The Heart of a NurseAugust 14, 2013
By Diane Stonecipher, BSN, RN. The author lives in Texas. Her forthcoming Viewpoint essay in the October issue of AJN, “The Old Becomes New,” will consider aspects of nursing that may be obscured or lost due to overreliance on technology.
I am somewhat embarrassed to admit that my initial interest in nursing came as a 10-year-old Yankees baseball fan. I could not get enough of The Mick, Elston Howard, or Mel Stottlemyre on my transistor radio, during televised games, or in my baseball card collection. I decided that I could be the team nurse—take their vital signs, set their broken bones, assess their injuries, and best of all, travel with the team.
This rather irrational desire was solidified when my aunt had a face lift. I was 14 at the time, and she recovered at our house, specifically in my room. She was swollen like a prize fighter, with bloody bandages that needed changing, pain medication to be dispensed, meals to be fed—I was hooked. I am not sure I even knew what a nurse really did, but my heart was stirred.
I sailed through high school, graduated with honors, and left for one of the three state universities that had a nursing school in Florida. With a limited number of spots, I discovered admittance required more than just grades. You needed some kind of hands-on experience, a family member in the medical field, or some reason to stand out among others. The latter my only option, I simply persevered by doing well and wanting it more. On my third try, I was accepted and my life education really began.
Nursing school was both exciting and terrifying. I was seeing things that I’d never seen before, and I now felt privy to a world of wonder. Babies brought forth; precise incisions, neatly sewn, healing almost magically; and all sorts of “conditions” for which there were treatments.
About the time I was alight with the goodness of this profession I had chosen, I also began to witness the losses, the sadness, the unfairness and the pain that is the flip side of the body amazing and life.
The very first preop patient I had by myself, as a new nurse on nights, could not sleep. He did not want the sleeping pill that was ordered. He wanted to talk. After my rounds, I sat spellbound at his bedside. I learned a great deal about Homer C.—he’d had an interesting life and he was a good storyteller. When he died on the table the next day, something I had never considered a possibility, I cried like I had known him my whole life.
When I moved to Houston and worked at a large medical center, I took report for the 3–11 shift on Mr. B. He was a young, strong firefighter, struck out of nowhere by some malevolent vascular anomaly that had already taken the tips of his nose, ears, fingers, and toes. This readmission was to amputate his right hand and forearm and left lower leg. These incisions were not magically healing, and Mr. B knew what that meant. When I entered the room for the first time I was unprepared for the fragility of this once healthy father of four. In my inexperience, my mouth slightly agape, tears welling in my eyes, I apologized for my sadness.
“I’m sad, too,” he said. He wanted no more surgeries; enough was enough. Many weeks and too much pain later, he died quietly on my shift.
I made rounds in the hospital on Mr. R because he was a patient of an incredible cardiologist I worked for. I had seen him and his wife in our office adjacent to the hospital for years. A collector of clocks, at least in retirement, he had the gifts of passion and patience. I looked through his chart, went to his room to find him awakening from a nap. I greeted him happily and he looked at me, unable to say a word. He had suffered, in his sleep, a massive stroke, one that would take his life within days. I will never forget the eyes of someone I’d come to care for and about, the way they looked at me with such vulnerability. I too was speechless. I fumbled for the emergency cord, never left his side until he was down in the radiology suite.
Later in my career, working for a gifted surgeon, I discovered that I could carefully dress wounds for weeks and months, whether or not they were likely to ever get better. While there was great satisfaction in a wound that was improving, there were also great connections to be made in these daily duties. You can’t help but look at your patients differently when you now know their life stories, how much they love their families, their joys and fears.
Often I had to go to the surgical waiting room and give updates, when my boss could not. Some of these expectant families I had met the night before and some I had known for many years, almost like my own family. Sometimes this was simply to let them know that things were taking longer than we thought or we’d gotten a late start. Other times, things were looking grim, and giving that information was in essence preparing them for the possibility of a bad outcome. Sometimes, I felt that the words that came to me were just the words that I would want to hear myself. I cared about this person too.
As nurses, we are drawn to the field for many different reasons. What is exciting and fulfilling to some is stressful and boring to others. Our ability to show compassion is perhaps our best nursing skill, better than our proficiency with machines, computers, and even procedures. It may not be what we do so much as how we do it.
It turns out that I never did become the team nurse for the Yankees, but I had the heart of a nurse all along.