Family & Patient SupportNursing & Caregivers

Nurses’ Notes: A Nurse Manager’s Philosophy on Nursing

By May 6, 2009 4 Comments

“Courtney, room 358 has called out for you,” the secretary advises. Although I know the call is coming, my heart catches in my throat. Slowly I make my way down the hall. I pause at the door knowing what I will see, but not knowing what to expect. It will indeed change my outlook on nursing forever.

Fresh out of nursing school, I came to the Aflac Cancer Center bright eyed and eager to learn. Although I question if this place will be right for me, and if nursing is the right profession at all, I feel confident that I will do well. After all, I feel like I have a good grasp on what nursing is all about. I have taken Pharmacology, Medical-Surgical, and similar courses. I have studied the theorists and philosophers from my field, and completed all my clinical rotations with ease. However, because the cancer unit is such a specialized field, I do feel a bit uneasy about the amount of information I will have to learn.

I quickly realize the amount of information that I must know is vastly overwhelming. I feel I will not be able to learn all this material over the course of my three month orientation. However, according to my preceptors, I adapt easily and have a good bedside manner. I am able to perform all tasks quickly and efficiently such as assessments, vital signs, interventions, and charting. I talk with the patients about their care, and I am kind, yet professional. I remember what I learned in nursing school, and do not want to develop the relationships further, for I might blur the boundary lines we must set in our profession. I work hard to complete all my tasks, trying not to leave anything for the oncoming nurse. To be a nurse means to address the patient’s healthcare needs. Some examples of these needs are giving the patient medications, assisting in activities of daily living, and completing dressing changes. I believe that being a nurse means that we are to assist patients to reach the highest level of wellness of which they are capable. This is what nursing is all about, right?

I slowly open the door, and see my sweet little Ali* lying in the bed. The room is dark, cold, and quiet, with the only sound being the IV fluids running through a pump. Sitting beside Ali is her father, Joe*, holding her hand and softly rubbing her arm. Memories of Ali quickly rush through my head. I remember the first time I saw her walking to the floor, the stubborn way she would not speak to me for the first week in the hospital, the way she rode her bicycle around the nurse’s station for exercise, how she loved to watch the movie Shrek, and how she loved to listen to music. She would make her dad and me sing “Somewhere Over The Rainbow” to her over and again. I remember all her completed art projects I have all over my refrigerator, how much she loves her daddy, her sweet laugh, and how much she would say “I love you”. I quietly sit on the other side of the bed and grab her other hand. She opens her eyes, and I smile. Her breathing is erratic and noisy as I say hello. She says hi and closes her eyes. Sitting with her, I realize that thirty minutes seems like an eternity. She opens her eyes again, and in her sweet voice asks her dad, “Who will take care of you daddy?” Her father softly replies, “You will baby, from heaven.” The four year old, content with that explanation, softly says “sing.”

It is at that moment that I have put it all together. My philosophy on nursing should not and could not just be to provide my patients with the highest level of wellness of which they are capable, but nursing is really so much more. Nursing is being able to put science and practice together with meeting a person’s personal needs. Nursing is not only about the science or completing activities and tasks, but it is about developing relationships with your patients in order to meet their needs. It is about listening and communicating with them on a level that makes a difference. It is being a teacher, an advocate, a confidant, and someone they completely trust. Nursing is about putting all the above together to guide your practice.

Ali’s father looks at me with his eyes filled with tears, and tries to sing. He opens his mouth, but no words will come out. I grab his hand and I begin to sing instead. A familiar tune fills the room. I know to this day that I made a difference in the life of this family. Joe has told me many times that out of all the nurses his daughter had, I demonstrated to him what nursing should truly look like. Do you think that Joe remembers the dressing change I completed every week, or the bed I changed daily, the Nasogastric tube I put down, or the chemotherapy I gave? Maybe, but what was most significant to him was that I knew him and Ali so well. Someone else may not have known at that most important moment, when there could be no words, what the real need had been. In the moment of her death, when he was unable, I softly began to sing “Somewhere Over The Rainbow.” To Joe, that made all the difference in the world.
*Names have been changed.

Join the discussion 4 Comments

  • Thank you for posting this.
    Our 6 yr. old son has battled cancer twice now and we are forever indebted to the incredible hospital staff.
    One moment I’ll never forget is when our son had his relapse a year ago. It was the day after we had found out and we had just come up to the oncology floor after another scan. There were some issues during the scan and our almost 5 year old son had to receive 3 pokes instead of the already dreaded 1 poke. By the time we got upstairs you could tell our son had been crying for quite some time just by the look on his face. Our nurse asked what happened and we explained. As we were talking to someone else, I turned back to find our nurse sitting on the hard hallway floor with our son in her arms as she rocked him. I will forever remeber that moment.
    We are so grateful for the staff at our hospital, Helen Devos Children’s Hospital in Grand Rapids, MI.
    Thank you!

  • Janine Wenclawiak says:

    Thank you to all the nurses on the oncology unit at Childrens Healthcare of Atlanta and the nurses at Aflac blood and cancer center. They have gotten us through this horrible time in our lives as our daughter Ava battles leukemia. They are the best!!

  • Margaret Ast says:

    My family and I have never been cared for as well as we were at the Aflac units at both Egleston and Scottish Rite. It takes a special person to work as a nurse, tech or doctor on those floors. I think it is impossible not to create an intense emotional bond with these people because when a child has cancer there is such a sense that no one else can possibly understand what you are going through as a parent. The hospital staff comes the closest with their kind service, presence, smile, laugh, touch, and even as in this case, a song. They make up the good memories in the cancer experience that can be found and remembered tenderly years later. It’s a very difficult job, and I am incredibly grateful for our nurses!

    Mother of an AML survivor

  • sanganagowda says:

    i m BSc Nursing staff would like to know more

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