By Lauren Elliott, RN
I was looking at pictures of flowers on the Internet recently when I stumbled across a picture of the brightly colored blooms. The same color, too.
I had not thought about the incident involving those flowers for a long time.
It looked like status epilepticus.
The EMS crew had not been able to get a line. We transferred the patient to our gurney, and with a couple of helping hands to stabilize her flopping arm, I got a line. First try, I might add.
It took a couple of rounds of medications to get the seizures to stop. Another IV, blood draws, CT scan electrocardiogram, cardiac monitoring, a catheter and lots of medications meant the charge nurse had to temporarily take my other patients.
Then the patient’s family appeared. Whenever possible, I try to allow family access. From the start they were a challenge. They sat at my computer terminal and took my stool. They placed filled, Styrofoam cups on my Mayo table where I had gathered materials. They were back and forth, in and out of the room to smoke and even bought food from a fast food place around the corner. No one asked permission to bring food into the exam area.
The husband was very forthcoming with the patient’s history and the events around the seizure onset, but after that, he had nothing to say to me.
He needn’t have said anything for me to get a message from him. It was conveyed by the swastika medallion hanging from his neck and the white supremacist insignia and slogans tattooed on every available inch of exposed skin on his arms and neck. His jacket and shirt both were emblazoned with stylized portrayals of the Confederate flag. His message was unambiguous.
After several hours the ER doctor walked in and explained to the family that the patient would need to be transferred to another facility for neurology services. Another nurse, walked in to ask if I needed any help with the transfer.
The husband regarded her for a moment.
“You have been here a long time,” he said. “I remember you,” he said, smiling for the first time.
“You are the best damn nurse in this hospital.”
She chatted with him for a moment, and one of the patient’s family members mentioned leaving to “get some clothes” before the flight crew arrived. I hope for the best when I send a patient off but never know if that might be the last time he or she will see their family. I suggested they not leave, but it didn’t seem as if anyone heard or cared about what I had to say.
The flight crew arrived. The family thanked them profusely for their help and filed out behind the team without as much as a goodbye, much less a thank you to me.
About a week or so later, the charge nurse told me I was about to receive an ambulance patient having a seizure. The crew rushed in with an actively seizing patient. They said they had a hard time with her IV. I recognized the patient as the same one I had cared for previously.
The husband, dressed the same way as before, told me what had happened with the transfer. He said he signed her out AMA when they failed to meet his expectations.
I felt the glares of the family even when my back was to them, and it was uncomfortable. Once again, the family filed out behind the flight crew, when she was transferred without a word to me. I pretended not to feel anything as the family bestowed effusive thanks to the flight crew. I honestly felt it was intended to make me feel bad.
On the last day of my contract, I was told I was getting a seizure patient from a grocery store. The EMS crew said they were having a hard time establishing a line and had not been able to give medications. I thought to myself, “No. Could it be the same person?”
I held my breath when the ambulance pulled into the bay.
“No way,” I said out loud to myself when I saw the family. It was the same patient. The line EMS established was blown, so I started another. I medicated her and got the seizures stopped.
This visit was different. She was going to go home after she was loaded with some Fosphenytoin. Hearing this, the patient’s mother and husband followed the doctor out of the room and spoke briefly with him. Then the husband came back in, leaned over the patient, kissed her and announced that they would be right back.
I went to attend another patient. When I returned minutes later, the husband and mother were back. Lying across the keyboard of my WOW was a bouquet of flowers.
I picked up the bouquet and handed it over to the patient’s mother. I needed my work space.
“Oh no,” she said, holding up her hand and leaning away from me.
“Those are for you,” the husband said. He was smiling at me.
“Those are for me?” I stammered.
“Yes,” the woman said. “When I walked in the door I looked around, hoping you would be here. I said, ‘Thank you Jesus when I saw you! ‘”
“All we kept saying on the way was please let you be here,” the husband said.
“We have been to two, specialty hospitals, and they were not as good as the care we got here from you,” he said, looking at me sternly.
“I watched you each time we came in here. You really checked her out. They didn’t do that.”
I told them I would be right back because I had an emergency with another patient. I didn’t want them to see my stunned reaction. I returned to the exam room when the infusion was done.
“You know,” the mother said as I removed the IV. “We are going to be in here a lot with this thing whatever it is. That’s not going to be so bad because we have you here.”
I felt my composure wavering so I just spat it out, bluntly.
“No you don’t,” I said. “I’m not on staff. I am a travel nurse, and this is my last day.”
“What? Where are you going when you leave here?” the husband asked.
I said I had not yet accepted another assignment and was not sure and then….
I saw it in his eyes. There was confusion. There was grappling with something that must have been difficult then he reached out and pulled me into an embrace.
“Thank you,” he said. “For everything.”
The mother stood up and hugged me, too.
“God bless you,” she said, wiping away a tear. “Now who do I talk to, to get you on staff here?”
I kept the bouquet of purple colored Alstroemerias in a vase on my dresser until the last petal fell. I don’t think I have to tell you why.
Lauren Elliott spends her time in emergency departments all over the country. When she is not wearing scrubs she can be found digging in her garden, blogging, fiddling, cooking, talking to her orchids and brushing up on language skills. The writer, musician, registered nurse and family nurse practitioner lives in The Northern Neck with her feline and canine rescues. She is the author of “The Tales of Anna East” and a travel nurse for The Right Solutions. She can be reached via email at Laurenssoapbox@gmail.com or follow her on Twitter at @LaurenSoapBox.