Wednesday, March 31, 2010

Popsicles & Pudding

I walked by the nurses' station, casually glancing through the open doorway. Happy for what I saw, I immediately came to a halt and backed up a few steps.

Kids. Two of them. Innocent, smiling grade-schoolers. Sitting on blue vinyl-topped stools at the nurses' work counter. They were doodling in thin, grayish, hospital-issued coloring books, crayons spilled to the sides of their pages. In front of each child, a plastic pudding cup sat, a white spoon handle rising from the middle of each chocolate mess. Stickers covered the rest of their counter space, layered like replaced shingles randomly tossed from roof to ground. The kids looked happy, content.

I couldn't help but smile to myself. Another nurse had earned her wings.

As with any other profession, to be in the medical field, you must carry a certain spectrum of talents. A sufficient font of medical knowledge, of course, accompanied by a respectable work ethic. An inherent sense of the happenings in the workplace. Passion. And respect for your fellow mankind, regardless of whatever capacity you encounter them in.

Most important on my list, though? Compassion. Easily. And not just compassion, but compassion delivered with kindness. Imagine, two staff members are each giving a homeless person a turkey sandwich. One tosses the sandwich to him as he's walking out the door. End of story. The other hands the sandwich over, sharing some eye-contact and a smile, maybe even shaking hands or patting the homeless person's shoulder.

Same task accomplished. But which one delivered the compassion with kindness? Was the energy necessary to be kind in this circumstance monumental? Hardly. When I saw these kids sitting comfortably in the nurses' station, I was recognizing a nurse's compassion delivered with kindness.

As it turns out, these children were in our ER with their sick mother. Fever, vomiting, diarrhea, abdominal pain--all symptoms that made the mother nervous. A single-parent household, a single-income checking account. No local family. No available babysitters or friends. No time to be sick. No choice but to bring her two younger kids with her to the ER.

The kids were typical elementary school-age kids. Initially, when they arrived, the kids sat in the lone corner chair of the treatment room, squeezing themselves between the black, plastic armrests. While their mother changed into a hospital gown, had her vitals taken, and had an IV started, these little kids sat quietly, a little confused and a lot scared, I suppose, soaking in all the happenings. After their mother was made comfortable, the nurse ran and got each child an Italian ice and turned the television on to a suitable station for them.

Soon, as kids do, they started getting a little more comfortable and exuberant within their surroundings. The TV remote became their dodge ball. The volume was played with, the channels were flicked randomly, and some minor argument started over which child had more room in their shared chair. Finally, to help the mother get a little rest and receive her treatment in a quieter setting, the nurse removed the children, taking them to the nurses' station and setting them up with some distractions and pudding.

It worked. And that's when I happened to walk by, finding two calm, coloring kids snacking on pudding.

"Hi, guys," I said to them, looking over their shoulders at their colorings, "nice job. You both are really good at coloring."

They both looked up at me, not sure what to make of me since I wasn't their mother's doctor and they had never met me.

"Don't stop coloring on my account," I told them, "I just wanted to say that you both are doing a great job there."

They showed me their shy smiles before continuing on.

Jamie, the secretary at this station for the day, shared with me the kids' story. When she was done, I was smiling big. "Thanks for helping out with the kids, Jamie," I said, "I'm sure this wasn't in your job description."

"Not a problem" she said, herself the mother of a very nice, respectful middle-school son, "this is the fun part of my job."

Jamie told me which nurse was taking care of these kids' mother and, because I had a few free minutes, I sought her out. She was a recent graduate and had just started in our ER this past summer. Already, she had impressed me with her skills and knowledge and work-ethic. Now, I would add compassion to her list of strong credentials.

"Lindsey," I said, standing in the hallway, "do you have a minute?" "Sure," she answered, looking a little nervous, "what's up?" "It's nothing bad, Lindsey," I assured her, "I just wanted to tell you how impressed I am with the way you extended yourself to those children of the sick mother. I'm sure she really appreciates your kindness to her kids."

Lindsey blushed, asking, "Are you being serious?" I nodded my head "yes" as she searched my eyes to make sure I wasn't razzing her, that I wasn't in one of my silly, joking moods. "Completely serious," I finished, adding, "you went above and beyond making those kids feel comfortable while their mother was here getting treated. Well done."

She thanked me for acknowledging her work and then we both continued on with our work.

Before any nay-sayers speak up, I know, I know--we're not running a baby-sitting service in the ER. Flipping that coin, some might dare say that every patient deserves this customized, special treatment. Sometimes the ER setting is so damn busy, though, that despite our best intentions, we just don't have the time to devote to these extended acts of kindness. During those times when the hallways are packed with patients and chaos is smacking us around, we are focused on delivering excellent medical care. Quickly. At these times, unfortunately, the extra kindness and compassion that most of us strive to give may be sacrificed, pushed to the sidelines, to ensure our patients, sometimes with dire illnesses, receive quick, prompt emergency care.

In the midst of that day's shift, an act like Lindsey's served as a reminder of why most of us entered the medical field in the first place--to take care of patients and their families. To provide them the same treatment we would want our family to receive. To not get caught up in the rush of things and remember to be kind and extend our compassionate selves.

Lindsey didn't need to get the kids popsicles and situate them to watch TV. But she did. She didn't need to get them pudding, coloring books, stickers, crayons, and set them up outside of their mother's room, offering up her precious counter workspace and stools. But she did. Jamie didn't need the hassle of trying to accomplish her secretarial work while keeping an eye on the two kids sitting beside her. But she did it without complaint.

Despite the chaos, they extended themselves. And although Mom didn't demand it or expect it, I'm sure she appreciated the kindness shown to her kids while she lay ill in bed. What parent wouldn't?

So, a salute to Lindsey and Jamie. Makes me proud to be on their team.

I hope they treat themselves to a popsicle and pudding for a job well done.

As always, big thanks for reading. Next post will be Friday, April 2. Hope your week is going well. Until then...


WrightStuff said...

Reminds me of a time I'd like to share and to give thanks to the nurses concerned. My marriage was breaking up. Just to make things worse my husband suffered a freak accident and ended up in the ER in a neck brace and suffering back spasms. He was dosed up with morphine. I was in hysterical tears at both the sight of him and knowing my marriage was ending. Nurses whisked me and two year old toddler away - giving him attention and toys and me compassion and understanding. They weren't told about the marriage thing but somehow they knew my tears were more than just worry about the man in the bed. I wasn't the patient but they looked after me as well as if I was and I will never forget that kindness.

Katie said...

The other day in class we struggled to come up with a definition for "compassion". This is what we decided:
Compassion: emotion and action, caring and acting appropriately.

It was definitely exemplified here.

And good for you for taking a second to affirm both of these fine women.

<>< Katie

Empress Bee (of the High Sea) said...

beautiful story doc. a few years ago i had a lung removed and had the meanest nurse in the world. one day i was really feeling bad and got up the courage to ask her why she was a nurse. she stopped in her tracks. she looked me in the eyes. she said you know, i don't know. maybe it's time for a change. i agreed with her.

my daughter is a nurse and so compassionate. i am very proud of her.

smiles, bee

DownDoggin in MN said...

A salute to them and to you for taking time out of your busy schedule to acknowledge a positive action. So many times we only acknowledge the mistakes, I'm sure you made Lindsey's day a little brighter.

Jacqueline said...

It makes all the diference....when my mom was in the hospital back in January, we had the absolute best nursing staff...sure a couple were kind of loopy, but overall, they were awesome...answering our questions as best they could...comforting us...getting us what we needed as quickly as possible...the compassion extended even to the custodial custodian specifically always came in with a smile, got us extra pillows, made sure the room was extra clean, and she always asked if we needed anything and would get it or find someone who made a difficult situation a lot easier.

Carolynn said...

I don't have kids, but I'd hazard to say that Lindsay's act of calming the children worked to calm the mother, as well.

Anonymous said...

Nice post. I think you maybe could have stopped right after, "Another Nurse just got her wings," because the rest of the post came through in my imagination. But, as always, a great storyteller!

littlepretendnurse said...

What a great story. And I love how you sought her out to recognize her. I know that is not why she did it but the acknowledgment always feels good.

Rositta said...

I was a single Mom for a time but I was lucky enough to have some parental support when I became ill and hospitalized. Kind nurses are angels in my view and there aren't enough of them. The nastiest nurse I ever had was when I had a hip replacement. She was angry that I needed to buzz her to go to the loo at nigh. I wasn't permitted to get up alone yet. She was really a piece of work for sure...ciao

WWWebb said...

I don't bother reading your posts any more before sharing.g them on Facebook. I put them up annd then go back and read them. Consider this to be a positive affirmation of the quality of your writing.

Anonymous said...

As a former single mom, I'd like to say thanks for the kindness you and your staff strive to show those who turn up in your ER, for whatever reason. A kindness done is a kindness received. Everyone wins.

Nice story, Dr. Jim. :o)

Cathy said...

I have been on the receiving end of both type of nurses and caregivers. Most recently I had the best care anyone could ever expect. I mean that from the Doctors all the way to the kitchen staff, and housekeepers. Everyone went out of their way to be kind to me. The nurses were really the best I ever had. I don't just mean 1 or 2 of them, but all of them.

BUT, When I was in 5 years ago for knee replacement I had some of the meanest nurses I could ever imagine,. It ruined and made an already bad situation worse.

I am sure this mother appreciated the kind of compassion shown her and her children by her nurse and the secretary. Sounds like you have a great team. I have a feeling they take a look at their boss and follow in his footsteps.

Anonymous said...

We are so quick to tell each other what we're doing wrong. Thanks for telling Lindsey and Jaime what they were doing right!

You did right!


somedaydoc said...

As a medical student who works with many people that are "above" me and wonders how much they really notice about my work, I think it is wonderful that you took the time to speak with the nurse and secretary. It was only a couple minutes of your day, but I'm sure both those women felt happy and proud to have their generosity noted (though that's obviously not why they did it). I think every workplace would be better if more people took the time to comment on the good things.

t. said...

Please, please, PLEASE tell me you work in an academic setting-- you are such an amazing model to housestaff of what an ED doc can be.

Thank you for sharing your kind spirit!

SeaSpray said...

Hi Jim - I think it's terrific that you took the time to show your appreciation for what both co-workers were doing. They will remember that. Perhaps pay it forward when the moment comes. Also inspires people to want to do more of the same. You are a team player. You strengthen your team with both your words and actions. And we never know what may be happening in someone's personal life that is difficult and your kind words could also be as a soothing balm to their spirit.

They both sound like dedicated employees. So ..many people do not take the time to reinforce good behavior and some even tear people down. It's refreshing to hear when someone is encouraging.

The children were probably scared and mom worried about the kids and who knows what else and the staff probably did a lot to help put them at ease.

As someone who also had opportunity to facilitate comfort or give assistance to patients and families/friends is a rewarding feeling. I know how good I have felt when med staff gives that extra tlc. And I know how bad I felt when they were unkind or dismissive. No patient should have to put up with that.

As a patient ..particularly during these last few years ... I have been blessed with some fantastic medical personnel that helped to make some difficult medical experiences more bearable.

I did have a couple of negative ones... where I feel I was treated disrespectfully and it hurt and in one instance I felt like my bladder would rupture in post op. I knew I needed a foley cath in and the post-op nurse told me I didn't.Tears from the pain and a 1000 ccs later, she said "Oh you DID have to go. You put out a thousand CCs!" I was mad at them but did not show it and my doc was like the white knight in shining armor because he believed me and saw to it that I got it.

Thankfully most medical staff encounters are positive though.

I remember a tough as nails nurse I had in maternity. She was like a drill sergeant. Not much on personality... very matter of fact, by the book. I wasn't offended by her though. Her forceful non coddling words she spoke have helped me as a patient since then. She said it would hurt when I try to sit up after the incision ..but I HAVE to do it and the MORE I do it ..the sooner I will feel better. She was right. And so ..with other things ..I have remembered her words and tone and bite the bullet and just do it. :)

Jabulani said...

This attitude works in Education too.
I am a Governor at my children's school. We are fortunate to have a staff who constantly go Above and Beyond. They are priceless, in my opinion.

Our Headteacher is an absolute gem - he's beyond diamonds and pearls! He's a complete team player. He's also exceedingly thorough when it comes to acknowledging and thanking anyone who's helped in any way. I reckon he's learned a kind word or gesture encourages people to step up to the plate again and again, even if they would rather not. He constantly chases ways to get the best out of people, and for people (staff and pupils). He is an inspiration to more than just his staff!

There are many 'Going To' people in the world - they are always Going To do x, y or z. I would like my epitaph to be "She Thought and Did, not Thought and Didn't".

Fabulous post, hun. Thank you.

Karen said...

My daughter is pregnant and ended up in the hospital a while back hooked up to the monitor for a long while. She had no choice at the time but to take her 3-yr old with her. One of the nurses took a hungry 3-yr old to the cafeteria for some food while mom was hooked up and she appreciated it immensely. Kudos to you, too Doc, for praising the people doing this for their patients. I worked at a hospital and I don't think any of the doctors there would be caught dead giving a nurse a compliment.

Anonymous said...

I'm quite happy to see that you actually sought out the nurse to acknowledge her actions! There aren't many docs out there who would even consider doing that.

Anonymous said...

When my grandfather was very ill many years ago he spent a lot of time in the hospital; which meant I spent a lot of time in the hospital. I would arrive around 4:30 (am) to be sure I saw all of his doctors (there were about 6), left for work at 8:30, taught from 9-3:30 and was back to the hospital by 4:00. On the weekends I would arrive around 6 (AM) and leave around 10:00-10:30 (PM). I always had my school bag with me too. In the mornings I would curl up at the bottom of his bed and the first doctor in would wake me up. Everyday I would wake up covered with a blanket. His night nurse would see me sneak in (HA) and knew that I would be quiet and not disturb anyone but nevertheless, once they knew I had fallen asleep they made sure they "tucked" me in so I could go back to sleep. The same thing happened on the weekends. I found that gesture to be so kind and very much appreciated. I never missed a doctor, get all the info, but was running on three hours of sleep or less (sometimes three weeks at a time). This allowed me a few more hours of sleep on the days the doctors rounded a little later. Kuddos to the nurses who cared about my well being as much as they did the patient.

Jessica said...

i know this post is an older one but i work night shift in a home health setting and have had time (with a sleeping)pt to go back and read your posts. ive worked in the ER setting and might i just add that i would have LOVED to have worked with a docter like you! i can relate to "Lindsey" being a new nurse! by encouraging and praisng kind act she will be sure to do it again and again! Wish ther were more doctors out there like you!

Anonymous said...

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