Chicken Soup for the Nurse's Soul (26 page)
Read Chicken Soup for the Nurse's Soul Online
Authors: Jack Canfield
Time went by, and Hanneke became a nurse and found a job in the Beatrix Hospital. One day at work, she was instructing a patient when a lady who was questioning another nurse turned and deliberately walked towards her. It was Mrs. Groensma! They found an empty room where they could speak privately, and Mrs. Groensma explained what she was doing there.
She recalled having been in a dark and lonely place, all alone, until the voice of what she thought must have been an angel started speaking, drawing her attention. Later when that voice stopped talking to her, she longed for the sound so much that she started struggling to get to the place where the voice had come from. She came out of the coma and took a long time to recover. Meanwhile she had questioned the nursing home staff. They eventually told her they had instructions to keep away a certain nurse who had made the mistake of getting too attached to her.
As soon as Mrs. Groensma was able, she came to the hospital to find that nurse. When she heard Hanneke talk to the patient, she recognized the voice that had spoken to her during her coma.
Mrs. Groensma took Hanneke’s hand. “I have something I want to give you to thank you. I found it fifteen years ago in a ditch and originally wanted to put pictures of my late husband and me in it and give it to my daughter. When she died I was all alone and wanted to throw it away, but I never got to it. I now want you to have it.”
Mrs. Groensma handed Hanneke a small box. Inside, sparkling in the sunlight, lay a golden four-leaf-clover locket. With a pounding heart Hanneke opened it to see her parents’ photos.
Hanneke now wears the locket day and night and visits Mrs. Groensma whenever she wants.
And they talk and talk and grow more and more attached.
Carin Klabbers
H
e who wishes to secure the good of others
has already secured his own.
Confucius
Early in my nursing career, I worked in an intensive-care unit alongside a social worker of quiet faith. In response to client situations of overwhelming tragedy or senseless accidents, she reminded the nursing team that while only God controlled the outcome of each patient’s situation, we could powerfully impact the process through the nursing care we provide. I was privileged to work among nurses who role-modeled this kind of nursing care.
Mr. Nolan was a patient in the intensive-care unit at our regional medical center. I loved my job and enjoyed implementing his challenging, complex treatment regimen. His large extended family was a joy to know: so supportive of him, so appreciative of his care, even as they faced each new hurdle in his declining situation. Mr. Nolan exuded a quiet dignity that confirmed his family’s report that he was a treasured husband, father, grandfather, friend and truly a man of excellence.
A recently retired bank executive, he’d had a heart attack while awaiting a coronary bypass procedure. He recovered adequately to undergo the bypass surgery and was admitted as a “routine” case to our ICU. But complications commenced soon after his arrival in the unit.
An extended period of low blood pressure resulted in kidney failure, and he subsequently required hourly peritoneal dialysis. To survive, additional coronary surgery was needed, and eventually a balloon pump was inserted to support his heart function. The balloon pump catheter was threaded through a groin access. Despite every effort to reposition the catheter, circulation to his right leg was compromised and gangrene developed in some of his toes. Finally, the balloon pump was removed, but not before the entire right foot was cold and black.
Each shift brought greater challenges in maintaining Mr. Nolan’s stability. While all agreed he was a “lousy” surgical risk, we knew he couldn’t survive long without the required foot amputation. In the OR, the doctors found the gangrene had spread internally through the entire leg. Though stunned to receive him back from the OR with a total right-leg amputation, it was heartening to see how rapidly his vital parameters improved once the toxic impact of the gangrene was gone.
Mr. Nolan stabilized somewhat over the next week, yet the numerous medical complications and operations had taken a devastating toll. It became clear to medical personnel, Mr. Nolan and his family that he was failing and wouldn’t survive. I came up with a plan that would give a lasting memory to the devastated family and dignity to Mr. Nolan.
When the family called earlier in the shift, I told them to be prepared to wait a little longer to see him when they came to visit that afternoon. Meantime, on top of the demanding nursing care regimen, I set out to accomplish the hygiene care reserved for quieter night shifts. I gave Mr. Nolan a wash, shampoo and shave, and trimmed and styled his hair to look like it had in a picture the family had shown me. I coordinated care to give him extra rest, hoping he’d be more alert when they came. Meantime I got a team of staff and necessary supplies ready to respond on cue.
With news of the family’s arrival, the team went into action, assisting Mr. Nolan into a geri-chair. Linens covered the ventilator tubing and dialysis equipment, and the bed curtains were strategically placed to block the family’s view of the numerous IV pumps, tubings, monitors and equipment. I put his glasses on him, then welcomed his family into his room.
For the first time in weeks, Mr. Nolan greeted his wife and family sitting up in a chair with a smile and a twinkle in his eye. The family’s laughter and tears flowed while I carefully monitored the machines behind the curtains. The preparations for this brief visit had taken every extra minute I could eke out from his complex nursing care time. Yet the memory of the smiles that family shared will stay with me a lifetime.
Mr. Nolan passed away during my next days off. A few shifts later, I was surprised to see one of his daughters waiting at the front door of the ICU as I arrived. She said the family had directed her to come and tell me how seeing Mr. Nolan sitting up, looking like “Dad,” rather than a “hospital patient,” was a positive memory that made the ordeal of his hospitalization and death more bearable.
Now as a nursing instructor, I teach my students that every nurse must have complex technical skills, high-level knowledge and thinking abilities. Yet I urge them to aim beyond knowledge and skill and recall that while only God controls the outcome for each of their patients, they can, through the nursing care they provide, powerfully impact the process. I urge them to provide the sort of nursing care that considers the memories the patients and their families have forever.
Catherine Hoe Harwood
I have worked closely with nurses all my professional life and have been enormously enriched by their competence and expertise, as well as by the friendships and affiliations we have shared. The first nurse who made a significant difference in my life worked in the newborn nursery at Tripler Army Hospital in Hawaii, where I delivered my first baby in 1968, as a twenty-year-old, premedical student and Navy wife. My sailor-husband, Larry, had returned home a few days earlier from a six-month tour of duty in the West Pacific during the Vietnam War. Our nearest relatives resided thousands of miles away. We were overwhelmed with parenthood and totally inexperienced in infant care.
Although everything appeared to be routine after Peter’s birth, he soon developed jaundice, due to an incompatibility between his blood type and mine. The morning after his birth, the babies born to the other three women in our rooming-in unit were brought in their bassinets to remain with their mothers. When I inquired about my baby, I was informed that Peter would be kept in the nursery for observation and regular monitoring of his bilirubin level (the chemical that causes the yellowish skin discoloration of jaundice). As a military dependent, I had seen a different doctor at each prenatal visit and did not have a designated personal physician who could answer my questions and calm my fears.
Being a premedical student, I owned a Merck Manual that provided a brief synopsis of common medical diagnoses. Larry brought the book to the hospital so I could read the paragraphs about newborn jaundice. I learned that elevated levels of bilirubin could be toxic to an infant’s brain, and that a level exceeding 20 mg% potentially could cause brain damage (a medical belief at that time). Unfortunately, a little knowledge proved dangerous, as I exaggerated the gravity of Peter’s condition and was consumed with anxiety. I became obsessed with the results of each bilirubin measurement and fixated on the number 20, which was now linked in my mind with certain brain damage. To make matters worse, the visitation practices of that era did not permit me to enter the nursery or hold my baby.
For a brief hour each day, I could look through a glass window and observe Peter being cared for by capable nurses, while there was seemingly nothing I could do for my son. By the second day of life, Peter’s bilirubin level had risen to the high teens, and by day three, the level peaked at 22 mg%. I was asked to sign permission for an exchange transfusion to be performed to quickly reduce Peter’s bilirubin level to a safer range. I was frantic with worry and dread. Even if Peter survived what I surmised was a life-threatening procedure, surely he would be brain-damaged, since his bilirubin level had already exceeded the ominous number of 20.
Throughout the whole ordeal, a compassionate, matronly nurse, who took a special interest in our situation, stood out as our emotional anchor and our source of hope. As preparations for the procedure began, this nurse angel gently reassured Larry and me that Peter would be all right. She hurried to my room afterwards to be the first to report that all had gone well. I found out later that she had even baptized our son before the exchange transfusion, in an unabashed act of love.
I was briefly exhilarated when the medical crisis was over, but a nagging thought soon stifled my joy. What about the chance of brain damage?
Even though I was young and the risks were low, I had contemplated during my pregnancy the very real possibility that my baby could have a birth defect or other medical problem. I resolved that I could love him no matter what. Now I wondered whether I was a bad mother for wanting to know his prognosis.
I mustered all my courage to ask the pediatrician on rounds, “Do you think my baby could have suffered any brain damage from his high bilirubin level?”
His answer devastated me. “We won’t be able to tell for about a year.”
I couldn’t handle such uncertainty. I needed a vision of hope after spending Peter’s first four days in an emotional wringer. The doctor left my room, unaware that his answer had stunned me.
Shortly thereafter, the wonderful nurse who had offered such optimism yesterday returned to my room. Her benevolent face reflected genuine concern, and I ventured to ask my question again.
“Do you think my baby could have suffered any brain damage?”
“Absolutely not,” she shot back.
“How do you know?” I countered.
“You see, when I bang his crib, he startles and throws his arms out, and that reflex proves he is normal.”
Her unwavering reassurance was precisely what I needed to hear. I was instantly ecstatic. Bolstered by her words of encouragement, I triumphantly took my baby home and treated him like a normal child.
A few years later, during my pediatric training, I would learn that the arm-flailing response the nurse had described was known as the Moro reflex, a primitive startle reaction of newborns that is present even with minimal brain function. Yet, my nurse had mercifully cited this reflex as definitive proof that my baby would be all right, and I had believed her. I thought about the doctor’s answer to my question and realized that his ambivalence reflected his preoccupation with being right, without weighing the impact of his answer on me. Although his response was technically correct, I wondered what might have happened if I had taken Peter home with lingering doubts about his development. Would I have interacted with him differently? Could I have created a self-fulfilling prophecy?
The nurse’s answer was based on right motives, at the risk of being proven factually wrong one day. I will always be grateful to her for allowing me to embark on motherhood with unrestrained hope and optimism.
Today Peter is a highly competent and compassionate psychiatrist, and often, when I am with him, I smile and say jokingly, “Just think what you could have been if it weren’t for the brain damage.”
“Dr. Mom” Marianne Neifert
P
ain is the deepest thing we have in our
nature, and union through pain and suffering
has always seemed more real and holy than any
other.