new grad. I wanted to be so proficient at getting things done that, essentially, no one even noticed me. While I have to admit, becoming proficient at tasks and managing my time well is still important to me, being a good nurse is more important. If being a good nurse means the same thing to you as it does to me it is truly why we all got into this to begin with. 

One night, I was working in the nurse assistant role on a unit that was understaffed with aids. I had been running my fool head off, in and out of all the rooms, and met the patients briefly while taking their vitals. A few hours later, I heard some restlessness down the hall. That "fear the fall" mentality drove me toward the noise. So I poked my head in to see if everything was okay, and the sweet woman in bed 2 just couldn't sleep. She asked if I would walk with her. We got her necessary equipment and strolled the dark halls at 2am for over an hour. I was supposed to be doing 10 other things. She was supposed to be sleeping. At first, all I could think about was falling behind on my task list. But, here we were wandering around the unit, talking about naturopathic medicine, strange miracles, holistic health, family, her farm, our friends, traveling, our dogs, nutrition, telling jokes, smiling and laughing, and I had forgotten all about my task list. At 2 in the morning, I had a deep realization while walking with her about what really matters. We know what really matters, but we get lost in the world of getting things done. In the fast-paced, pressure-filled, stressful, exhausting, emotionally trying journey that is being a new grad nurse, take the time to walk the halls with that sweet woman at 2am because she can't sleep and wants your company, and you need a refreshing conversation with a really cool gal. It is the most fulfilling and rewarding and powerful part of this whole being a "good nurse" thing. The tasks will still be on your work list when you're done connecting with that patient. 

 

 

I hope you...get endless hugs

Michelle S. 

Minneapolis, MN, USA 

 Post Partum RN

@michellerae23

My first hospital job out of graduation was in a Level 1 Trauma center. I was a medical-surgical float RN, and trained to go to 10 different floors. To say each day was terrifying when I was first off orientation & on my own, would be an understatement. Each day, I would walk into the front doors of the hospital and attempt to mentally prepare myself for the day, wondering where I'd be sent. I would go to the staffing office to find out where I would be assigned for the next 8 hours, before then switching to a new floor for a whole new 4-hour assignment after that. 

That first Thanksgiving working there was my first of many holidays I missed from being with my family. Day shift, starting at 0700, 12 hours, and I found out that I was assigned to the oncology unit. Alright. One of the hardest floors, yet one with the best co-workers and great teamwork. This can't be too bad. 

One of my several patients that morning was a 54-year old male, diagnosed with lung cancer. I will never forget his story and age as he was the same age as my own father and immediately that morning, we had a deep heart-to-heart about how he felt being stuck at the hospital on a holiday, Thanksgiving. That very morning we joked about whether the cafeteria food would be his "favorite Thanksgiving meal" of his life, and whether it would be his last year being around for it. He was alert, oriented, and we really connected. 

Just 3 hours after that, he had the biggest Thanksgiving party on the floor. He had his wife, his 3 daughters, and their significant others at the bedside. I could hear laughter from their room even out at the nurses desk. By 1pm that day, just mere hours after the majority of family members and his daughters had left for the day, I could note that something was different...I chatted with another nurse to validate my assessment. "Oh, he is being followed by the palliative team, he is fine!" ... but his breath sounds are different, but he isn't speaking in full sentences like he was this morning. 

To the wife and children that were at his bedside that very afternoon, I know he needed you there. You are just what he needed to feel complete. To his wife, who came back up to the room and spent his last hours of his life holding his hand, I think of you often. With me being the first one in the room to respond to your call light where you immediately looked me in the eyes and stated:  "He's. Not. Breathing." Is something I don't take lightly. Being the one to call the physician for the first time in my life to say "it appears as though the 54-year old male in room 08 is not breathing" is something that I don't take for granted. Being the nurse in the room, working my first Thanksgiving, witnessing my first patient death, is something that can't be described. Yet, through all of this, I held your hand. I held it together, even when the physician had tears in his eyes, even when you fell to the floor in sorrow and yelled "no". But inside I was broken. A life taken from us too soon. But again, he needed you there. He needed all of you there that afternoon, he held it together to be there with his whole family that afternoon, and it was clear to see he was proud of his daughters and loved his wife.  Year after year, I think about you. I think about how it feels to be without your husband, particularly on Thanksgiving. I wish I could give you a hug over and over again like we did that evening, that holiday. There were not enough hugs to describe the pain I could feel in your heart, the pain felt in my heart too, for you to lose a loved one. 

Following my shift, I went back to my childhood home...9pm, standing at the top of the stairs, end of my shift, and there was my healthy, 54-year old dad, with a big smile on his face, saying "Happy Thanksgiving". I lost it....I gave him the biggest hug of my life, as I cried my eyes out thinking how my patients' daughters will never do that again. And that's just it, people will always say "it must be SO nice to leave work at work when you're done for the day!" And it's actually the opposite, each patient you meet has a story, and a family, and although you may never see them again, they're in your heart and mind, one hug at a time. Forever. 

 

I hope you…Get the Littlest High Five

Lana L.

Chicago, Illinois

Neonatal Intensive Care Nurse

IG: @LanaLasch

As a child I always dreamed of being a nurse.  Okay, maybe I wanted to be an artist first, but I quickly learned that drawing was not my strong suit.  Frequent doctor visits, minor hospitalizations, and a few stitches later I found myself taking notice of the nurses who provided care to me when they gently woke me up in the middle of the night for vitals or and made IV insertion seem like a minor thing.  However, it was the nurses who took my doll and gave her a fake IV, placed EKG stickers on her, and put her in a mini hospital gown that showed me what I wanted to be: a pediatric nurse.

Fast forward to my transition to a new graduate nurse and I found myself in the Neonatal ICU, somewhere I never thought I would be.  I was anxious and nervous.  Yes, this was pediatrics, but it wasn’t pediatrics, was it?  These babies could not interact with me, play with me, or laugh at my (admittedly awful) jokes.  How would I be able to implement the little things into my care?  The components I was so looking forward to, the decorations for a child’s room, toys, movies, games, or anything to make their stay as “normal” as possible.

I quickly learned how wrong I was. They say NICU is an area that you do not really cover in nursing school, and whoever “they” are, they’re right.  As the weeks went on, I began caring for a sweet little boy who had entered the feeder and grower stage.  Each day I came in for my shift I looked forward to greeting his family and taking care of him.  This patient was trying to hit the 5lb mark, so each day I commented on how big he was looking and how strong he was feeding, giving his mother the reassurance she needed during this tough time.  

These weren’t just words I spoke because the family needed to hear them, they were true.  He was growing and getting stronger, so strong that we bet that by the start of the new week he’d hit his 5lbs.  I still remember the look of shock on his mother’s face as she asked, “you think so?”, to my preceptor and I.  We responded with, “I know so”.  Sure enough, this little boy hit 5lbs that Monday.  This milestone, something that had been a marathon for him and his parents had finally come, so I took construction paper and my sharpie that was on my ID and traced his small hand and labeled with the date and “high 5, I hit 5lbs”.  

This moment, was the moment I had been waiting for.  This moment was a little thing, but it was a big little thing.  So, while I never did become an artist, I do get to implement creativity in my care every day.  The big things, like physical care are important, but in some cases, they are just as important as the little things that provide comfort to both the patients and their families.