I Need You

A nurse cares and desires at the deepest level for his or her patient to feel that sincere intention and, as a result, feel better as a result of all their effort. Nursing is hard. More often than not a nurse hears complaints about what hasn’t been done as opposed to what he or she worked so hard to accomplish on behalf of the patient.

The last few weeks have been busy. Busy is the nature of the ED, but busy with extremely high acuity that places any patient not intubated and/or on a presser or sedative a bit lower on the totem pole. Not on purpose, but by the very nature of prioritization of care. It is these days that can be the most trying. I run from patient to patient and delegate out tasks when I can’t be in two places at once, and then realize that the patient who has been in my care for the last three hours hasn’t seen me in two hours, because my coworkers have been helping me out while I was stuck in my ICU patient’s room. While this is the beauty of teamwork, there is a piece of me that sometimes feels as though I’ve failed that patient by not being present for their every need. Do they think I don’t like them? Do they feel neglected?

I return to check in, always apologizing for the time delay, and take a seat as I explain the latest updates and plan of care. The patient usually understands as they can hear the ambulances rolling in and have watched the nurses rush past the room back and forth for the last several hours.

In the midst of one of these days I cared for a sweet elderly woman who was mostly French speaking, though she spoke enough English to communicate her needs. She had a history of brain injury which resulted in some short-term memory loss. She was so patient and humbly accepted care for all her needs. When she first rolled in I smiled and spoke to her like I speak to all my patients. A patient who doesn’t speak your language still understands the language of your touch, tone, and feeling in your eyes. I gained her trust with a smile and she felt my sincere desire to meet her needs.

This patient was on her call light multiple times an hour, and it was one of those days where my coworkers graciously jumped in to help answer her light while I was in with other patients. Although each time another nurse walked in she asked where I was and wanted me. Upon hearing the news I was touched that she trusted me with her care, but a little frustrated since I was unable to be in her room as much as she called.

Upon entering her room I remembered that she could read my emotions more than my words. I took a breath and smiled. “What do you need?” I asked.

“You,” she stated.

“What can I do for you, sweetheart?” I leaned down to look her in the eyes.

“You. Right here,” she gestured to the chair next to her bed. “Sit here.”

I realized what she was asking. She wanted company, someone to sit there with her while she waited...

I took her hand and explained in the simplest terms that I had to care for other patients too and was not able to sit there.

“Oh. I will wait,” she said her face slightly falling.

It broke my heart not to be able to give her what she felt she needed in that moment. She just needed someone’s presence. I gave her all the time I could, made sure she was comfortable, and then smiled, assuring her I would be back to check on her.

As nurses we like to be superheroes and meet everyone’s needs at all times, and I struggle when I feel I have fallen short and not met everyone's expectations. It is not always possible and at the end of the day as long as I have given my best in every care and taken care to make my interactions intentional with my patients, I have to feel ok hanging up my scrubs for the day and recognizing that I am not superwoman. 

My best is all I can give in a day. Tomorrow will be a new day with new patients and experiences, and I need to arrive, once again, ready to give it all I’ve got...whatever my 100% is for that day.

On My Team

I walked through the door two and a half hours later than usual to my husband's smiling face. That smile fell as he saw the sadness in my eyes followed by the stream of tears. "What is wrong??" He asked with great concern. I shook my head. As much as I wanted him to understand the sadness and brokenness of my heart at that moment, it wasn't something I could explain."My patient died."

This is the reality of healthcare. On a day to day basis we are faced with situations involving life and death, some easier than others. This was the first time I had come home and felt so affected by the events of the day. My patient was sick. He rolled in with lab values not compatible with life and in need of emergent filtering of his blood. But he talked to me for the whole 4 hours I cared for him. He was alert, oriented, kind, and very sick. I administered meds and drew labs as ordered and called report to the ICU for transfer. Night shift arrived and the plan was to wheel him upstairs before I went home.

The staff assist button rang out. I ran into the room with many staff members to find the patient seizing and moments later in cardiac arrest. My incredible team went to work initiating chest compressions, passing meds per protocol, and working with the docs to assess what could reverse possible causes. It was straight to business. His heart wasn't working and we needed to intervene immediately. 15 minutes passed and it was my turn to do compressions. As I leaned over his chest I pumped to the beat of Stayin' Alive. I looked down at this man I had cared for over the past 4 hours and something clicked. I was no longer "doing compressions on a body", I was pumping my sweet patient's heart with every ounce of energy to keep his blood moving and give him the best chance of survival. It was suddenly very personal. I began to pray as I compressed, giving every ounce of life I could into my hands. 

After exhausting all options he was pronounced dead, and my heart sank. One hour ago this man was talking to me...

I tried to hold it together. This happens all the time. This shouldn't affect me. There's still work that needs to be done.  Tears brimming, I pulled it together to help with the paperwork. My heart was broken and aching for the family and the circumstances, while another part of my heart knew he was in a better place. 

Sitting at the computer on hold with the coroner I felt arms around my back in a hug and the scent of cigarette smoke. I turned to face a woman with electric blue hair and a patient visitor sticker on her chest. She spoke softly, "I just needed to give you a hug. You do such a great job and I hope that one day you're on my team".  She smiled, embraced me, and walked back to the room across the hall from my patient....She had seen the whole thing. 

I turned back to my computer and lost all emotion I had been holding in. The tears flowed and my sobs were evident to my coworker next to me. That woman, who I didn't know, had been God's voice saying, it's ok to feel. You can't always be in control. Control was the furthest thing I had at that moment. 

"I hope you're on my team"...I mused over the words. What a powerful statement. I had done everything in my power for that patient, as had my team. I had never felt so supported in such a situation and was so grateful for my teammates who were present. That woman recognized that we put heart and soul into our work and reminded me that sometimes an outcome is beyond my control.


I pray that this dear patient rests in peace. I also pray that each day I wake up with a renewed spirit to perform my work. Days like this are tough and can break a nurse down. I cried a lot that night, and that was what I needed. Then I woke up the next day and walked in to work knowing I could face similar cases. However, I walked in with a smile on my face. Each coworker, each patient, each family member I was going to encounter was on my team.  As a team sometimes you win and sometimes you lose, but you walk away with your head high if you've given your heart and 100% and recognized that you have only so much you can control.  

Being on God's team means recognizing that He has a plan. It means being His hands and feet, but at the end of the day remembering that He is in control.

Are you on autopilot?

Wake up, work, eat, sleep, and repeat. 

So often I find myself in autopilot day in and day out. After too many days in a row I almost feel numb to what I'm doing. Even on my days off it's just checking off my list what didn't get done during the days I was working. Sometimes I catch myself in this cycle of what I like to call being on autopilot. 

The problem with this mode is that is loses all variety and feeling. I forget why I'm doing what I'm doing and tasks become monotonous and the passion and drive is lost. 

Wake up, breathe, work, breathe, eat, breathe, sleep and repeat

Other times I find myself in this routine of tasks, but I take time to appreciate each task and its purpose in my life at that time. I have to cook dinner changes to I get to prepare a nice meal that will allow time for my husband and I to sit and talk for a period of time. When I take a moment to reflect on the meaning behind my actions life becomes less mundane and pressured, and more real and meaningful. When it's hard to find meaning in something like taking out the trash, at least I've taken a moment to acknowledge that it needs to be done and can appreciate the weather as I trek to the garbage bin. 

Wake up, pray, work, pray, eat, pray, sleep and repeat

 After I've acknowledged that I need to breathe throughout that day, I take it a step further to let that breath become a prayer. In taking time to acknowledge God's presence throughout even the mundane tasks of life, I am able to practice a spirit of gratitude. Gratitude grows to joy, which in addition to making my heart happy, touches those around me on a day to day basis. 

So now I've taken a typical Monday morning and transformed my daily tasks as I appreciate the capabilities I have to get these jobs done, acknowledge the people around me, and recognize God's presence in my day. It's amazing how this spirit of thankfulness can help you remember why you do what you do, or how you can make the best of where you are right now. 

Take yourself off autopilot, and let God drive your day.

Blessed by a Patient

A huge part of my nursing philosophy is to be the hands and feet of Christ is my daily work. This does not mean evangelizing my patients, but actively working every day to find the good in those I interact with, assume the best, and care for the whole person. My Jesuit college education spoke of cura personalis, Latin for care of the person. As defined on the Regis University website, it is "dedication to promoting human dignity and care for the mind, body and spirit of the person".
In the midst of a busy day and multiple patients all needing important things it is very easy to become task focused as opposed to person focused. I sometimes have to stop and remind myself that  my sweet man with dementia who doesn't remember the last time I was in his room still deserves the same respect and intentional time as my alert and oriented patient who counts the minutes between each encounter. 

As I begin each day my goal is to bring joy to my patients through my work. They don't deserve to feel the stress and multiple things on my mind. They may need to understand my time is limited in the emergency setting, but they need to feel the genuine sincerity and care in each encounter to feel safe and cared for int their time of need. Another sweet gentleman asked if I could stay and rub his back. My typical nurse reaction of annoyance was trumped by sympathy for him from the sincere look in his eyes and pain and frustration he was feeling. He wasn't asking because he was needy, but because he was scared and lonely. I had to kindly break the news that this was not possible with the patient acuity we had and how I wished he was my only patient in that moment so I could help him feel better. 

That broke my heart. I wanted so bad to give the best  care to each of my patients. He felt lonely, another left against medical advice because he waited so long due to a mass influx of critical patients, and then a patient passed away after every attempt to restore life. Whether I wanted to recognize it or not, at the end of the day I was emotionally and physically exhausted. 

Day three began pretty mellow and I encountered a young woman with onset of symptoms that warranted admission. She was kind and I gave her the same care I give all my patients. I entered her room to pass on the good news that she finally had a bed ready. We had made friendly small talk but nothing deep up to that point. She looked up at me and stated confidently, "I need to pray for you". 

I was taken aback and elated. "I would love that!" I exclaimed. I was totally surprised being that faith had never crossed our conversation. She took my hands and began to pray out loud. I was on the verge of tears feeling so touched. She prayed a heartfelt prayer asking God to bless me in my work as I had touched her. She thanked Him for the care she received today and prayed that I might be touched by others in the way that I touch each and every one of my patients. My heart melted as I took her hands and prayed for her healing. I gave her a hug and she was rolled out of the department.

Little did she know that she was God's voice to me that day. After three long 12 hour shifts and trying so hard to help each person and not feeling totally successful, God reached down through this patient and said take a breath, you're doing just fine. Keep your heart up and know that I am here. 

It is these moments I hold on to. These moments I remember why I do what I do and fuels me to keep going. When things get tough I remember her words, take a breath, and continue to smile. God shines through joy, and sometimes joy can break the fear and uncertainty that is present when one walks through the doors of the ER.

Give the Best to get the Best

I got a Groupon to get my nails done, not realizing it was a solid 30min drive from my house. Oh well, it was a good deal and a once in a while thing. I planned ahead to be sure I would arrive on time and respect her time. Right before leaving she sent me a text "Running behind...". This was an hour before my appointment and I figured maybe she had the wrong number. Sure enough I show up on time to sit and wait for 20 minutes past the scheduled appointment. Is it because I have a Groupon? Who else is more important that she probably "squeezed in" at the last minute??

I was tired, traffic time was ticking closer, and I was annoyed. I had scheduled the rest of my day based on being in and out of there. Recognizing my impatience I took a deep breath to breathe out my frustration. Life happens. Yes, this had happened the time before as well, but I needed to give her the benefit of the doubt. 

She came to greet me calmly, peppy, and with a huge smile. My frustration was immediately shaken by her warm welcome. It's not like she did it on purpose. We chatted through the appointment and she did an excellent and quick job to where I was out of there before I had expected, even with the late start. 

As I walked out I shook my head at how silly and unnecessary my irritation was when I was struck by a thought: Is that how my patients feel sometimes? The thought made me laugh at how silly my emotions were.

On busy days I run around trying to give equal time and attention to all my patients, but when a trauma or stroke rolls through the door I drop everything for sometimes over an hour if I have to stabilize that patient. How do my other patients feel? Sometimes annoyed, some think "who is more important than me?", others frustrated and wanting an explanation....all the same feelings I felt today....

And yet, when I walk in their door with a smile, pep in my step, and an enthusiasm to return to their care after a delay, it tends to help break the irritation. A quick apology and brief explanation is usually welcomed when it is sincere. Then care is updated, completed, and the patient walks out the door or is rolled upstairs to continue the rest of their day. 

Sometimes I can't help what rolls in or what life brings, and at work I always like to think people will give me the benefit of the doubt. What a concept. Note to self to practice carrying this same spirit to give to others on a day to day basis.