The call came in from EMS as “72-year-old man with end stage lung cancer in respiratory distress. Vitals stable. Family requesting transport to the ER for evaluation. He is on Hospice – the nurse tells us the family is no longer able to cope with him at home.” I went to room 7 to prepare for my patients arrival.

My patient arrived 10 min later on the EMS stretcher. His gaunt frame fought to hold up his head. His skin was dry but pale, respirations were labored but controlled at approximately 32 bpm. His eyes were open wide and they never left my face as the paramedics brought him into the room and moved him to the bed. The venti mask covered his mouth, so I couldn’t quite understand what he was saying to me. The paramedic was delivering his report but I was so distracted by the look in my patient’s eyes that I went to him and removed the mask so he could talk to me.

“My wife is coming (breath) with my son (breath) please let her (breath) in when she gets (breath) here…she (breath) has Alzheimer’s (breath) disease and she (breath) is easily scared (breath).”

I placed the oxygen mask back on his face and reassured him “My name is Bobbi, and I will be your nurse tonight. Read more…

I walked into room 15 to introduce myself to my new migraine patient and I found her rocking back and forth on the stretcher. Both of her hands were firmly pressed into her forehead and covering her eyes. The chart says my patient is 17 years old but her tiny frame all curled in a ball made her look 10 as she rocked in pain. An older woman sat in a chair in the corner of the room and looked at me with pleading eyes.

I quietly closed the door and moved to the stretcher. I sat the chart down on an empty chair and softly introduced myself to my patient and her mother.

“Hello (name), I am Bobbi and I will be your nurse today…I promise I will get you feeling better soon.”

“Please help me,” my patient answered without moving her hands from her head. I asked her to rate her pain on a scale of 1-10 with 10 being the worst pain. She whispers “9”. I asked her an acceptable level of pain and she whispers “not a 9.”

Her mother informs me that my patient has a 4 year history of migraines since suffering a major trauma…she mouths what the trauma was to me with a look of great distress. Read more…

Her little blue eyes darted from her mother to me repeatedly as tears built up and dropped onto her cheeks. I smiled at her and set my equipment down on the counter. Her little chin quivered with fear as she struggled to compose herself. Her mother quickly rushed to her side on the stretcher and held her tiny body close as she explained, “I’m sorry honey but we have to do this.”

I sat on the stool near the counter, a few feet away from the stretcher, waiting for this little girl’s mother to finish consoling her child. I was well aware of the fact that this little one knew all too well how painful things were about to get and she was trying so hard to be brave. (2 months prior to this date this child came in and had to have a large MRSA boil lanced and the IV didn’t go so well. She was drawing on the only experience she had and FEAR was very palpable…)

“Do you have to do the IV?” she pleaded with her eyes for me to say NO.

“I’m sorry honey, but yes, I do have to put in an IV…BUT I’ve been doing this for 23 years and I promise you I will do it quickly!”

“The other nurse last time didn’t get the IV and someone else had to do it…it hurt as bad as when my brother hit me in the head with his body on the swing set and knocked me over.”

I tried not to laugh but she was being so cute! Read more…

Something was said to me on Christmas that has left me pondering just why being a nurse is so wonderful. The comment was, “She is such a smart girl. She shouldn’t be in the nursing program. She should be a doctor.”

Well…Hmmmmmmmm. I admire the intelligence of some very fine doctors I’ve worked with over the last 23 years and this posting is in NO way a slam to any of them. The person speaking holds himself in high regard in his own profession and I don’t think he even realized what he was saying or how it sounded to a NURSE!

I’m not going to rant about how smart nurses have to be because we all know how smart nurses are. We nurses know that on many an occasion we save the patient from the doctor and we save the doctor from him/herself! I’m not going to go into all the technical things we need to know and all the skills we have to perform on a daily basis. What I want to talk about is the heart of a nurse…what makes a nurse isn’t always their brain. Though of course that helps. It’s their heart. Nurses want to be nurses because of the human connection. Read more…

A category 2 abdominal pain patient was brought into room 5 from the waiting room of my ER. She was an early 20-something who happened to be 17 weeks pregnant. She was complaining of diffuse belly pain, fever and nausea that had escalated over 48 hours. I watched the tech wheel her by the nursing station to go into room 5. She was petite in stature, and even smaller in appearance as she hunched forward guarding her stomach with her arms. A very worried-looking older woman accompanied her.

I quickly exited out of my charting on the computer, grabbed her triage information and scanned it. I went to the med room and collected an IV tray, saline, and a Doppler. As I entered the room I quietly laid my equipment on the counter and walked to the stretcher. Worried eyes looked at me from the face of this attractive young woman. She sat on the stretcher in a semi-fowler position with her knees drawn up to her stomach. She held the older woman’s hand and barely changed expression as a tear fell from her left eye.

I outstretched my hand to her as I introduced myself to them both. “My name is Bobbi and I will be your nurse tonight. Read more…

I could hear her crying and screaming in pain as I entered the ER for my evening shift. The door to her room was closed but the bone-chilling cries echoed out beneath the wooden door and filled the airspace of the nursing station. I inquired about her. “She got here almost an hour ago and we cannot seem to get a handle on her pain…” I looked at the board to see her name—I knew her… My heart raced and I felt a lump gather in my throat…I hadn’t seen her for almost 9 years now. My mind sped back to the time that our paths had crossed.

I was doing home health nursing then and she was a teenager with a newly diagnosed sarcoma. I was to care for her while she received treatments. I was in her home several times a week for a several months. We bonded and I cared about her. She knew my daughter. I wanted her to live…I prayed for her day and night. She was tough…strong and determined. She had spirit and spunk far beyond her years…I wanted to take care of her. Her case brought out the best in me, but also that part of me that wanted to take over and do it all. Read more…

I went to room 13 to check on the patient I had just received report on… the ER was CRAZY but for some reason I felt the need to check on him first. Late teens, sick for 3 weeks with diarrhea, waiting on a stool sample (all other labs were back and relatively normal), loss of 20 pounds… I found him asleep on his left side with his left arm outstretched to expose the 18 gauge needle in the anticube with IV tubing attached to NS running at 400/hr (second liter). He was a handsome boy but pale and thin with dark hair all messed up, skin was dry and monitor showed a normal sinus with a rate of 96. His oxygen sat was normal at 99, blood pressure also normal at 120/76. The room was empty except for him of course and a purse…pink with brown trim (I’m assuming not his).

History was that he had been experiencing diarrhea several times (5-8) a day for 3 weeks, no fever and no vomiting. Pt. does however have pain in his lower abdominal region that is intermittent but ranges from a 7-8/10 on the pain scale. Pt. had a prior bout of this diarrhea last year around this time. Read more…

I watched him pace the back wall of the emergency room, cry, kick and scream while he watched my every move. “What is behind your back?” he half screamed and asked. The left side of his flushed face was swollen, more swollen than it was 2 days ago. This was our second encounter and the thought of him thinking I was going to hurt him ripped my heart apart.

When I saw his fear, and heard the question…“What is behind your back,”

I was transported to a time when I was a small child, in the hospital and I asked a nurse that same question…she lied to me and said nothing…then she pushed me over and jabbed a needle in my derriere. I have NEVER done that to a child and I never will; I quickly showed him my empty hands and I slowly sat on the stool.

A dental extraction that ended up infected brought this amazing little boy to me. Our first encounter was 2 days prior…he was a week out of an extraction and his face was swollen and he was in pain. I started his IV with minimal fanfare and he received pain med, antibiotics and fluid. Read more…

The room was dark and quiet as I finished up my nursing note.  My patient was tucked into her own bed and finally asleep as her daughter slowly ran her fingers through her mother’s white curls.  I nodded goodbye and stepped out.  Once in the car I checked my phone and found a message from the hospice intake worker that I had another patient to go and see…an urgent open.  I read the directions and something tugged at my brain telling me I knew this address.  I ran into the office to retrieve the paper work.  Once back in my car I opened the file.  The name was that of my friend…my friend that was NOT in the endstage of breast cancer with metastasization.  “What is going on?” I muttered to myself.

I called the intake nurse and asked about the call for this patient.  “I got an urgent call from her doctor telling me that she had just returned from Boston after receiving trial medications that failed…and she is days from dying. She wants to die at home…she asked for you.”  My heart raced and my stomach clenched…tears ran down my face as I heaved in deep breaths…this cant be true…I just talked to her a couple weeks ago and she said how well she was doing…

I prayed during the 20 minute drive for courage, wisdom and strength…I prayed it wasn’t true. Read more…

I sat in the back row of the large Catholic Church and watched the young people and their families file in. Most heads were bowed but some were looking around with sad eyes. My heart was racing and I physically felt uncomfortable as I fought to not let tears escape my eyes. The open casket at the front of the church kept calling to me but I couldn’t look at it…not yet. Her family was escorted in—mom was crying and her little brother appeared fearful—no father. They sat next to an elderly woman in the front row that I hadn’t met before.

I have no idea what the priest said that day because as soon as he started talking my mind went to the images I knew of this amazing young woman. Her room was painted in purple. Let me rephrase that—her entire room was painted in purple—including the ceiling! The walls were lined with teenage posters and Polaroid pictures of her and her friends, trees, fish and her family. She took Polaroid pictures of everything! She had a huge fish tank on top of her dresser that held a multitude of fish that she cared for. Each time I entered the room I was taken aback by the amount of clothes that could be found on the floor. Read more…