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. I nod to her that I understand and move to my patient. I tell her that I will start and IV and hang some fluid to get started while we wait for the doctor to come in. 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. We see more than a body part in despair…we see the whole person!

A scenario says it best:

I walked into the ER for my shift on Christmas. Just after entering the nurse’s station my heart began beating a little faster—something was wrong. I sensed sadness and grief. 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. I promise to take very good care of you and make you more comfortable as soon as possible.”

She answered tearfully, “Thank you…and my name is ***** and this is my mother. I’m pregnant.”

After she finished telling me about her abdominal pain I examined her, assessed her vital signs again and started an IV, drew blood and hung NS at 150/hr. Read more…

I went to retrieve the 13 year old patient from the busy ER waiting room. I took her chart and looked around the waiting area. Amongst the noisy crowd; I saw a young girl, head in hands, lying in her mother’s lap. I called her name, watching to see if this was the young girl with the complaint of a migraine headache. Sure enough she briefly lifted her head, grimaced and then closed her eyes.

I got her a wheelchair and brought her and her mother to room 14. “I can’t talk right now,” she cried as she tried to lie down. I assisted her to lie on the stretcher, covered her with a warm blanket, put a cold washcloth on her forehead and turned off the lights. Mom and I softly whispered.

“Does she normally get headaches?” I inquired.
“This has been going on for a year now, we have been to her pediatrician several times and we see a specialist next week. “
“Do you see a pattern at all?”
“The first headache she got was 3 days before she started her period and they seem to come every month just before she starts…” mom replied.

I nodded my head in recognition of awareness and then asked her if anything made the pain better or worse. “Well, ibuprofen and Tylenol seem to help a little but we cannot seem to find anything that gets rid of the pain other than getting her to go to sleep but that is so hard because of the pain and everything makes it worse. Read more…

Fear has crawled into my heart and its talons are gripping tighter…As I sit on my stool, hands in my lap, I silently scream to God to help me. I know that what this young woman is going to tell me is going to haunt me and I fear it. I’m waiting to hear the horrific details of my patient’s experience prior to running to our ER at 2am, half naked, bleeding and disoriented. I’ve been called in to be her SANE nurse. (Sexual Assault Nurse Examiner). When I arrived at the ER I am met by a sheriff who was standing guard outside her room. “She is afraid they will return.”

I knock on the closed door and a scream of “no…no..” echoes from inside. I slowly open the door a crack and tell her, “I’m a nurse…I just want to come in and sit with you.” No reply, so I slowly enter the lit room and sit on the closest stool. She briefly looks at me from her spot on the floor and then a look of pain, fear and sadness distorts her face as a cry racks her body.

She is huddled in the corner of room 5 of my small rural emergency room. Her knees are drawn up to her forehead and her arms are tightly wound around them. She is rocking and continues the gut wrenching sobs that last for minutes. Dirt is caked in her hair and on her feet as well as smeared on her legs and arms. Read more…

I stood in the doorway and watched my 15 y.o. behavioral psych. patient. She sat cross legged on the stretcher, hands tightly clenched in her lap, head down and eyes closed…rocking back and forth. A loud,continuous hum escaped through her throat…not a song kind of hum…but a static sound of humming.

She came to us after being kicked out of her foster home for aggressive behavior and suicidal language and she now is boarding with us until a new home or psych hospital bed opens up for her. Because of her suicidal language all of her belongings were removed from her and she was in our blue hospital scrubs, on a watch with security and in the behavioral health section. The areas is small, has a TV, a bathroom and small area to walk around—no windows.

Hour 90 was upon us and she was melting down. As I watched her, my heart broke. This child was alone—her life story is of abuse and neglect—and now once again she is alone…Life isn’t fair for this child!

Earlier that day I silently prayed for her and I sat and talked with her. She liked to write and to draw, listen to music and take long walks. Her two siblings were with another foster family and she hadn’t seen them in over 6 months…and there were no relatives to help them out. She was afraid of where she would end up and wanted to run away. Her suicidal thoughts continued and she wanted to cut herself. Read more…

She kept calling out repeatedly for help, with a loud, shrill, shaky voice. “HELP, HELP, HELP, HELP….” I could not comfort her or reassure her that she was okay, nor could I get her to stop yelling for help. The staff was getting weary and the other patients thought we were killing her…that fragile little 98 year old women with dementia in room 8.

She came to our ER from a nursing home with the complaint of, “she won’t stop yelling for help and this is not her normal behavior.” We worked her up for altered mental status—and none of the tests revealed a reason for her behavior change.

I tried everything to calm her; I dimmed the lights, I sat and held her hand, I turned the TV on and then off, I repositioned her repeatedly and called her
daughter (who was in Florida). The morning rolled on and she kept yelling. The ER traffic flow subsided somewhat and an opportunity arose for me to have 15 uninterrupted moments with this woman. I turned off the lights, closed the door, turned on some music and performed Reiki on her. I started from her head and went to her feet. At first she didn’t appear to even realize I was there, let alone gently laying my hands on her head. After approx. 2min she stopped yelling. I continued.

The room was silent except for the soft music.I watched the monitor—her pulse went from 112 to 88, her blood pressure went from 160/98 to 142/80 and her respirations went from 32 to 18. Read more…

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Coming up on the show: A salute to teachers, great advice for parents of babies, defining lollygag and other popular sayings plus Donna Smith and Marsha Podd.

Donna Smith, our National Nurses United D.C. correspondent brings us up to speed on all things Washington. Donna also shares a bit of personal news about her own health. Donna Smith is best known as one of the documentary subjects of Michael Moore’s 2007 movie, “SiCKO.” Donna now works as a national single-payer healthcare advocate and community organizer for National Nurses United. Read more about Donna.

And, it’s always a treat to have our friend RN Marsha Podd with us in the studio. A.K.A. the “Baby Whisperer.” When Marsha comes to the studio we all go to sleep. We mean that in a good way, as Marsha has one of the most soothing voices you’ll ever hear. Marsha, is the author of Secrets of a Baby Nurse. The book is getting rave reviews and if you know of anyone that is expecting a child, has babies or toddlers already, has looked at a child or even thought of a child–you need this book!

Being a nurse is hard work! There are the perennial issues of not enough…staffing, time, appreciation. But on the blog this week, Love Your Nursing Life RN author Bobbi McCarthy writes about one of the ways nursing renews the spirit in The Gift in Room 3.

Win FREE TICKETS to RN Alison Whitaker’s play “Vital Signs” at the Marsh Theatre in San Francisco June 8 thru July 21. Read more…

Standing in the middle of the nurse’s station, I faxed a chart to Spring Harbor for our psych patient in room 11 and I watched the patient in room 3. Her twisted body was lying on the stretcher in a semi-sitting position. She was covered in a blanket and her feet were hanging out, uncovered. I chuckled to myself because that is how I lay as well—I hate my feet covered! She was talking to her husband. He was gently rubbing her crooked hand…they noticed me watching and both smiled at me, so I smiled back.

I finished faxing the chart and then went into room 3. “So how ya doin in here?” I asked her.
“Just fine.” She answered with a smile.
“Can I get you anything, or reposition you?”
“I would like to be turned.”

I grabbed our tech Paula to help me and we gently turned and repositioned her to the left side, propping pillows behind her and under her legs and between her knees. I gave her a back rub, applied some lotion and covered her with a warm blanket. She thanked us and then said “I’m so sorry to make so much work for you girls.”

“Please don’t say that…it is our pleasure to help you.” I answered with a smile, and I meant it.

This woman has MS and it has ravaged her body…she is not old…she fully has her mind and can breathe on her own but she has no use of her body whatsoever! Read more…