By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Heartstudy by James P. Wells, via Flickr

I was precepting a senior nursing student last week. During an idle moment, I asked her why she’d decided to go into nursing.

She shrugged, averted her eyes, and mumbled something like “I’ve just always wanted to.”

I didn’t press it, but I’m sure there’s more to it than that. I probably shouldn’t have asked, given that I cringe when posed the same question, and usually give a faltering and inadequate “I like helping people” kind of answer . . . when “that’s too personal of a question” would be more honest.

I’ve been a nurse for years, and there are certain aspects of the profession I wouldn’t attempt to broach in casual conversation. I doubt that I could have articulated my motivations when I was a student, even if I’d wanted to. That exchange, though, calls to mind one of the most defining experiences of my nursing career.

I was a senior nursing student, doing a clinical rotation in the ICU. My preceptor and I were caring for a patient who’d been in a motorcycle accident. He’d not sustained a head injury; he’d worn a helmet. But he’d suffered a high cervical injury, and it was complete. The weight of the helmet, combined with the force of the crash and pathological changes, had caused his neck to snap.  (“Like a stick!” I remember the trauma surgeon saying.) The poor man was wide awake but completely paralyzed.

My recollections of the specific events of that day are clouded by inexperience and shock. I only know that, at some point, a day that had seemed completely normal took a tragic turn. I remember standing by the patient’s bedside, helplessly, as his heart rate suddenly and inexplicably dropped and the trauma surgeon and code cart magically appeared at his bedside.

I remember it becoming incredibly busy and frenzied. In an effort to stay out of the way, I stationed myself at the head of the poor man’s bed.  I laid my hand on his forehead, mumbling futile platitudes as he gazed up at me with fear in his eyes, mouthing words that I never grasped for what felt like an incredibly long time, until he lost consciousness.

I remember his final moments in crystal detail.

Years have passed, and I still think of him often. (Mostly, I remember his eyes.) I’d like to think I was able to provide some measure of comfort in his last moments, for I’m sure he knew something was terribly wrong. I’m an employee in the same ICU today, and given the same situation, I wouldn’t be standing still, with my hand resting on a paralyzed and dying man’s furrowed brow. I’d be far busier with science than spirituality. In a situation like that, there simply wouldn’t be time for anything else.

While I was in nursing school (and even now, to be honest), I had the secret conviction that I was led to nursing as a calling, with a purpose to fulfill, and that there was possibly one specific person I was meant to help. I wonder, now, if that was my moment. It’s possible that, before I’d even graduated from nursing school, I helped the one person I was meant to help. Perhaps I was uniquely qualified, in a special way, to help that one specific person when I could still be more affected by the look in someone’s eyes than their vital signs.

I go to work anyway, though, just in case there’s someone else. And I hold students in the highest regard; the clarity born of inexperience can be priceless, even if we don’t discuss it.

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