Thursday, February 17, 2011

to heal

I was 40 years old when I started nursing school, and no greenhorn to life.  When I graduated from nursing school, I truly expected to be able to go out and heal everyone I touched.  That was my goal.  I thought it was a realistic expectation.  I knew people died in hospitals, but I didn't think it would ever happen to me.

Shortly into my nursing career I had a wake up call.  In one night I lost two patients.  Not quietly or peacefully.  No, I had two code blues.  Within an hour of each other.  And lost both people.  I was devastated.  After the second code ended, I crumbled in the arms of my nursing supervisor.  I will never forget how that felt.  I felt like a failure.  I had done something wrong, or not done enough.  I spent hours trying to figure out what I could have done differently.
I finally realized there was nothing I could have done.  Sometimes, with all we do, and doing our very best, it just isn't enough.  So my thoughts and beliefs gradually changed as reality set in.  Very seldom did I get a chance to help someone "heal".  Mostly I spent my time stabilizing what was going on medically and trying to teach them how to stay healthier.  Sometimes I was somewhat successful, but much of the time I saw the same people come back again and again, sometimes to the point that there was no way to retrieve and stabilize them.  And so they died. 

It is hard to watch people die.  I have a place inside my head I go to when I am losing a patient, so that I can support that person and the family.  Because that is what nurses do.  We support.  We spend time.  We listen.  We provide for the basic needs of the body and protect the dignity of the individual.

So I spent most of the past 16 years working in many areas.  I have done orthopedic, general surgery, cardiac stepdown, general med surg, neurology, pediatrics, and psychiatric nursing along the way.  Psych nursing is my true love, and pediatric nursing was my least favorite.

Until I went to Alaska.  And was placed on the pediatric side of a hospital unit out in the tundra.  Bethel was four hundred miles from Anchorage, and the only way in or out was by plane. 

I thought I would be miserable on the pediatrics unit.  I had not enjoyed doing pediatrics 12 years earlier, and thought it would be another round of the same.  But as I worked there, I discovered something.

I was a seasoned nurse now, and all the previous experience I had helped me to deal with sick babies and support the parents.  And I loved it.  Absolutely.  For the first time in my nursing career I was able to see my patients actually heal, and go home with smiles on their faces.  Sometimes they literally ran from us (we gave that nasty tasting medicine after all, and poked and stuck them with needles).  But I knew that for the most part, they would grow up to be healthy, happy adults.  We had awesome, caring doctors, and I worked with some of the best nurses I have ever had the privilege to work with.

As I talked about Alaska yesterday, I talked about my toughest case.  The case that was my epiphany.  That brought all my thoughts and experiences into one cohesive understanding of what being a nurse was all about.  We had a baby brought in with burns that happened when he innocently pulled a pot of boiling eggs off a hot plate and spilled boiling water on his right side, from his face down his chest and arm.  It was one of the worst things I had seen in my life.  I stood by day after day and watched the wound care nurse and physical therapy debride and dress those burns.

Then the weekend came, and guess who the debridement fell on to do?  The pediatrician and me.  The pediatricians at this hospital were probably the best I have ever seen.  They amazed me with their skill, their understanding of the culture, and their caring attitudes.  I particularly looked up to this pediatrician, and trusted her implicitly.

So we medicated the baby with IV Morphine and debrided.  And to debride a burn, you SCRUB it.  Hard.  You have to debride to keep the skin from scarring, and to allow the antimicrobial ointment to prevent infection of the burn.  The person I was telling this story to asked me how I did it, how I listened to the screams of the baby (there was no way to deaden his pain completely, the morphine just took the edge off his agony) and I told her that I went to a place inside myself and focused on what I was doing, and kept repeating to myself that it was to help the child, to help the child, over and over like a mantra to myself. 

We repeated this for several days, because the wound care nurse was out.  I helped the pediatrician, and I helped the physical therapist.

Then I noticed something.  The child was healing.  New skin, and we were debriding less and less every day.  And his screams lessened as the pain lessened.  He was HEALING.  When the wound care nurse came back and saw how well he was healing, she praised our work.  By the time he went home, he had on just one or two small dressings that we taught his mom to change, and gave her ample supplies to do at home.
And I realized as they left, that I had done what I had believed I would be doing when I became a nurse.  To heal the sick.  To send people home to live a healthier life.  I had a hand in that.  And the gratification I felt was worth every minute of all the years I had studied and worked as a nurse.

I felt it all the way to my soul.  And knew in that moment that you follow a path not knowing where it leads, until you get to the end.  And realize what the purpose for traveling that path was.  Everything I did as a nurse, led me to that baby.  And a greater understanding of what a nurse is, and why I became a nurse.


  1. Way to make me cry, Cathy. You already know how invaluable I think nurses are, but the tough things you've had to do. . .debriding. Oh gosh.
    We had palliative care nurses come in every day for three months. . .they looked after my husband AND me. For a long time there they were my best friends.
    I'm sure I'd have loved you to be in the hospital for my recent hand experience, no matter how minor that actually was.
    Josie x

  2. I would have loved being able to help you through your recent surgery Helen, and as far as I am concerned, there is no such thing as minor surgery...
    I appreciate the kind words about nurses. Words that nice are always appreciated...
    xo cath