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Stories from the point of care…for the love of nursing
Telling our stories about our ‘work as nurses’ can keep us connected to it in extremely satisfying ways. Yes, joy at work is possible with enough nurses of like minds determined that this is what they and their patients deserve. Kaleida nurses deserve this and have the ability with support from managers, educators, recruiters and leadership to grow and sustain a culture of value and respect, “joy”.
All of us have special stories, some of our most memorable experiences; the ones that touch our hearts and souls have involved our practice of nursing. Let’s take the opportunity to celebrate the extraordinary contributions of nurses and nursing. Please consider writing a few lines about your most memorable nursing experience and email to firstname.lastname@example.org.
Finding grace…. sometimes our patients teach us about the most important things in life without ever speakingDebbie Sciandra, RN, joined the Pediatric Intensive Care staff at WCHOB 24 years ago as a new graduate. Debbie says, “ I didn’t know I had found my niche when I first started in the PICU but I did come to realize this fairly quickly. I love my job! I really look forward to going to work, I feel really grateful, and I have such a wonderful team to work with! The patients and their families are inspiring, I feel honored to care for them”. As a true nurse Debbie acknowledges the blessings in “being fully engaged in the profession of nursing” impacts us personally as well as professionally. According to Debbie, “my co-workers, patients and their families have not only made me a better nurse they have made me a better mom, friend and person. “
Debbie recently took care of a young teenage girl who “touched” her and she felt the need to tell Grace’s (not her real name) story. Grace had been admitted a few years earlier but Debbie didn’t recall this at the time. When Debbie met Grace she was on a ventilator and unable to communicate. A sign hung over her bed “Let your Life Speak”; it would come to mean as much to Debbie and the PICU team as it did to Grace and her family.
Grace had quickly progressed from severe URI symptoms to a diagnosis of cardiomyopathy. During the next several weeks Grace had constant procedures and treatments and her progress was a roller coaster of response and relapse. It became clear that surgery was the only solution to address the numerous complications and deteriorating cardiac condition that was becoming Grace’s prognosis. Multi-system failure - liver, kidney, cardiac and several bouts of sepsis were weakening this “survivor” and her family. Still, everyone was “praying and rooting” for Grace and she was finally scheduled for surgery at the end of the week.
The next day Grace developed another fever; this was no surprise and even with another diagnosis of sepsis Debbie and the team felt that surgery would just be postponed. Everyone remained optimistic, sure that their “Grace” would persevere. Another round of antibiotics was initiated but this time, no response. Grace’s blood pressure started to fall. The team remained certain that Grace’s spirit and determination would once again prevail. The goal was clear; they needed surgery to realize it. Everyone dug in their heels, as did, it seemed, Grace.
Grace continued to deteriorate over the next 36 hours. Fluid resuscitation was necessary and continuous. Grace and her failing heart were assaulted with powerful isotopes to maintain perfusion to her vital organs without success. Coagulopathy followed, requiring continuous infusion of blood and blood products to stem the subsequent bleeding. An ultrasound revealed an acute abdominal process. The surgeons were once again consulted to see if they could cut away the “bad things” that were “killing” Grace.
Discussion regarding the goal of treatment was initiated and continued; Grace’s parents were left to wonder whether or not the goal was “OK” for Grace. As aggressive treatment continued everyone wondered and agonized over what would be best for Grace. Was the decision to stop, giving up? In retrospect it seemed Grace knew how impossible this decision seemed to be for those who loved and cared for her, to have to decide, and she died.
Debbie said that she was immediately struck by how brave and remarkable Grace was to relieve her parents and the PICU team of the burden of stopping treatment. At first it appeared as if the grief and anguish was overwhelming for her parents but then what really struck Debbie as remarkable was the presence of “grace”. According to Debbie what made her get up in the middle of the night after Grace’s death to record her passing was the power of “grace”.” In the midst of great suffering and death, I saw grace. I can still feel it when I think back to that moment. It is what sustains me when the outcomes aren’t what we and our families would wish”. Debbie feels that this is the privilege of nursing, to have enormous responsibility yet have the privilege of being in the presence of great love, courage and grace. Debbie encourages all nurses to look for it, grace, because it is there, everyday.