The Pain Left Behind: Reflections on a Medical Mission and an Island’s Overwhelmed Nurses

“My family left after the volcanic eruption,” Sister said to me with a heavy heart. “But I asked myself, who will take care of my fellow Montserratians who stayed behind?”

These poignant words reflect the resilience and dedication of the nurses I encountered during my recent medical mission to Montserrat. During my time on the island, I collaborated with cardiologist Icilma Fergus Rowe of Mount Sinai Medical Center in New York City, who returns each year to provide much-needed cardiac care. The team serves over 100 patients in just five days, providing essential cardiac consultations, follow-up visits, and diagnostic echocardiograms, as well as referrals for further treatment or testing in Antigua or sometimes the United Kingdom (UK).

Local nurses under strain.

While many patients waited all year for consultation with our team and our presence was met with gratitude, local nurses who facilitated this care also revealed to me that our visit placed additional strain on the already overwhelmed nursing staff. Now, as I reflect on the benefits brought by medical missions like ours, I remain aware of the poignant reality that when you leave, you leave behind hurting colleagues whose pain stays with you.

The lasting effects of a devastating volcano eruption.

This small island in the Caribbean 25 miles southwest of Antigua, once a thriving community, has faced numerous […]

2025-01-08T10:20:14-05:00January 8th, 2025|COVID-19, disaster preparedness, Nursing, Public health, volunteering|0 Comments
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The Critical Role of Nurses in Intravenous Fluid Conservation

Image credit: AHVAP.org (Association of Healthcare Value Analysis Professionals)

Baxter International’s North Cove Facility in North Carolina was severely damaged by Hurricane Helene on September 26, 2024. The temporary closure of that facility and production interruption has resulted in significant shortages in intravenous, dialysis, and irrigation fluids and supply disruption impacting health care facilities across the United States. The responsibility to effectively and responsibly manage these critical resources has fallen heavily on the shoulders of nursing teams and health care supply chain professionals.

The crucial role of nurses during shortages.

Nurses are responsible not only for administering IV fluids but also for monitoring fluid needs, assessing patient status, and adjusting plans of care accordingly. When these lifesaving fluids become scarce, nurses must ensure that every intravenous fluid or irrigation product is used wisely, balancing patient safety with resource availability.

Why conservation is essential.

The consequences of IV fluid shortages extend beyond inconvenience. Fluids such as 0.9% normal saline and Lactated Ringer’s are vital in stabilizing patients, hydrating those who cannot take fluids orally and serving as carriers for essential medications. Shortages can lead to critical delays in patient care, increased length of stay, and negative outcomes for patients who […]

2024-11-18T13:53:43-05:00November 18th, 2024|climate change, disaster preparedness, environmental health, Nursing, Public health|0 Comments
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A Chorus of Nursing Voices and the Timeless Truths of Ancient Tragedy

Nurses’ yearning to be supported and seen as human beings.

Fluorescent lights flicker. A relentless symphony of beeps and alarms, the scent of disinfectant wipes seeping through the fibers of a surgical mask. Keystrokes on keyboards keep charts in check while medications are meticulously prepared: the science of nursing, a 24/7, 365-day dance of care. In stolen moments of quiet—in empty locker rooms or bathroom stalls—the weight of the workload settles. Tears well up in eyes etched with exhaustion under the crushing burden of impossible patient ratios, the sting of disrespect from colleague and patient.

Nurses are classified as hospital overhead, a line item on a spreadsheet, and our humanity is rarely considered. A stolen sip of water during a 12-hour shift is a luxury. Bathroom breaks are a gamble, the ever-present fear that a patient’s need, a monitor’s alarm, or a desperate call for help will erupt the moment we look away. We are the invisible safety net, the unwavering presence, the nurse at your bedside.

Behind our dedication to our profession lies many unspoken truths. We function within a system that depends on our commitment yet has not committed to us and seems to forget the high price we pay for such loyalty. Though we are expected to quietly color […]

2024-05-08T09:27:02-04:00May 8th, 2024|Nursing|1 Comment
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A Pediatric ICU Nurse Finds Relief in Not Compartmentalizing Hard Emotions Like Grief

Editor’s note: Hui-wen Sato is a pediatric ICU nurse in California and a regular writer for this blog who has gone deeply into the topic of grief, her own and that of patients and their families. Her insights reverse our usual ways of understanding grief, finding a generative energy instead of a wasteland. Here is a key passage from a TED-style talk (see video below) she gave at the last End Well Project conference in November 2023. End Well is “a nonprofit on a mission to transform how the world thinks about, talks about, and plans for the end of life.”

“And so I realized that what I was going to need to learn how to do was not compartmentalize, but integrate all of my experiences into all of who I am. And as I started to learn how to integrate all of my experiences, there came a curious relief and freedom with this integration. Because I no longer had to pretend that I didn’t grieve for my patients. I could just grieve. And I could then get in closer and actually learn more about who they were, who their families were, and I could start to provide a kind of care I think I perhaps had always wanted to provide, but perhaps was a little too scared to get close enough to learn how.”

2024-03-28T14:03:14-04:00March 28th, 2024|end of life, Nursing, pediatrics|0 Comments
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The Pitfalls of Being the ‘Nice’ Patient: A Nurse’s Perspective

Image Brent Keane/via Pexels

I have often heard health care professionals in various environments say, “If you’re nice to the nurses and doctors who take care of you, you’ll get better care.” As a bedside nurse myself, I understand the sentiment. No busy health care worker loves being met with antagonism or pressing demands that don’t strike us as critically urgent.

But when my husband and I both became patients with serious illnesses last year, we learned the clinical pitfalls of being the nice patients. I am left wondering how patients should be expected or permitted to advocate for their own care without worrying that they will be frowned upon or brushed off because they’re perceived as “difficult.”

First cautionary tale.

In early 2022, I discovered a small lump under my right breast that I initially wrote off as a cyst. Surely, I told myself, as a woman in her mid-40s with no risk factors for breast cancer, this had to be benign. A screening mammogram in May 2022 gave me an all-clear, and I went on my way.

But by November, I knew the lump had grown. I reached out to my PCP to ask for a diagnostic mammogram, and he emailed back a casual reassurance. “I know you’re worried, but I’m […]

2024-02-07T16:57:09-05:00February 6th, 2024|Nursing, nursing stories, patient experience, Patients|15 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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