Intensive Care of a Different Ilk

MayReflectionsIllustrationThis month’s Reflections essay (“Intensive Care”) is by John Fiddler, an NP who describes his work as an inpatient hospice nurse in New York City as being “as close to the ideal of nursing as I have ever been.”

This is a big claim—but if you read Fiddler’s brief, artful summary of the evolution of his nursing career, which started in an actual ICU, and then his description of what he found when he went to work in a hospice, you might find that he makes a pretty good case.

Here’s a small excerpt:

Inpatient hospice to me was the room at the end of the palliative care corridor that I had never bothered to visit. I had pictured it as a quiet haven for the dying, where birds chirp outside and music is heard playing through open windows as patients calmly drift off and up into dusty shafts of sunlight.

Not quite.

Instead, picture a unit where patients arrive on stretchers in extreme pain and distress, afraid, breathless—usually with families trailing behind, holding on to as much emotional and personal baggage as they can carry. Often these patients bear the physical and psychic bruises of a prolonged ICU stay.

And this is what happens here…

Maybe the author will someday find another ideal of nursing care, or maybe he won’t, but it’s worth reading his account of the current one. Reflections essays are open access. (Click through to the PDF version for the most attractive, readable version.)—Jacob Molyneux, senior editor

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2016-11-21T13:04:48+00:00 May 9th, 2014|career, nursing perspective|2 Comments

About the Author:

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


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  2. Ashley K. May 9, 2014 at 10:38 am

    I started my nursing career in 2010 in a med/surg/oncology unit. A move to a new state found me working at a 24 bed inpatient hospice unit. It is more medically intense than I ever imagined, with chest tubes and TPN and wound care. Playing a role in getting a patient’s pain, nausea, or dyspnea under control is far more satisfying than administering another futile round of chemo to a patient who should be home and enjoying what time they have left with their families. Hospice truly is the most intense form of nursing I have done, and the most soul-satisfying as well. Thank you for putting that into words so eloquently.

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