I was working as a psychiatric liaison clinical nurse specialist in a department of medicine when I was called to see Anne.  Her attending physician had requested that I talk to Ann because “she was not dealing appropriately with her diagnosis of pancreatic cancer.”  As I listened to his discussion of Anne’s history, I kept thinking to myself, “How does one deal ‘appropriately’ with being told you have cancer, especially pancreatic cancer.”  The reason I was perplexed by this situation was that pancreatic cancer is known to be deadly and has a year to two years of survival after being diagnosed.  From Anne’s history, she had been having symptoms for at least a year.

As I entered Anne’s room, I noticed a thin, frail woman whose eyes spoke of merriment and life.  I told her that her doctor had wanted me to talk to her because she had been diagnosed with cancer and he was concerned how she was dealing with the diagnosis.  She looked at me and said, “Not well. I mean, is it normal to be thinking about your funeral and how you want things done?”  I shook my head and continued to look at her because I did not think that she was finished saying what she wanted to say to me.  “You know, I’ve done a lot of reading about the pancreas.  I’ve gone to medical school libraries to check out books and read journal articles about the different pancreatic disorders.  You see, I’ve had these pancreatic symptoms for a year and a half.  The doctors haven’t been able to find anything definitive until today.  This was my third CAT scan and the cancer finally showed up on this scan.  So, you see, I know that I don’t have much time to live.”  As I sat listening to her talk, I kept thinking to myself that this lady knows herself and knows what she wants to do.  Now, whether the doctors or her family will allow her to do what she wants in another story.  And, I also knew that she was correct about not having long to live.

As I nodded my head in agreement, Anne continued to say, “How do you tell your husband that you love that you are dying?  How do I tell my two daughters that I won’t be here much longer?  Am I insane to be thinking about my funeral?  You know, they (her husband and daughters) won’t know where to begin.”  I looked at Anne and saw how much concern she had for her family and said, “No, it’s not insane to be thinking about your funeral.  Remember, though, you have been reading about the pancreas and its disorders for a long time.  You have been worried that you had pancreatic cancer all this time and now have found out.  However, your husband and daughters haven’t had the same amount of time to deal with this.  It will be a shock to them.  Let’s progress slower with them.”

We discussed how she would talk to her husband and daughters that evening and that she would just talk about her diagnosis and that she did not have long to live.  I returned the next day to find her in better spirits, but still worried about her family.  Anne said, “They don’t want to believe that I don’t have much time.  They keep telling me that everything will be O.K.  I guess they feel they have to do that for me.”  We talked about giving her family time to deal with her diagnosis of cancer and when would be a good time to talk to her husband about funeral arrangements.  She decided that while her family was dealing with her diagnosis, she would write down directions for her funeral and what she wanted done.  During the week that she was in the hospital, we talked daily about her and her family’s progress.  On Friday when she left the hospital, she decided to tell her husband about her funeral arrangements.   I found out that Anne died six weeks later.  I’m glad that she was able to have the time with her family and plan her funeral for them.  It was her last gift to her loved ones.

Jane Bryant (Neese), RN, MS, CS 
Baltimore, MD

– excerpted from Touched By a Nurse©

The specifics of my story take place on New Year’s Eve in Maimonides Medical Center, Brooklyn, New York.  While this special time was shared this night, a longer tale of “touched” was ongoing for about five months prior and continued for ten months after that evening.

I was a new grad in August, having been working on a Surgical Specialty unit for six weeks. I was 19 years old at the time.  Sal was admitted after surgery during the day shift.  He was 16 years old, and had been working a construction job with his father when he fell off a high ladder.  He sustained a broken spine and was paralyzed from the neck down.  The prognosis was somewhat hopeful for slight recovery but pretty bleak for full functioning.  We were told he would recover some abilities over the course of a year and that it was not clearly predictable what his condition would be at the end of that time.  The entire staff was particularly taken with his youth and extent of his disability.  Sal came to us in a full body cast, asleep from anesthetics and pain medications.  I vividly remember thinking, “How awful!  What a tragedy, he is so young.”  Actually, the reality of how close in age we were was particularly disturbing.

Sal was a GREAT patient, he rarely complained, he was almost always in a good mood.  When some awful and ugly medical procedures needed to be done, or some routine but pretty uncomfortable physical needs were cared for, he was quick to set the way for humor and a sense of decorum.  Sal, at 16, had wisdom and wit that had style.  People might think this was a “New York” style.  He was raised in Brooklyn, one of four children to a poor-middle class blue- collar father and homemaking mother.  They were of Italian decent, Catholic by religion. Sal said, “I’m not much of a student, I like working with my Dad, as soon as he’ll let me quit school I will.” For 16, he seemed somewhat mature, certainly flirtatious and a bit precocious.  He had a girlfriend who visited frequently when he was admitted, but after a few weeks, slowed her pace.  His mother, father and three sisters visited every evening initially and after a couple of months, they too slowed their visiting to once or twice a week.

Sal put up a good front, but the reality of his situation was very obvious to us, his caretakers and “new” family.

I loved being a nurse, I loved working with the patients, the feeling of ‘helping’ people and doing some good.  I loved “talking” with the patients.  I felt a strong need to listen to them and let them share with me their feelings as they encountered physical hurdles that left them emotionally unbalanced.

Sal and I shared many touching moments over the long span of his inpatient stay on my unit, but New Year’s Eve stands out as somewhat special.  I regularly worked the day shift, but during the holiday week, Sal asked if I would work New Year’s Eve.  I considered his request against the possibility of attending a friend’s party as well as my general dislike for the night shift.  I decided, oh well, what the hey, and switched with a grateful co-worker to work that night.

Arriving on the unit at 11 PM, I took report and found us full as usual.  There were no untoward events occurring, and all patients were resting comfortably.  Many would be discharged the next day.  Making my first set of rounds, Sal was awake and asked me to make sure to come to see him before Midnight and wish him a Happy New Year.  After managing my routine duties, I checked on Sal, thinking, “What a New Year for this kid, what is his future, what is his hope?” I got back to him at Midnight, after rounds, Sal smiled brightly and displayed a bottle of Champagne.  Whew, I thought, this is not ok. Sal is under age, he’s a patient under my care and shouldn’t be drinking and it sure isn’t ok for me to be drinking champagne with him.  He told me I was a “fuddy-duddy”, he assured me he had no sleep nor pain medications, (confirmed as true) and reminded me that- “Well, what the heck, life is short!” His father had bought him the champagne as a gift for a NEW, New Year, “Make a wish”, he said, “and it will come true!”  Sal asked me to help wish him to walk again in the New Year.

Despite all my reasonable concerns my “gut” told me Sal needed to do this. So, we shared one glass of champagne for me, and frankly I’m not sure how many for him.  We wished for his walking power.  My rational brain told me this was not ok, but my heart said, yes, this is how to touch a person who happens to be a patient.  Sal was touched by a nurse, but I was touched by a patient.

At the end of a very long stay, Sal, at 17 was discharged to a rehabilitation facility.  He had the ability to stand with assistance, but not walk as yet.  I think of him still.  He would be about 45 years old now, I hope he can walk.  Sal taught me that my true talent is in the “talking” field and I have worked in Mental Health for the past 25 years, hopefully touching others with my heart as they continue to touch me with theirs.  The talented science of nursing is a phenomenon but the “touching” art of nursing is our true talent.

Marlene Nadler  (Moodie), RN
Maimonides Medical Center

– excerpted from Touched By a Nurse©

The recovery room had been very quiet for the last 3 hours.  I was the “charge nurse” for the 3-11 shift, which meant I was by myself.  The hospital justified having only one nurse on duty at this time because there was not supposed to be any scheduled surgery during this shift.  The key word here is “scheduled”.  I was working in an inner-city teaching hospital in a large city in the south.  All the trauma cases arrived at this hospital at all hours of the day and night.  I was busy getting ready for the patient that was due to arrive from surgery any minute.  I was sure I knew everything and had been trained to handle any and every emergency that might come my way.  I was 22 years old and had just completed my Bachelor of Science degree in Nursing.  I had been working in this recovery room for the last 2 years as a “professional student nurse”, and I knew it all.  This night would be different and my view and understanding of nursing and healthcare was about to be changed forever.

The call from surgery, telling me my next patient was on his way up, came around 10:00 PM.  When I asked for details about the patient, I was told he was a white male in his early 30’s who had attempted a jail break that afternoon.  He had jumped out of an 8th story window to gain his freedom.  What he had gotten was a fractured pelvis and both legs shattered.  He had been in surgery for hours and was coming to the recovery room in a full body plaster cast from his chin to his toes.

A few minutes later, Clyde rolled in.  He was indeed in a full body cast and because he was a fugitive, his leg, in the cast, was handcuffed to the bed.  At the time I remember thinking how absurd this seemed.  The man was barely conscious, and with his cast he certainly wasn’t going anywhere!  After checking him in and giving me the report of how the surgery had proceeded, the operating nurses left me to go back downstairs.  I was left alone with my patient.  I jumped into action taking his vital signs, asking him if he was in any pain, and trying to make him comfortable while he breathed off the anesthesia, and so I was surprised to hear a noise at the door.  At first it sounded like a tentative knock, which I ignored.  No visitors were allowed in the recovery room.

The next thing I knew a white male was standing beside me with a gun pointed at my face.  He looked more frightened than I felt.  I stood there wondering which drugs this man wanted to steal.  My mind was racing with the thought that I had not been taught how to deal with a robber, and I was indignant that this man was in “my recovery room”.  I did not want to get hurt, and I was not stupid.   I was prepared to give him whatever he wanted to take, except the one thing I was amazed he requested.

He looked around to be sure we were alone and then he demanded that I hand over Clyde!  He told me he had come to break Clyde out and finish the job that Clyde had attempted that afternoon.  I could not believe my ears.  This man was going to kidnap my unconscious patient!  I calmly told him that his friend was in a full body cast and was handcuffed to the bed.  The man came to the bedside to examine Clyde.  Clyde was not awake enough to acknowledge his rescuer and I told the man that he was more than welcome to take Clyde and the bed, which he was going to need to transport Clyde.  I even volunteered to help disconnect Clyde from the monitors and push him out the door to the elevators for the ride to the first floor and the door to “freedom”.

As soon as the door to the elevator closed I walked back into the recovery room and called the policeman who was sitting at his usual station at the entrance to the hospital.  I informed him that a man had just robbed me at gunpoint and had taken my most precious possession at that moment, my patient.  I told him the patient was stable, barely conscious, in a full body cast, and handcuffed to the bed.  I also stated that his friend was obviously stupid, unstable, armed, and headed his way.

Thirty long minutes later, my patient was returned to me.  He was now awake, in pain, and visibly upset.  His friend was on his way to jail.  The police officer assured me he would be staying with me in the recovery room and Clyde would have a full time guard until he was returned to jail.  Many hospital policies were created as a result of this incident.

Today, nobody would believe it could have happened, and I’m sure this story could win a spot on America’s Dumbest Criminals.  When I think back on this incident now, I just laugh.  I have forgotten how afraid I was at the time, and how angry I was that I had not been trained to deal with this kind of situation.  I often wonder what ever happened to Clyde.  He is not the only patient I have ever lost, but he was my first, and luckily the only one to leave at gunpoint!  He never knew the role he played in my growth as a person and a nurse.

Renee P. McLeod BSN, RN
City of Memphis Hospital

– excerpted from Touched By a Nurse©

Billy Holland was a tall, gangly 21-year-old guy from the inner city who was admitted frequently to our chronic ward at the state psychiatric hospital. He had a diagnosis of schizophrenia but even more tragic, he was often violent and aggressive. Whenever his behavior was violent, he would be restrained by two or three physically strong security guards. If the behavior was repeated frequently, he would be sent to the psychiatric prison down state, a facility for the criminally insane. Billy was terrified of this place and would cry and wail painfully when being transferred there. He reported abusive treatment by both guards and other inmates. When he was violent, the staff would often threaten him with being sent to the prison, but these threats did not influence his behavior even though he was afraid and intimidated by the place. He did not seem to be able to control his violence, even with the help of anti-psychotic medications.

Working as a psychiatric clinical nurse specialist on the unit, I was very distressed whenever Billy was sent to the down state psychiatric prison. He was such an appealing and friendly guy when he wasn’t violent and I liked him a lot. One day I decided to talk to him about controlling his violent behavior. I asked whether or not he could tell me ahead of time if he thought he could not control himself. He asked what would happen if he thought he could not control himself. I told him, “We’ll help you.”

“Are you strong, Jackie?” he asked.  I thought a minute and then said, “Yes.”   “Strong as a bull, right?” Again I hesitated and then nodded.

He squeezed my biceps muscle and then pronounced, “Yep, strong as a bull.”  I was more than a little embarrassed by my concurrence with this description, as I’ve never been known for my muscle strength or my size and I am actually a great deal smaller than Billy.

Every day when I came to work Billy would ask me if I was strong and every day he would squeeze my biceps and I would agree that I was strong as a bull. The ward lost its tension for a couple of weeks as Billy laughed and talked and helped out with other patients, occasionally shouting out “Are you strong, Jackie?” During this time he gave us the gift of his joy, his spirit and friendship.

I went away for 2 weeks and when I came back Billy had been sent down state again. We didn’t see him for months, and then a year passed. Finally, we heard that he had died while at the down state facility. His mother came later to pick up some of his things and she confirmed his death. She said he was troubled and afraid and “maybe it was for the best.”  She thought he died of heart failure. We all wondered and missed him in our lives.  I know I was able to influence him in his time with us; he has continued to influence me.

Jacquelyn H. Flaskerud, RN, PhD
UCLA School of Nursing

– excerpted from Touched By a Nurse©

It was 12:30 PM in Los Angeles in a modest apartment close to the ocean. The day seemed slow and uneventful this quiet Sunday afternoon.  Theresa was completely the opposite as she was  preoccupied with anticipation of her first child.  This young man was already 10 days late and she wondered when she would get to meet him as she paced the apartment. Rubbing her swollen abdomen she felt a twinge of anxiety when the phone rang. The nurse midwife on the phone who had followed her pregnancy said “I was looking at your ultrasound  again and that boy seems large and ready to be born. It’s slow today, would you like to come in and be induced  today instead of  tomorrow?”  Theresa, a nurse herself, knew about the procedure she was to encounter, but never imagined  her labor and delivery experience to be so difficult.

The drive to the hospital was exciting. Theresa talked about her delight and joy  with her husband. She felt supported and safe, thinking what could be better than having a psychologist as a Lamaze coach.

As Theresa entered the hospital and was asked to sit in a wheelchair she felt odd. Being the caretaker and more importantly, in control in medical situations  as a nurse was what she was accustomed to. She felt this strange odd feeling repeatedly as they started the IV and injected the Pitocin. Silly questions came to mind such as “where did she go to school?”

Then, rapidly the idyllic anticipation of a child slipped away as the contractions began.  Her loving husband tried to soothe her. Every relaxation technique was attempted without success. She began ordering her husband to do it this way and that way and then finally ordered him out of the room.  The nurses watched patiently. Some were intimidated and left as soon as their task was done.

One, however, had the courage to enter her world of pain and loss of control.  She approached Theresa and said, “I know what you’re going through, it’s not easy being a patient when you’re a nurse.”  The nurse sat  by Theresa and said nothing. She waited to be invited into her pain.  Theresa  finally said, “ help me.”  It was then, that the relationship began and the journey into motherhood  began a little easier. The nurse gave her permission to cry out, to give up all control, and to be vulnerable.

The time seemed endless for Theresa as she labored to have her first child.  The pain was excruciating, yet bearable as the nurse broke through the barriers and successfully got Theresa to relax.  Theresa  remembers the stroking of her head, wiping the perspiration from her brow, singing, the smell of her perfume, and her quiet, patient, accepting voice. They tried everything together, breathing, squatting, grunting, laughing for brief moments, and story-telling.  What Theresa remembers about the nurse was her devotion, patience and loyalty. What she still wishes to try and remember about this nurse is her name.

To this day Theresa has this experience imprinted in her heart, the birth of her first child.  Theresa believes that she would not have been able to persevere with the labor and delivery of her child hadn’t it been for this unnamed nurse. She is inspired having witnessed a colleague in action and to have benefited  from her expertise and caring. Two nurses met , one as the patient and the other as the caretaker. Theresa will be forever grateful and appreciative, and even though she will never have the opportunity to change roles with the nurse who cared for her, she will pass on the collegial  tenderness whenever possible.

Jan Cipkala-Gaffin, MN,RN,CS
Los Angeles, CA

– excerpted from Touched By a Nurse©

I was a very young new RN after graduating from nursing school only eight months earlier.  I was employed at the Rochester Methodist Hospital next to the Mayo Clinic.  One evening while at home, I received a phone from my mother.  She told me that George, a gas station owner and church member from my hometown, had been diagnosed with leukemia.  He was being treated at my hospital.  He and his wife, Connie, would be there today.  My mother asked me to pay them a visit and help with the transitions of being in large urban medical center.  I knew today would be different.  I was gradually realizing that the title “nurse” meant more than a routine job.

As I approached the front desk to get his room number, I felt a sense of eagerness and dread.  I was eager to see a familiar face from my hometown, and dreaded knowing that I would have to help deal with George’s terminal illness.  Walking down the long corridors toward his room, I reflected back to my early childhood when I first met George and Connie.  I remembered them from church.  Their two sons were a few years ahead of me in school.  Funny, we had only been acquaintances for the past 20 years, but now in this particular time and place, we shared an automatic kinship.

I took a deep breath upon entering his room, I did not know what to expect.  I composed myself as my body reacted to the shock of seeing George with bluish-gray skin from poor oxygen exchange.  His face was drawn and he was very thin.  I looked him deeply in the eyes and smiled a warm greeting as we gave each other a hug.  I then sat down at his bedside and asked how he was doing. After a few minutes, we had little to say as we silently colluded in the knowledge that his time was limited.  He told me, “Connie has just stepped out to get some lunch.  She should be back soon.  You will check on her, won’t you?”  “Of course.” I responded emphatically. He seemed comforted.

I thought back to all the times I had walked by his gas station on the way to and from school every day from kindergarten through high school.  I had always perceived him as a quiet, somewhat serious man, and in my younger years I was even a little afraid of him.  Now, at his deathbed, it was I who was expected to be the stronger one.  I felt a wave of sorrow and compassion for him.

I excused myself to get back to my unit and told him I would find Connie and let her know that I had visited.  I waved good-bye and promised to return the next day.

The following day, I again walked down the long corridor to George’s room.  As I turned the corner, I felt something odd.  I saw that the curtains to his room were completely closed.  As I walked nearer, I knew George had just died.  His body was still in the bed.  A chill came over me, but I bravely stepped closer and saw his body lying peacefully with stone-like pale, ashen skin.  I whispered a gentle “good-bye”.  Tears filled my eyes as I turned to perform my final promise.

The nurses at the desk told me to check for Connie in the chapel, so I raced down the hall to find her.  Quietly, carefully, I opened the chapel door. In the third pew from the back, I saw Connie on her knees, head bowed. As I approached her, she stood up, turned around and saw me.  Her face was filled with sorrow and anguish, but her eyes lit up as she threw her arms around me.  “Oh, I am so glad you are here–you are like an angel!” she exclaimed.   My heart was heavy yet filled with a deep sense of gratitude for this moment.  I was glad to be here, too.

Jill Bormann, RN, PhD, FAAN (visit Jill’s website)
Rochester, MN

A warm July night breeze flowed through the open window in the hospital emergency room in Leesville, Louisiana.  A young mother in her early twenties, Adeline, and her one and a half-year-old son, Kyle, entered the admission area at 8:15 p.m.

“He has a fever.  My little man has a fever,” she cried in a high pitched Southern accent.

“Bring him in here,” I motioned her to the examination area.  I saw her sweat as I checked the child’s vital signs.  His temperature was 103, so when I called the physician on call that night, he ordered the usual x-ray and blood work to help him arrive at a diagnosis.  After about an hour, the physician reassured the mother that her little man would be ok, he had bronchitis.  She went home with medications and a list of “to do’s” to promote recovery.

Almost midnight, I sighed to myself thinking it was almost time to go home.  Suddenly the back door at the ambulance entrance flew open and the young mother, Adeline had her limp child draped over her arms.  “Something is wrong with Kyle,” she screamed.

The medic grabbed the young boy from her arms and put him on the table.  I checked for breathing and there was no breath.  Immediately initiating artificial respiration I could taste vomit and saliva in my mouth as I became his lungs.  The rest of the staff rallied around, each doing a task: chest compressions, starting an intravenous, administering drugs.  The anesthesiologist finally arrived and placed a tube into the child’s his lungs to connect to an ambu bag or respirator.  As we worked on young Kyle trying to reclaim his young life, I noticed his mother watching numbly, as if this were a TV drama.  I escorted her into the waiting area and sat down with her as she told me what happened after they left the ER earlier in the evening.

After they arrived home she carefully gave him some juice and his medications.  She held him awhile then feeling her own exhaustion, she laid him down in his crib.  She went to have some tea and felt herself dozing.  Before going to bed, she went to check on her little man, only to find him lying on his back covered with vomit and looking very bluish-pale.  She screamed to her neighbors in the next trailer and they flew out of the door.  She would not let go of Kyle as she told them to drive her to the ER.  I sat with her and listened, helpless to do anything else for the moment.

In what seemed like hours, the physician slowly made his way towards Adeline.  I could feel my whole body stiffen as he looked at me. I knew.  Then said to her half making eye contact, “I’m sorry.  We couldn’t save him.”

Time stood still.  All the people in the waiting area, the oncoming staff, my co-workers and this young mother froze in the flood of our tears.

I don’t remember what happened after that.  I know I could not say a word.  I felt like screaming, like running, like being anywhere else than in that place.  As a twenty one year old, new graduate I was still cloaked in the vision that modern medicine can make happy endings.  Maybe it could.  But it didn’t on that summer evening in July in the emergency room.

Karen Bauer, RN
US Army Hospital at Ft. Polk, Louisiana