April 27, 2016

By: Jennifer J. Brokaw, RN, WCC, OMS

Not ‘just a nurse’

It’s just another day for just another nurse as I make my way through the busy corridors of this sprawling facility. The hallways are bustling with activity as various personnel rush from here to there wearing the assigned-color scrubs of their discipline. There goes a transporter pushing a patient on a stretcher. There goes a phlebotomist with his cart of needles and tubes. There goes a pharmacy tech delivering much-needed medications to a patient. Oh, and there goes just another nurse, like me.

My rounds take me to a familiar unit where the staff knows me by sight. We smile and wave or even stop for a brief “hello, how are you?” if time allows. I glance at my patient list and remind myself of the few details I have regarding this next consult, just another nurse just going about her humble duties.

I enter the patient’s room – she is in the bed next to the window – and introduce myself. “Hello,” I say. “My name is Jennifer and I’m a wound nurse. I’m here to take a look at your foot ulcer.” Mrs. K nods in understanding and moves her leg out from under the covers. The room is dark even though it is almost noon and I notice the shades are drawn. “Can I turn on your light to better see your wound?” I ask. The patient nods and turns the light on for me. It is then I see the red-rimmed eyes puffy with tears.

Not wanting to pry, I complete my assessment of her foot ulcer. It is on the plantar surface with callused edges and scant serous drainage. It measures 1cmLx1.5cmWx0.2cmD and has a pale pink wound bed. My findings suggest that the wound is a result of diabetic neuropathy, an alteration in sensation resulting from nerve damage caused by prolonged exposure to elevated glucose levels. The alteration in sensation not only resulted in Mrs. K’s inability to feel the injury when it occurred, but perhaps it also impairs her body’s ability to heal the wound.

After determining the cause to be neuropathy, I ask if she is a diabetic, and Mrs. K nods to confirm my suspicion. Then, per my usual routine, I ask how the wound occurred and what she has done for it thus far. Mrs. K quietly reports that the wound began as a callus and only recently revealed itself. She has not treated it except to clean it when she bathes. I next ask Mrs. K if she has been to a podiatrist. This is when the tears and the words begin to flow. It turns out her son just died unexpectedly in an auto accident and the wound on her foot is the least of her concerns.

Taken aback, I do the only thing I can: I sit at the bedside and hold Mrs. K’s hand as she quietly weeps. I have never had a child of my own to lose, so I cannot comprehend her pain. I apologize for not having any words, and she apologizes for crying. We sit in silence for a while. When Mrs. K is ready, I explain my assessment findings and recommend a course of action. She smiles half-heartedly in appreciation and nods. Before I take my leave, I offer my condolences and ask if I can call a chaplain for her, but she says her primary nurse has already done this.

“Is there anything else I can do for you?” I ask.

“No. Thank you, doctor.” She replies.

“You’re welcome, Mrs. K,” I say. “But I’m not a doctor. I’m just a nurse.”

“No,” she corrects me, “you are so much more than that.”

I leave Mrs. K’s room with mixed emotions, and I continue to think about her throughout the day. Later, while finishing up my documentation, I reflect upon my interaction with Mrs. K. I can’t tell you how many times I have been referred to as “just a nurse” during my 18-year career. I’ve been called “just a nurse” by colleagues, doctors, patients, and even by my self. “I’m just a nurse” is a phrase uttered by countless nurses since the dawn of our profession. But, as Mrs. K was quick to point out, we are so much more than that.

Being “just a nurse” is being a clinical coordinator, a caregiver, a comforter, and a confidant. Being “just a nurse” is being a patient advocate and advisor. Being “just a nurse” is being educated, intelligent, skilled, professional, and capable. Being “just a nurse” is being ethical, wise, and compassionate. Being “just a nurse” is being a healer of both body and spirit.

We are not “just nurses”. We are the heart and soul of healthcare. Remember that the next time you say, “I’m just a nurse.”

Jennifer J. Brokaw is a wound and ostomy specialist at Tampa General Hospital in Tampa, Florida.

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