Make every day count
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EDITOR'S NOTE: April Hothersall, RN, OCN, CMSRN, works at Maine Medical Center in Portland. Patient name has been changed.
It was a fall evening shift, and I was hoping it wasn’t going to be as busy as my previous one. One of my patients was Luke*, a 34-year-old man.
People were uncomfortable caring for him because although he was close to death, he continued to agree to transfusions and treatment. I have to say I was one of the nurses who felt that way. Each day’s transfusions included at least two units of platelets and a unit or two of blood.
Some nurses questioned Luke’s decision because he was dying and blood was in short supply. He was of sound mind and was informed multiple times a day about his prognosis, and the decision to prolong life through transfusions was his call.
I received my report and then went to see patients. I saved Luke for last because I knew I would spend extra time with him. He was sitting up in bed and greeted me warmly. He always had a smile and a cheerful hello, no matter what was happening that day.
We first met when I was a new nurse, only a year and a half out of school. At that time, Luke was 32 years old, diagnosed with lymphoma, and was to have a stem cell transplant. I entered the room and was greeted by his cheerful hello and a smile that just lit up the room.
Luke taught me something textbooks and nursing instructors cannot. As nurses, we are fortunate to know things about the medical treatments we give and their outcomes. We sometimes question why a person would want to put themselves through the difficult treatments, the tubes, the wires, the multiple surgeries and the pain. What he taught me in those brief moments was that despite the many things we see, it is “one more day” that patients want.
I cared for Luke as well as I could. I made sure to comb his hair, so he looked great for the camera. I can’t say that each time I left the room I didn’t want to curl into a ball and cry, but I just focused on what he needed for that moment in time. I also started to help other nurses understand why he subjected himself to the treatments.
It was a few weeks later when I learned he had passed away peacefully. It was a difficult journey for him, but in the end he lived and died the way he wanted. I was very fortunate to have him teach me such a valuable lesson about life and my nursing care.
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I want one more day to see the sun rise and fall, one more day to hear voices of the people I love and one more day to tell my baby girl
I love her.”
— Luke
As I was performing his assessment, Luke told me he was a single dad of a 12-year-old daughter. He was worried about her because he was in the hospital. I could tell she was everything to him. As he told me about his daughter he started to put up pictures of her around the room, along with some of her drawings. I left the room committed to supporting him and his daughter during this difficult time. He did well through the stem cell transplant and was sent home when his blood counts recovered. Unfortunately, the transplant did not take and the lymphoma came back quickly. Luke was treated again in Boston, but that treatment didn’t take either, and when he came back to us, the disease had significantly progressed.
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Two years later, Luke still has that amazing smile and cheerful hello, but now I also could see the sadness in his eyes as he thought of his daughter. She lives with his elderly mother and comes to see him, usually after school. On this fall day, Luke was making his daughter videos to play at various points in her life; he was up to age 16. It’s a project he had been working on for weeks. Luke told me he wanted her to know how much he loves her and is proud of her and about all she can become and accomplish. Luke looked me in the eye and said, “You know I have fought hard and I want to fight right up to the end. I know people don’t understand why I am doing this and this is no way to live, but I just want one more day. I want one more day to see the sun rise and fall, one more day to hear voices of the people I love and one more day to tell my baby girl I love her.” He told me about the things he planned to tell her on the video. Choking back tears, I agreed to do whatever I could to help him. As I left the room, I couldn’t hold back the tears. How could you not cry after speaking with someone who knows he is dying and just wants one more day?
* Saturday, March 11th * 10:00am–6:00pm.
Are you interested in caring for medically complex children? The Elizabeth Seton Pediatric Center is a not-for-profit, pediatric specialty care facility, serving the most medically complex children in New York State.
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RN, RRT, CNA, Nursing Supervisor, Assistant Nurse Manager, Nurse Manager
Open House
Full Time/Part Time/Per Diem, Day & Night Shifts Saturday, March 11th, 10:00am–6:00pm 300 Corporate Boulevard South, Yonkers, N.Y. 10701 Instant Interviews will be held For a full description of these positions or to apply, please visit www.setonpediatric.org
The Elizabeth Seton Pediatric Center is a not-for-profit, pediatric specialty care facility, serving the most medically complex children in New York State. The Pediatric Center, which is a 137-bed and 165,000-square-foot complex located in Yonkers, is in its 28th year of service. We are nationally recognized for our state-of-the-art, child-centered building, which is the only LEED Gold certified “green” pediatric facility in the country. The Elizabeth Seton Pediatric Center is expanding its campus to care for an additional 32 ventilator-dependent children. This expansion, opening in June, will make the Pediatric Center the largest provider of pediatric ventilator care in New York State.
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By April Hothersall, RN, OCN, CMSRN
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How to make ethical decisions
What a patient wants should be of paramount importance when a decision needs to be made.
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Make every day count
A nurse helps a dying patient spend as much time as possible with his young daughter.
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Know the code
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Base your practice on strong moral principles.
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Are you an ethics champion?
Operate within three core responsibilities to make a critical difference in patients’ lives.
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CE catalog
From bioethics to palliative care, several education modules provide important ethics lessons for nurses.
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Detect human trafficking
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Keep it confidential
Nurses who work in the community are obligated to follow confidentiality and privacy policies.
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A beautiful death
Nurse learns valuable lessons about end-of-life care and experiencing a beautiful death.
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