Can Nurses Care Too Much? - Well Blog - NYTimes.com - The Diigo Meta page

• 20 Feb 09
  

  rein608
• 06 Feb 09
  

  Ben Wheeler
  • “I don’t know,” I told him, turning away to put the used syringe in the sharps container. My voice seemed small and tinny. “I wish I could look in a crystal ball and find out, but I can’t,”
• 

  Preston King
  • “If he dies I don’t know what I’m going to do,”
  • These are basic tests of neurological function
• 

  Ashley Hadden
  • In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • autologous stem cell transplant
  • 5 more annotations...
  • • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.
    • “So am I gonna live or am I gonna die?” he asked me.
    • This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me.
    • C.M.O. means “comfort measures only”
    • A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  cameron carlock
  • In medical oncology our patients stay in the hospital often for weeks or even months.
  • And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • 7 more annotations...
  • • I had been his nurse off and on since his initial diagnosis the previous spring, and had cared for him more recently after an autologous stem cell transplant.
    • I had been his nurse off and on since his initial diagnosis the previous spring, and had cared for him more recently after an autologous stem cell transplant.
    • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
    • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
    • She had remained calm and kind throughout his many hospitalizations, but I could hear the worry in her voice.
    • Why did this patient matter so much to me? This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me. One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car. The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.
    • The lounge to the N.I.C.U. was filled with his family members, all sad, some crying. I saw his wife, who hugged me. She asked me if I wanted to see him, but I said no, since he wouldn’t have known me. Instead, we talked about the two of them, about trying to pick up her life, about making sure that he wasn’t suffering. When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.
• 

  kathryn jones
  • In medical oncology our patients stay in the hospital often for weeks or even months.
  • In medical oncology our patients stay in the hospital often for weeks or even months.
  • 6 more annotations...
  • • or because they need more chemo, or because they’ve relapsed
    • autologous stem cell transplant
    • a no-win situation where compassion routinely gets hijacked by grief
    • On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.
    • I asked him to follow my finger with his eyes and to push up and down against my hands while I pushed back. These are basic tests of neurological function
    • When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.
• 

  asmira delic
  • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief
  • The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
  • 2 more annotations...
  • • “I wish I could look in a crystal ball and find out, but I can’t,” I said, forcing myself to turn back around and look at him.
    • It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  Jillian Wilson
  • We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.
  • 3 more annotations...
  • • We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
    • The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.
    • It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  Samantha Raley
  • In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • “If he dies I don’t know what I’m going to do,”
  • 6 more annotations...
  • • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.
    • but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
    • The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world.
    • I had several days off following that shift and I called work on my third day at home to ask about him. “C.M.O.,” our secretary told me, and I swore into the phone
    • When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.”
    • It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  Cassie Morris
  • I asked Theresa Brown,
  • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.
  • 4 more annotations...
  • • something just seemed off.
    • One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car.
    • I called work on my third day at home to ask about him.
    • When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.
• 

  Austin Morrow
  • Theresa Brown
  • medical oncology
  • 7 more annotations...
  • • chemo
    • autologous
    • no-win situation
    • but we’re the ones who are always there
    • ammonia levels were rising due to his failing liver
    • who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me
    • cerebral bleed
• 

  kenneth durlin

  nursing

  • Too Much
  • “If he dies I don’t know what I’m going to do,”
  • 3 more annotations...
  • • The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.
    • He died later that day
    • It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  thomas reinscheld

  nursing

  • Too Much
  • we end up caring about them.
  • 3 more annotations...
  • • will be a nurse
    • Why did this patient matter so much to me?
    • Now, though, he was struggling.
• 

  Steffphon Pettigrew

  Nursing

  • Too Much?
  • oncology
  • 1 more annotations...
  • • She ordered a CT
• 

  jamie silverberg

  nurses caring too much

  • Too Much
  • And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • 1 more annotations...
  • • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief
• 

  Bradley Venable

  Nursing

  • Theresa Brown
  • medical oncology
  • 5 more annotations...
  • • we’re the ones who are always there.
    • heparin, a blood thinner,
    • “So am I gonna live or am I gonna die?” he asked me.
    • This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me.
    • but I said no
• 

  Danielle Hogue

  nurses

  • Too Much?
  • , but we’re the ones who are always there.
  • 2 more annotations...
  • • Why did this patient matter so much to me?
    • It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  Justin Jenkins

  nursing health hospital

  • Too Much
  • we end up caring about them.
  • 1 more annotations...
  • • If he dies I don’t know what I’m going to do,
• 

  Toni Marvel

  oncology nursing

  • Too Much
  • . One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car.
  • 2 more annotations...
  • • I love you
    • You girls get too attached,
• 

  chris bullard

  oncology nursing

  • Too Much?
  • In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • 1 more annotations...
  • • if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.
• 

  david moyes

  nursing

  • Too Much
  • a patient I had gotten to know well,
  • 1 more annotations...
  • • “If he dies I don’t know what I’m going to do,”
• 

  mary huynh

  Oncology nursing

  • Too Much?
  • autologous stem cell transplant
  • 3 more annotations...
  • • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death
    • The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.
    • When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day
• 

  mary claire elson

  oncology nusing

  • Too Much?
  • The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.
  • 2 more annotations...
  • • I called work on my third day at home to ask about him. “C.M.O.,” our secretary told me, and I swore into the phone. C.M.O. means “comfort measures only”: they were withdrawing care.
    • It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.
• 

  jamie brown

  oncology nurse

  • Too Much
  • We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.
  • 5 more annotations...
  • • person caring for you in your last days, hours, and minutes will be a nurse
    • We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
    • So am I gonna live or am I gonna die?
    • Why did this patient matter so much to me
    • One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car.
• 

  maegan young

  oncology nursing

  • Too Much?
  • But what about nurses?
  • 2 more annotations...
  • • When I did my initial assessment of the patient that afternoon, something just seemed off
    • Without even thinking about it I decided to go to the hospital where I knew his family would be gathered.
• 

  Tabatha Phelps

  oncology nursing

  • Too Much?
  • We get to know them
  • 6 more annotations...
  • • we end up caring about them.
    • a no-win situation where compassion routinely gets hijacked by grief.
    • if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.
    • “He’s got a fever!” I said, as if it was the first fever in the history of the world
    • C.M.O. means “comfort measures only”: they were withdrawing care
    • When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.
• 

  jeremy evans

  oncology nursing

  • Too Much?
  • is scary and ominous.
  • 2 more annotations...
  • • Could the heparin have caused a bleed inside his head?
    • “I wish I could look in a crystal ball and find out, but I can’t,” I said, forcing myself to turn back around and look at him.
• 

  Terry Elliott

  oncology nukr4sing

  • Too Much?

    • 

      Terry Elliott on 2009-02-06

      I suppose, but the author I hope answers this.
  • we end up caring about them.
  • 8 more annotations...
  • • we end up caring about them.
    • rural Pennsylvania for years
    • is scary and ominous.
    • a no-win situation where compassion routinely gets hijacked by grief.
    • f you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.
    • I called the doctor. She was leaving the hospital for the day when she got my page, but she came back and examined the patient. His ammonia levels were rising due to his failing liver, something that can cause “mental status changes.” He was getting large doses of heparin, a blood thinner, because of his clot. Could the heparin have caused a bleed inside his head? The doctor’s exam, like mine, showed some deterioration in neurological function. She ordered a CT of the patient’s head and she prescribed a treatment to bring down his ammonia levels
    • C.M.O. means “comfort measures only”: they were withdrawing care.
    • she’s right, of course.
• 

  Cory Gearlds

  Nurse Care

  • Too Much?
  • In medical oncology our patients stay in the hospital often for weeks or even months.
  • 8 more annotations...
  • • We get to know them, their families, even their friends.
    • “If he dies I don’t know what I’m going to do,” I confided to the dayshift nurse. She looked at me, then looked down at her papers and nodded.
    • This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.
    • ut if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.
    • e watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.
    • I called the doctor. She was leaving the hospital for the day when she got my page, but she came back and examined the patient. His ammonia levels were rising due to his failing liver, something that can cause “mental status changes.” He was getting large doses of heparin, a blood thinner, because of his clot. Could the heparin have caused a bleed inside his head? The doctor’s exam, like mine, showed some deterioration in neurological function. She ordered a CT of the patient’s head and she prescribed a treatment to bring down his ammonia levels.
    • Why did this patient matter so much to me? This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me.

    • The lounge to the N.I.C.U. was filled with his family members, all sad, some crying. I saw his wife, who hugged me. She asked me if I wanted to see him, but I said no, since he wouldn’t have known me. Instead, we talked about the two of them, about trying to pick up her life, about making sure that he wasn’t suffering. When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

      
      

      It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

Public Stiky Notes

• 
  Terry Elliott on 2009-02-06
  I suppose, but the author I hope answers this.

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