A Chinese Dialysis Nurse’s Moving Story About Chronic Illness

Skip Navigation Links“I’m preparing for the university entrance exam,” he often told me. He was upbeat and grateful, despite the disease. I admired him for his strength and spirit and felt terrible that he’d been diagnosed so young.

CaptureThe March Reflections, “Skipped Two Times,” submitted to AJN by a dialysis nurse from China, is about a potentially avoidable crisis in the health of a young man with renal failure secondary to lupus. It’s about chronic illness, patient self-management, and a nurse’s remorse.

To my knowledge this is the first Reflections essay by a Chinese nurse that we’ve published. We’ve already heard from more than one reader who was moved by the story. It’s free, so give it a look.—JM, senior editor

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2016-11-21T13:08:11-05:00March 7th, 2013|nursing perspective|0 Comments
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Precarious Hope: A Hospice Nurse Balances Truth and Kindness

This couple might be your elderly neighbors: he helps his wife into the house as she moves slowly, step by unsteady step, in time with her four-point cane; at the same time, you know that he is recovering from recent chemotherapy treatments. Or they may be your aging parents: your mother’s role as primary caregiver hampered by her right leg weakness from a stroke and advancing heart disease, while your father needs more care from day to day as his renal failure approaches the decision to begin dialysis or not. They support and care for each other.

PrecariousHopeIllustrationThe December Reflections column in AJN, “Precarious Hope,” is by an RN case manager at a hospice. She describes a couple in which one partner has dementia and the other has cancer, their mutual dependency, and the challenge of knowing how best to care for them:

In hospice, I’m often confronted with the difficulty of balancing honesty with kindness. I love a quote often attributed to the Buddha: “When words are both true and kind, they can change our world.” It follows that sometimes what is true is not kind, and that truth must be cloaked in kindness—as in this instance, as I sit at the table listening to George, whose hopeful, unrealistic comments confirm that he simply can’t hear the truth.

It’s a sensitive portrait of love, the fine line between self-delusion and perseverance, and the way that sometimes simply bearing witness is the […]

2016-11-21T13:08:44-05:00December 14th, 2012|nursing perspective|1 Comment
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Can’t Even Think About It: An ICU Nurse’s Personal Taboo

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

The weekend was busy in the ICU; several critically ill trauma patients were admitted in quick succession and the unit was filled with grieving families. The air was heavy with tragedy and misery, and it was draining to work under such weight.

I had a single day off, which didn’t feel like enough, and when I returned to work there were new patients in the beds and the mood in the unit had drastically changed. Disarming, but not surprising; the ICU is always the same and yet different.

One of the young patients from the weekend had become an organ donor, which had been anticipated and was considered a positive outcome, relatively. In discussing the weekend events and the ways in which things had resolved, one of my colleagues mentioned that, if given the opportunity, she’d embrace the chance to go to the operating room with the organ procurement team. Her beloved niece had been an organ donor and she sees organ donation as a validation and continuance of life, an ultimate example of “paying it forward.” She takes great comfort in knowing that her niece did not die in vain; lives were saved. She’d like to see, firsthand, the workings of the surgical team as they extract the organs.

“I would never do that,” […]

2016-11-21T13:09:07-05:00October 10th, 2012|nursing perspective, Patients|4 Comments
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The Kiss: Hope in the ICU

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

by limegreeen9, via flickr creative commons

I always look forward to interdisciplinary rounds. I’ve worked with most of the team members for years and enjoy the differing perspectives and collaboration. Today is no exception; I know my patient very well, as he’s been in the ICU for months. As the interdisciplinary team moves through the ICU like a small mingling mob, pausing at each room for a brief nursing report and lingering for discussion, I stand in anticipation, ready to present my patient’s case.

My report, though, is politely cut short by the medical director.

“What’s changed?” he wants to know.

And I feel pressed to produce some crumb of improvement. 

“Well…” I say. “He kisses his wife. His GCS* remains eight, but he kisses his wife.”

A few people smile, and I hear a few chuckles.

“It’s a reflex!” I hear someone say as they move away.

I know, of course, how little the kisses mean from a medical standpoint. His initial injury was neurologic, and his neuro status is quite compromised, but stable. His cardiovascular, gastrointestinal, and genitourinary systems are stable, as well. It’s respiratory insufficiency that keeps him in the unit. Puckering his lips in response to his wife leaning towards him is not significant […]

2016-11-21T13:09:58-05:00June 4th, 2012|Nursing, nursing perspective, nursing stories, Patients|4 Comments
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At the Terminus of Romantic Dreams, an ICU

It was early. The sun had yet to rise, but already the ICU was filled with stark fluorescence and beeping alarms. My patient sat alone and aphasic, helpless amidst the bustle of the unit. The day stretched long ahead of us.

The circumstances of Frank’s admission were unusual. The nursing report (conveyed with a snicker) was that, while vacationing in our coastal city with his mistress, he’d slipped away and visited yet another lady friend. While engaged in an “intimate” act, he’d hit his head on the coffee table and been knocked unconscious.

The paramedic’s report backed up that version of events, but Frank’s admission CT scans of the brain weren’t consistent with head trauma. Instead, a vascular abnormality was found. He’d suffered two seizures since admission to the hospital.

That’s the start of “The Love Song of Frank,” the Reflections essay in the May issue of AJN. Click on its title to read the entire essay (and, once there, perhaps click through to the PDF version for the best read). 

Those of you who know the T. S. Eliot poem “The Love Song of J. Alfred Prufrock” (beautifully spun, and a favorite of bookish adolescents for its highly quotable and world-weary take on conventional society) will recognize the irony in the title.

But the essay, by ICU nurse and regular AJN blogger Marcy Phipps, stands on its own in its sympathetic but unsentimental description of a nurse’s encounter with a man who’s reached the limits of […]

2016-11-21T13:10:15-05:00April 26th, 2012|nursing perspective|3 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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