We’re Not Going to Lie to You

By D’Arcy Norman, via Flickr

By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

“Hgb 4.1,” the lab tech said, and we jumped as though someone had fired a starter pistol. While one nurse called the on-call trauma doctor, the rest of us mobilized in preparation for the interventions we anticipated.

The “critical results” call wasn’t a surprise. The teenager’s pelvis had been crushed when he was run over by a delivery truck. His blood pressure was holding fairly steady, but we didn’t put much faith in that. In cases of hemorrhagic shock, young patients tend to compensate until the very last second, and we knew that.

His heart rate was soaring and his color was terrible. In the 15 minutes since he’d been wheeled into the unit, flat and flaccid on a stretcher, he’d gone from barely arousable to completely nonresponsive. Aside from his shallow, even respirations, he looked strikingly dead.

A good nursing team functions like a choreographed troupe, and we were at our best that day, moving with staccato precision. Massive transfusions can do wonders; still, it was amazing how quickly he improved. He lost the gray-white pallor and his heart rate stabilized. Then his lashes fluttered and he opened his eyes.

He regarded us working over him for several minutes. The air of urgency remained, and the gravity of his condition was no secret.

“This is bad, isn’t it?” he asked.

And it wasn’t a time for platitudes.

“We’re […]

2016-11-21T13:12:12-05:00August 8th, 2011|nursing perspective, nursing stories, Patients|3 Comments
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Neither Crime Nor Demeanor

By Marcy Phipps. Marcy is an RN in St. Petersburg, Florida. Her essay, “The Soul on the Head of a Pin,” appeared in the May issue of AJN, and she has contributed several thoughtful posts to this blog in recent months (here’s the previous one).

My patient’s ICU stay was short, as his injuries were fairly unremarkable. Far more striking were the circumstances of his admission; he’d been injured while committing an appalling act of grisly violence. An armed police officer stood sentry at his bedside, and the nature of his crimes gave him a sinister notoriety among the medical staff.

“Alleged” crimes, I should say.

But it was difficult to give him the benefit of the doubt. I’d read the paper and seen the crime scene photos on the news.  The media’s case against him made his innocence hard to fathom, and as a police officer’s daughter I found myself inclined to prejudice. I not only planned on, but also counted on disliking him, at least on some level. Although I would certainly provide care to this man, I exempted myself from caring about him as an individual.

I was surprised to find his demeanor dramatically different than my expectations. He was soft-spoken and retiring, exceedingly polite and appreciative.

I don’t mean to imply that we chatted. Our conversations were limited to his physical condition and general plan of care. He never acknowledged the officer at the bedside or spoke of his alleged crimes, and neither did I.

It’s possible […]

2016-11-21T13:15:59-05:00August 25th, 2010|Nursing, nursing stories|2 Comments
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The Long Fall

I wish I could make sense out of why these events unfold on days that start out completely ordinary. I suppose what I’m trying to say is that our lives and goodbyes are completely unpredictable. And it occurs to me that, regardless of the starting height, all falls are “long falls,” and they all happen way too fast.

2016-11-21T13:17:13-05:00June 16th, 2010|Nursing, nursing stories|1 Comment
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The ER Exit vs. the Long Goodbye: Notes of a Hospice Nurse on the Morning After

“Mourning Dove Bailing,” Bob MacInnes/ via Flickr. “Mourning Dove Bailing,” Bob MacInnes/ via Flickr.

I’m exhausted and shaky, and the “pssssht!” sound of the pneumatic doors of the ER closing behind me on the way out sounds final, and just fine. I didn’t used to feel this way when I worked in the ER. Of course, that was at the other end, the beginning, of my nursing career, when I was young(er) and callous and every code was a challenge and a rush—as if the people were characters in a play, and I got to join in each evening. I hadn’t a clue what they were going through. Now, 30 years and two dead parents, a dead best friend, and a score of minor players later, I’m beginning to understand. I suspect that this glimmer of connection and compassion is what makes hospice nursing sometimes so draining. […]

2016-11-21T13:33:13-05:00April 27th, 2009|nursing stories|0 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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