It was a typical day in the ICU. I was wrestling with the numerous tasks I had yet to do, wondering how I would get them all done. I had three patients, I needed to draw blood gases and give my afternoon medications, and the charge nurse had just informed me that I needed to transfer one of the patients to the step-down unit-we were in a crunch for beds, and patients were waiting in the ED.

I still had a total bath and bed change to do, but the family members were in the room of the patient I needed to bathe. I had politely asked them to step out for a few minutes so I could finish my work. Now I gathered my supplies and went to the room, hoping they would take the hint.

I can’t remember her name, but I can still see her face and the fear in her eyes—and in the eyes of her family every time her cough triggered the alarm or she grimaced in obvious respiratory distress. She was on the ventilator—and much too young to be dying of breast cancer.

OctoberReflectionsSo begins the Reflections essay in the October issue of AJN. The essay is about how quickly roles can reverse themselves. It’s also about trying to strike a balance between efficiency and compassion; many nurses, we imagine, face some version of this challenge, if not so extreme, on a daily basis. Do you?

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