About Hui-wen Sato, MSN, MPH, RN, CCRN

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse in Southern California and blogs at http://heartofnursing.blog.

The Ethical Use of our Therapeutic Connections with Patients’ Families

“What would you do, doctor?” The family had been explicit in wanting straightforward communication about their child, whose neurological disease had progressed to the point where she was continually seizing, despite every medication the physicians had tried. The seizures were in turn damaging her brain, such that she was minimally responsive to stimuli and was not expected to regain significant awareness of her surroundings.

I held my breath as I anticipated the doctor’s reply. She had spent many hours with this patient and family, and had built trust with the parents.

“As a physician . . . I would transition my child to comfort care and ultimately let her go. But as a mother . . . I would struggle to do this.”

The patient’s mom nodded tearfully. The doctor had given an honest reply, and had still ultimately left the choice to the parents.

I took care of this patient in her final few days of life. The parents were heartbroken but also clear in their decision. We walked them through each step, and made sure they felt supported to the best of our ability, down to their very last goodbye with their child.

******

There is power in the medication and therapies we apply. […]

2025-12-18T10:39:59-05:00December 18th, 2025|Ethics, family, family experience, narratives, nursing roles, nursing stories|1 Comment
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In Times of Overwhelm as a Nurse and Citizen, Begin with One Intentional Act at a Time

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN

With the recent devastation and loss around our local Los Angeles wildfires as well as our country’s political disarray, one of the most difficult things about trying to remain empathetic, engaged, and informed as an individual and a nurse has been a sense of utter overwhelmedness.

I think most nurses are both empathetic and action-oriented, traits which can be helpful—but also sometimes crippling when we see needs for help and advocacy everywhere and don’t know where to start. Any action feels like such a miniscule drop in the bucket.

I was carrying this emotional, mental, and spiritual heaviness into work with me a couple of days ago. I sat down to get report on my patient assignment. My patient was so sick, so complicated; she’d been teetering between life and death in recent days. Her parents had been on a roller coaster of the worst kind. ‘Two weeks into this hospitalization, are we still holding onto hope for recovery? Are we gathering relatives to say goodbye?’

I knew I was walking into a space that was very loaded for the parents. They had seen many nurses, respiratory therapists, and doctors come through their doors. For as long as they had been in our unit, […]

2025-03-03T14:13:18-05:00March 3rd, 2025|family experience, Nursing, nursing perspective, nursing stories, pediatrics|0 Comments
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When Nurses Are Caught Between Hospital Policy and Frustrated Family Members

A difficult exchange

Photo by Riccardo Chiarini on Unsplash

She was one of those patients who remind me of my own daughters, who make me consider up close what it would feel like to watch a terrible disease process insidiously take over my own child’s body. Her cancer had spread and she was struggling to breathe.

The team had told the parents it was likely we might have to give her a breathing tube before my shift was over. The parents were teary-eyed as I told them I would do my best to walk with them through a difficult day. They went downstairs to get food, at which point the patient, who had been dozing in bed, sat up and looked around. I went to her immediately, rubbed her back, and assured her that her parents would return shortly.

When her parents returned to the room, they brought more visitors than the three that our hospital policy allowed. I was a little anxious because I had already heard that this had been an issue overnight and that the parents had pushed back on efforts by another nurse to hold them to the policy.

I did my best to wait for a moment when bringing up the hospital […]

2024-11-04T09:49:56-05:00November 4th, 2024|Nursing|1 Comment
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A Pediatric ICU Nurse Finds Relief in Not Compartmentalizing Hard Emotions Like Grief

Editor’s note: Hui-wen Sato is a pediatric ICU nurse in California and a regular writer for this blog who has gone deeply into the topic of grief, her own and that of patients and their families. Her insights reverse our usual ways of understanding grief, finding a generative energy instead of a wasteland. Here is a key passage from a TED-style talk (see video below) she gave at the last End Well Project conference in November 2023. End Well is “a nonprofit on a mission to transform how the world thinks about, talks about, and plans for the end of life.”

“And so I realized that what I was going to need to learn how to do was not compartmentalize, but integrate all of my experiences into all of who I am. And as I started to learn how to integrate all of my experiences, there came a curious relief and freedom with this integration. Because I no longer had to pretend that I didn’t grieve for my patients. I could just grieve. And I could then get in closer and actually learn more about who they were, who their families were, and I could start to provide a kind of care I think I perhaps had always wanted to provide, but perhaps was a little too scared to get close enough to learn how.”

2024-03-28T14:03:14-04:00March 28th, 2024|end of life, Nursing, pediatrics|0 Comments
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The Pitfalls of Being the ‘Nice’ Patient: A Nurse’s Perspective

Image Brent Keane/via Pexels

I have often heard health care professionals in various environments say, “If you’re nice to the nurses and doctors who take care of you, you’ll get better care.” As a bedside nurse myself, I understand the sentiment. No busy health care worker loves being met with antagonism or pressing demands that don’t strike us as critically urgent.

But when my husband and I both became patients with serious illnesses last year, we learned the clinical pitfalls of being the nice patients. I am left wondering how patients should be expected or permitted to advocate for their own care without worrying that they will be frowned upon or brushed off because they’re perceived as “difficult.”

First cautionary tale.

In early 2022, I discovered a small lump under my right breast that I initially wrote off as a cyst. Surely, I told myself, as a woman in her mid-40s with no risk factors for breast cancer, this had to be benign. A screening mammogram in May 2022 gave me an all-clear, and I went on my way.

But by November, I knew the lump had grown. I reached out to my PCP to ask for a diagnostic mammogram, and he emailed back a casual reassurance. “I know you’re worried, but […]

2024-02-07T16:57:09-05:00February 6th, 2024|Nursing, nursing stories, patient experience, Patients|15 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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