Well - Tara Parker-Pope on Health
December 22, 2010, 12:23 pm
Simple Gifts on the Hospital Floor
By THERESA BROWN, R.N.
Svitlana Niedielska

I think it’s safe to say that no one wants to spend the holiday season in the hospital. Whether you find this time of year inspiring, oppressive or a bit of both, the hospital tends to feel a little more alien than usual.

It’s a hard thing about the job of nursing. For many people December brings a slower pace to work. People and families come together. We open presents, eat too much and stay up late. Fireplaces get used, friends give gifts of cookies and neighbors take the time to chat despite the cold outside. In the hospital, though, it’s business as usual.

But that doesn’t mean it’s without its gifts.

My very busy day began at 7 a.m. Among my patients was a woman in her 30s with severe mouth sores, a difficult side effect of chemotherapy and immune suppression. The pain can be so great that patients need more or less continuous narcotics. The special pump we use for self-administration of pain medicine is called a PCA, for patient-controlled analgesia. Because it contains a narcotic stored in a large cartridge, the nurse can open it or adjust its settings only by using a special key.

On my floor, PCA keys seem to disappear with the frustrating regularity of matching socks in the clothes dryer. That day, late in the afternoon, I realized the key that usually hung by a slim rubber band from my wrist was no longer there, and I had no idea when it had gone missing.

I looked all over the patient’s room and checked through, under and around the cart that holds my medications. I tried hard to think when I had last seen the key, but the afternoon had been a flurry of activity and it was the last thing on my mind.

The lost key was the only one available for the entire floor. I needed to find it.

I told the charge nurse I had lost the key. She thought it likely I had accidentally thrown it away while taking off the gloves and gown we wear for patients on isolation precautions. It made sense. We take off our gowns by pulling them down and off, with the gloves attached. I saw how the key could easily get caught up in the gloves and end up in the trash.

The problem was, I had no time right then to sift through the garbage looking for the key. I needed to get caught up with other patients before going to look for it. My patient with the mouth sores could, for now, still medicate herself. But my other patients needed things only I could do: give pills, hook up IVs, draw blood for labs.

I was feeling very frustrated at not being able to be two places at once when the charge nurse, along with another nurse, put on gloves and gowns and started the very unpleasant job of going through wastebaskets in search of the missing key.

They started with the wastebasket on my med cart, then moved into the room of the patient with the PCA. Still with no success, they quietly started in on the trash for the patient on isolation.

Then, as I was coming down the hall, they emerged from the isolation room. The charge nurse smiled at me and held up, hanging from a thin beige rubber band, the small, shiny key.

I squealed and hugged her. She looked at me archly, but also happily. “I hope we’re at least going to get a coffee out of this,” she joked.

I promised her they would. For me and my fellow hospital workers, “coffee” has a meaning that goes beyond the standard cafeteria java. It means the mocha drinks and lattes, even hot chocolates with frothy whipped cream, from the coffee shop across the street. It can be a taste of happiness, an artificial slowdown in an otherwise nonstop day.

So when the three of us were back at work the next day and another nurse volunteered to go across the street to get coffee, I handed over my card and insisted on treating my colleagues to whatever they wanted.

One of my favorite Christmas images comes from the 1966 cartoon version of Dr. Seuss’s “How the Grinch Stole Christmas.” Near the end of the story, the Grinch has collected a sled full of toys, decorations and canned hash that he’s stolen from all the Whos. As he is about to dump them atop the highest mountain in Whoville, he hears the singing of the townspeople in the valley below, awakening him to the idea that Christmas is about more than just presents and tinsel. As the sled slowly slips over the edge of the peak, the Grinch finds the strength to rescue the sleigh and hold it proudly over his head, and we hear, “The Grinch’s small heart grew three sizes that day.”

Sometimes I wonder if I have enough heart to do this job. My shifts are challenging enough. Losing the key made it feel that much harder.

But having my colleagues sift through the trash — I never imagined that could feel like such a gift, that the generosity of two nurses could make my own heart feel so much bigger on a difficult day. And they did it unasked, without saying much and, despite the coffee quip, not expecting anything in return.

It’s the holiday season. For all of us in health care, the work and the giving continue.