A Thanksgiving Memory

This is my favorite Thanksgiving Memory.  I post it every Thanksgiving to remind me of how truly thankful I am for all the wonderful people in my life!!

Vintage Thanksgiving Postcard

Vintage Thanksgiving Postcard

Dear Nursing Administrator,

Today I witnessed an act, which for the first time, made me grateful to have worked Thanksgiving Day.  Before I explain, you need to understand a little background.

For the past month or so we have been caring for a nineteen year old-young man in room 419, who is slowly dying from lymphoma.  Over this past month I have never looked after, nor been involved in this patient’s care.  In fact, I didn’t even really pay attention.  Why?  I’m not sure.  As charge nurse I was up to date on his name, age, room number and diagnosis.  I knew his mom was a nurse and his father was a New York City Police Officer.  I knew that one or both parents never left his bedside.  I knew I found it extremely uncomfortable to participate in his case, what I didn’t know was why; I’m still not completely sure.  Maybe it was his age, maybe it was because his parents were always there, maybe it was because I identified with this family on some level and steeled myself from getting involved.  My apathy, or perhaps cowardice, found it helpful that their room was at the very end of our unit, so far removed from the nurse’s station, that their daily story played out on what seemed a far away stage.

Our unit is a twenty bed Cardiac Care Unit (CCU), not a hospice ward.  I’m used to dealing with critically ill, older patients in cardiac distress.  Even when those patient’s are terminally ill, I somehow rise to the occasion to support their crumbling family.  But this boy, what was he doing here?  What did I know of caring for a nineteen year old?  Apparently there are cardiac complications that come from bone marrow transplants which led this boy to our unit, and subsequently into our lives.

So while my head was buried in the sand for the past month, there were several amazing nurses consistently caring for this patient.  But today, Thanksgiving Day, I would soon come to find out just what I had been hiding from, because today I was assigned to care for this boy.

What had I been hiding from?  His family was lovely; two devoted parents sitting vigil in their hopes and tears.  His nurse mother was someone I could have easily seen myself working side by side with, and his NYPD dad, well, I must confess was a reminder of my own NYPD dad.  But this boy of nineteen was so ill.  His body reflected the disease that had stolen his youth and replaced it with the frame of an old man’s.  Swaddled in blankets to fend off the cold, his face was the only piece of flesh I could see; though his eyes were pale and hollowed, a spark, still dimly lit, reflected back, and a smile slow danced across his lips from time to time.

Room 419 was where this family would spend their last Thanksgiving together.  No fancy table, no turkey, nothing to remind them of the holiday unfolding on most American tables that day.  No, this room was the exact opposite.  The only reminder of the outside world I could gather was the pile of soda cans collecting on the window sill.

Then lunchtime arrived, and with it came Emma, one of our nurses, (off duty that day), with a large bag in her arms, and a six-pack of soda in her hand, heading for room 419.  As I went to greet her with a confused expression on my face, and a ,”What are you doing here on your day off?”  She told me she was here to bring 419’s family Thanksgiving dinner before she was due to catch a train to her own Thanksgiving dinner.  You see, while I was flying under the radar where this family was concerned, Emma was flying high; high on her morals, her faith, and her uncompromising dedication of what it means to be a nurse.  There was no way she could sit down for her own Thanksgiving meal, without first and foremost providing one for this family she had grown so close to.  What a special moment to witness.

Thanksgiving is such an American holiday.  We all take pride in our heritage, our sophisticated menu’s, our high-end wine lists, alternately, we take such a twisted approach on sharing a meal with family we might not want to be sitting next to.

Ironically, Emma is not at all American, she is Filipino.  But somehow, she, more than any American I know was able to take this holiday, and provide one family with the gift of thanks, when they probably felt too weak to feel anything but the life of their core slipping away.  I know this family was truly thankful for this one gift, this one meal, that this one very special nurse provided for them on what would be their last Thanksgiving as a complete family.

Vintage Thanksgiving Poem

I was thankful to have had the opportunity to witness grace in action.Several days later the boy in room 419 was granted his wish to go home to die.  His parents complied, and forty-five minutes after being laid to rest in his own bed, that nineteen year old boy died on his own terms, in his own way.

I will never forget this Thanksgiving as long as I live.  I am nominating Emma for the highest award we give to nurses in our hospital; The Daisy Award.  I’m sure every Thanksgiving I will be reminded of this family and be truly grateful for all the wonderful people in my own life.

Sincerely,

Jean

I wrote that letter over ten years ago, and I have never forgotten the family from room 419, or the nurse who made their last days bearable.  They make me thankful every year for the life I have, and the family I live it with.

Since that time I have become a mother myself.  Losing a child, any age, is unfathomable to me; it was my understanding he was their only son.

So on this Thanksgiving Day, don’t sweat the small stuff.  Who cares if the Turkey’s a little dry, or the company’s a little wet.  Be thankful to be together with your family and friends.

I know I’ll be!

Happy Thanksgiving Everyone!!

thanksgiving vintage postcard

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Madness Poetry Round 2

Well I’m excited to announce that I made it to Round 2 in the March Madness Poetry Competition! Head on over here to read some great poems and place your vote! This has been such a fun experience; there are so many talented writers, and amazing poems to read.

via Madness Poetry Round 2 — THE NIGHTINGALE TALES

Nightingale Awards: The Oscars for Nurses

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The Nightingale Award

Last night the Academy Awards rolled out the red carpet, and the stars unfurled their loquacious tongues showering praise upon themselves, rivaled only by the hubris of Narcissus. While most people will be focused on the Best Picture mix-up between ‘La La Land’, and ‘Moonlight’, I was left breathless by this quote,

“I became an artist and thank God I did, because we are the only profession that celebrates what it means to live a life.” Viola Davis

My breathlessness was not one of awe and beauty at the arrangements of those 24 simple words, but more the gasping tightness of bronchiole constriction in desperate need of albuterol. Did she just say that? Are artists the only people who celebrate what it means to live a life?

This of course forced me to look back on my 30-year career and wonder if my profession celebrates what it means to live a life? Maybe without awards we lack the clarity to understand what it truly means to live a life. I thought perhaps we could review, and award what I consider the true meaning of living a life by the only standards I am familiar with.

To begin at the beginning of life seems appropriate to me, even though this beginning is not my profession, but my observation during the birth of my 3rd child. My nurse coincidentally was the same nurse I had for the birth of my 2nd child, and although we work at the same hospital, we are not friends, and we are worlds apart in our professions. I am a critical care nurse, she is a labor and delivery nurse, a profession I learned early on in my training, I couldn’t stomach. We started her shift together at 7a.m. I was induced, given an epidural, and despite the fact that this was my third baby, I was, IMHO, progressing slowly. 12 hours later I was finally ready to give birth, and my nurse was ready to go home. I wasn’t her only patient, but we had a great rapport. She had a family to go home to, and a long commute, but after she finished her shift report, she came back into my room to see me through my delivery. I felt honored that this nurse would work past her 12-hour day to help me deliver my baby. That is the true meaning of celebrating what it means to live a life.

When I worked in the Cardiac Intensive Care Unit of a big city hospital I worked with a very special group of nurses. One in particular stood out to me on Thanksgiving Day when I ran into her in the hallway. I knew it was her day off. I was surprised and asked her what she was doing there. I found out she was bringing a 19 year old boy and his family Thanksgiving dinner. Remember it was her day off. That was the last Thanksgiving dinner this family shared together. The 19-year-old boy died the next day. That is the true meaning of celebrating what it means to live a life.

How many souls have I helped pass quietly onto the other side, and how many did I, not so quietly, fight to keep on this side? I have watched colleagues hold hands, shed tears, give hugs, grieve with family, and continue to walk tall, smile, and stay strong, carrying heavily the burdens of others piggybacked onto their own souls. That is the true meaning of celebrating what it means to live a life.

I’ve worked in many units including ICU, CCU, PACU, MICU, E.D., Med/Surg., Research, Burn Unit, and there are many that I have never stepped foot in like the PICU, SICU, NICU, TRAUMA, CTICU, and L&D, but we nurses have more that unite us than divide us no matter where we work. One common thread that gets us all through is our indelible sense of humor. Some would say it’s a sick sense of humor, I say it’s medicine for our souls. It carries us through when any other emotion would be crippling. We know when and how to use humor to protect ourselves, but also to protect our patients and their worried families to relieve anxiety. That is the true meaning of celebrating what it means to live a life.

So in honor of nurses and all healthcare professionals everywhere who don’t have grandiose award ceremonies, but do have a good sense of humor, I have decided to give out my own Nursing Oscars called The Nightingale Awards:

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Our first category is best Costume Design. The Nominees are:

  1. Grey’s Anatomy
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  2. Koi
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  3. Dansko
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  4. Cherokee
    cherokee-logo
    And the Nightingale goes to…Grey’s Anatomy. By far the most comfortable, diverse, and true to life costume that defines healthcare wear for the modern age. And they don’t make my butt look fat.

The next category is Best Sound Mixing that will drive you crazy. The Nominees are:

  1. The IV pump
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  2. The bedside monitor
    bedside-monitor
  3. The PCA Pump
    images
  4. The Call Bell
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And the best sound mixing that will drive you crazy Nightingale goes to…The Bedside Monitor. The plethora of alarm sounds generated from one machine can actually be heard in your dreams, while in a coma, after a 12-hour night shift, and even when you’re on vacation…amazing!

The Next Category is Best Nurse Impersonator. The Nominees are:

  1. Kathy Bates as Annie Wilkes in ‘Misery’
    1-annie-wilkes
  2. Louise Fletcher as Nurse Ratched in ‘One Flew Over the Cuckoo’s Nest’
    6-nurse-ratched
  3. Ben Stiller as Gaylord Focker in ‘Meet the Parents’
    7-greg-focker
  4. Caitriona Balfe as Claire Beauchamp Randall Fraser in the series ‘Outlander’
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And the winner of the Best Nurse Impersonator Nightingale goes to…Kathy Bates as Annie Wilkes in ‘Misery’, because lets face it sometimes a sledgehammer does work better than 5mg of Ambien.

The Next Category is Best Original Nurse Story. The Nominees are:

  1. Big City Nurse by Albert L. Quandt
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  2. Nurses are People by Lucy Agnes Hancock
    2eded00657f84680ab17ece50c3bb964
  3. Terror Stalks the Night Nurse by Blanche Y. Mosler
    c63e2acbdad75cb6f5e417215f4be64d
  4. Sinners in White by Mike Avallone
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The winner for Best Original Story Nightingale is…Sinners in White, by Mike Avallone. Why? Because you know who you are…

The Next Category is Best Team Member in a Supporting Role. The Nominees are:

  1. IV Team
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  2. Dietician
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  3. Pharmacist
    pharmacy_pharmacist_logo_keychain-r8ad7a5f8ea714c418e6af9f7b55c916a_x7jle_8byvr_324
  4. Physical Therapist
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  5. All of the Above

And the Nightingale for The Winner for Best Team Member in a Supporting Role goes to…All of the Above…We know these supporting roles are imperative to helping us do our job, plus lets face it if they go it’s just one more thing administration will ask nursing to do!

The Next Category is People we have to deal with in the Hospital in a Leading Role. The Nominees are:

  1. That patient always on the call bell
    nurses-call-bell-jingle-bells
  2. The Supervisor who tells you you’re floating to the ED
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  3. The CEO quoted as saying, “Safe Staffing ratios is Fake News!”
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  4.  All one million doctors working with us here in the USA.
    doctors nurse

The Nightingale for People we have to deal with in the Hospital in a Leading Role is…Yes of course it’s the one million doctors, sometimes we love them, sometimes we hate them, but we can’t take a verbal order without them! Did you really think I would pick anybody else…the patient constantly on the call bell?…yes definitely a close second!

The Next Category is Best Device in a Supporting Role. The Nominees are:

  1. The Intra Aortic Balloon Pump
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  2. CVVHD
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  3. The Ventilator
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  4. Pressors
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In the category of Best Device in a Supporting Role, the Nightingale goes to…The Ventilator! Airway is always first, and the Ventilator does a magnificent job supporting those who cannot support themselves.

The Next Category is The Most Helpful People in the Hospital in a Leading Role. The Nominees are:

  1. The family member who insists their google search diagnosis is the correct one
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  2. The Pet Therapy Dog
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  3. Nurses…all 3 million of us (I’m including all my male nurse friends here too)
    First 20 Navy Nurses Corps.
  4. The Person who steals your lunch out of the break room refrigerator
    Tired of repeatedly having her lunch stolen from the breakroom refrigerator, Debbie sprayed her bag with artificial Rotted-Lunch Scent.

The Nightingale for The Most Helpful People in the Hospital in a Leading Role proudly goes to…Yes of course all 3 million nurses! For their tireless dedication to patient care, long hours, weekend, night, and holiday work, tolerance of abusive administration, full bladders, empty stomachs, ability to drive in any weather condition, ability to work sick, ability to multitask while working sick, ability to lift weight beyond what was thought physically possible, ability to deal with completely mental people not including patients and families, and last but not least the ability to field phone calls from home from spouses who cannot find their underwear or the cat, and aren’t sure what they should cook for dinner.  God Bless Nurses!  And God Bless all the people Nurses work with!

Last but not least the Final Category is Best Picture:  You Choose…try not to mess it up!

Night Nurse Warner Brothers

Night Nurse Warner Bros.

U.S. Nurses playing cards, reading, and relaxing circa 1918. U.S. Navy History and Heritage Command Photo.

U.S. Nurses playing cards, reading, and relaxing circa 1918. U.S. Navy History and Heritage Command Photo.

Nurses showing worn out heels after a sixty day hike out of enemy territory!

Nurses showing worn out heels after a sixty day hike out of enemy territory!

4.

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Florence Nightingale attending the wounded in the Crimean War.

My heart breaks for these people.

How Nurses feel.

Oh and when it comes to making mistakes, Hollywood gets to blame theirs on someone else, we however take full credit for our mistakes…then we lose our jobs, get sued, and commit suicide!  So yes once again we are so aware, and fully cognizant of how to celebrate what it means to live a life!

Congratulations to all the Nightingale Award Winners!!

Broken

lifesupport

 

I work in the complex, convoluted, and often challenging American health care system.  I strive to provide the best care to my patients.  It is troubling to me when one of my loved ones enter this system, and are not met with those same standards.  Our health care system is broken.  Health care providers are expected to do more, with less, in the fastest amount of time possible. This hasty, fast-food approach to American health care is unhealthy, and unsustainable. We hear the nations cry of ‘health care for all’, but that doesn’t necessarily equate to good health care for all. It’s no wonder medical errors are the third leading cause of death in America today (Makary, and Daniel, 2016).

The piece I wrote below is my interpretation of the experience of a loved one struggling in this broken system.

 

The Broken Column, 1944 by Frida Kahlo

The Broken Column, 1944 by Frida Kahlo

I woke up today in pain.

I reached out to you,

You didn’t see.

I continued to have pain.

I reached out to you,

You didn’t hear.

I was scared by this pain.

I reached out to you,

You didn’t speak.

I still have pain!

I reached out to someone else.

They saw me, they heard me, they spoke to me.

I was broken.

I reached out to you again to let you know,

Your apathy was palpable.

Perhaps it is not me that is broken…

Makary, M.A., Daniel, M. (2016). Medical error-the third leading cause of death in the US. BMJ 353:i2139

Halloweensie Winners

happy and sad pumpkin

Today on Susanna Leonard Hill’s website the winners were announced for the Halloweensie contest.  I was honored to have made the final 13 this year with my entry “The Haunting”.  Though I did not make the final cut, the fabulous entries, and their creative writers deserve to be recognized for their amazing Halloweensie stories.  Congratulations to all the winners, honorable mentions and everyone who had the courage to put their work out there (I know for me that is the hardest part)!  Now it’s on to the Holiday Contest…I can’t wait!!

P.S.  A big thank you to Susanna Leonard Hill, (and her helpers), for her time, hard work, and enthusiasm for hosting these fabulous writing contests!!

A Letter to my Patient

I know you don’t know me, how could you, we met while you were unconscious, so there’s not much to go on except for what I see and hear as I go in and out of your room. I catch bits and pieces of you from your family’s conversations, their obvious grief and concern over your well-being.   I am a complete stranger as far as your concerned, yet here I am caring for you in the most intimate way. Would you be embarrassed, annoyed…would you care at all? Can you hear me? Can you feel my touch?

Compassion

     As you lie there, I am like the ultimate puppeteer. Your tubes are my strings, and I carefully operate medicine, oxygen, and nutrition through the plastic lines running into your body all in a careful balance to bring you back to life. We spend twelve hours together, but you will never know me; even if you open your eyes, you will never remember me. I however, will always remember you. I take you home with me. I think about you in quiet moments. “Will you get better? Will you wake up?”

I have such a long list of things to do for you today. Your medication list is growing. You have an infection. Your lungs don’t look good. I must keep you asleep for another day to let you rest while your ventilator will continue to help you breathe. Your family is so nice.

I learned something about you today, and it made me laugh. Your friend stopped by. He was obviously distraught over your condition; he wanted to talk about you. I was so busy, but I stopped to listen to his stories. He told me you two were good friends, but that was obvious, then he told me you two smoked meat together. I was thinking “What??”   He said you had a smoke house, and liked to smoke meat. I laughed out loud. Not because I was making fun of you, but in all my years I don’t think I ever met anyone with a hobby of smoking meat. I was intrigued, and amused all at the same time. I’m glad I stopped to talk to your friend. He misses you in the smoke house. He’s a nice guy, which makes me think you must be too. Now I really want you wake up. Your family is nice, your friend is nice, you are surrounded by good people.

Deep down though I know you are probably too sick to wake up. Your infection is worse, and your body is dying. I’m losing control of the strings. I’m sad to see you go. You will never know me; you will never remember me…I will always remember you.