Far from Home, a Flight Nurse Cares for One of COVID-19’s ‘Peripheral Victims’

‘Deemed stable to fly home.’

Our fixed-wing air ambulance was recently dispatched to Spain to bring 87-year-old John and his wife of 62 years, Rose, home to the US. They’d traveled to Spain for their annual vacation before “COVID-19” or “coronavirus” were household terms, but John had fallen early on in the trip and broken a hip. He’d spent four weeks in a local hospital and had his injured hip surgically repaired, and then was deemed “stable to fly home” by a doctor. And so he’d been transported back to his hotel two days prior to our arrival. The crew deposited him in the bed, bid farewell to his wife, and left.

Spain’s deserted beaches seen from author’s hotel room, March 2020

And now John was dying. He lay on the twin bed in his hotel room. His eyes were closed. His breathing was rapid and shallow. My partner and I stood, stunned into momentary silence. We had come straight to his hotel from the airport, and his condition was far worse than we had anticipated.

We’d left our equipment in the aircraft, as John’s transport was planned for the following morning to allow time for our pilots to rest. John’s respiratory rate was 60 with frequent pauses, his pulse weak, heart rate about 95 and irregular. He wouldn’t open his eyes or respond to us verbally, but he fought us when we tried to move him. He was covered in feces.

No room at […]

Will your ‘RN’ Name Tag Protect You from Violence?

When I stepped into the entryway, I was met by a group of men, crouched on the floor over a game of craps and shouting excitedly. One of them stood up when he saw me come through the door . . . He dropped the dice, pulled a gun from his waist, and pointed it at my face.

Workplace violence prevention training has become the latest mandatory education module in many hospitals. But what about nurses who work in non-hospital settings? In this month’s Viewpoint, “Workplace Violence Outside the Hospital Setting,” NP and visiting nurse Joanne Schmidt describes the terrifying situation she walked into one day at the start of her morning home visits.

In many community settings, no cameras or security staff.

Schmidt points out that nurses who work in home care, mobile medical vans, school clinics, and other community-based settings may be considerably less safe every single day than those of us who work in relatively protected hospital environments. At least in acute care there are cameras and security staff! […]

2020-02-20T10:55:11-05:00February 20th, 2020|Nursing, nursing stories|1 Comment

Putting Down Her Burden: A Patient’s Final Choice

‘goodbye, inhaler!’

Chronic illness as a Sisyphean bargain.

Sisyphus was a legendary king of ancient Greece who was condemned by the gods to eternally roll a rock up a hill, only to have it roll down again each time as it neared the top.

Many people with chronic illness today may be able to relate. Chronic illness can mean years or even decades of worsening symptoms and ever more complex medication and treatment regimens, side effects of treatments, treatments for side effects, monetary pressures, activity limitations, a sense of separateness from the legions of the merely ‘walking worried’ around us, and the subtle pervasive tension and vigilance of never quite knowing what might come next.

The ironies of advanced medicine.

The assumption, of course, is that all the effort is worth it. And it is: many of us benefit from, or know people who benefit from, drugs that keep them alive when 50 or 100 years ago they would have died long ago, or keep them able to walk, or breathe without a struggle, or sleep without excruciating nerve pain or the itching of terrible skin sores, and so on. Life has always been about compromise; these are simply new refinements of a universal […]

A Nursing Way with Meaning

“I have found that the residents of Johnson Tower teach me more about being a nurse and a human being than you would imagine.”

Despite our seriously malfunctioning health care system, sometimes we are lucky enough to be reminded of the richness of our practice. Most of us experience a bright spot or two on most days—a patient’s condition finally improves, and we know we had a hand in that; we are able to spend some “quality time” to help a patient cope with her illness; a discharged patient returns for a happy visit.

Thriving, not just surviving.

A few of us, though, are lucky enough to have nursing work in which we can thrive, and not merely survive, every day. In this month’s Reflections column, “The Way of Johnson Tower,” nurse practitioner Mark Darby describes his work in an unlikely setting: a medical clinic located in a public housing high-rise. Resources may leave something to be desired—occasional leaks from the laundry above seem to target the clinic’s centrifuge—but his practice is rich and fulfilling.

“All these people, despite their circumstances, teach me more about generosity, perseverance, and hope than I could learn anywhere else.”

[…]

Caring for the Patient You Never Had a Chance to Get to Know

“For months, we simply knew him as this often agitated, sometimes unstable, generally nonverbal, nonpurposeful patient whose actual personhood seemed, if I’m honest, unrecoverable. We didn’t even know who we were trying to recover…”

This month’s Reflections essay in AJN is by Hui-wen Sato, a pediatric intensive care nurse in California. This piece is difficult to describe because it fits no clear category; this is also what makes it alive and engaging.

In “Beholding the Returning Light,” Sato explores the the experience of caring for a patient without ever having had a chance to get to know that person. What do you feel for that patient, and how much do you invest yourself in his or her possible future?

The ‘unthought known.’

Such questions and others may exist on a subconscious level throughout an ordinary work day for nurses in a number of settings. Sato, as she traces the sequence of events, her own emotions, and the role of the patient’s family, adroitly brings them to the surface. […]

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