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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000403372.50789.07
Reflections

The Letter

Patterson, Melanie L. RN

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Author Information

Melanie L. Patterson is currently a mental health supervising RN at a hospital in the Pacific Northwest. Contact author: mcpattersonrn@gmail.com. Reflections is coordinated by Madeleine Mysko, MA, RN, mmysko@comcast.net. Illustration by Janet Hamlin.

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Abstract

When do you know you're really a nurse?

There's an imaginary line that one crosses when becoming a nurse. This line divides the floundering nursing student from the confident and experienced nurse. After four months of nursing, I found myself wondering where it could be found so I could cross it. Everybody around me already accepted me as a bright and talented nurse, yet I had doubts. I could manage patient care assignments calmly and efficiently, but I sensed that nursing wasn't as superficial as checking off items on a list. Sooner or later, I'd face a more complex situation, with no instructor nearby to give me confidence.

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Around this time, I had a patient at a long-term care facility who'd recently been diagnosed with cancer. Samir never caused any trouble. He was an elderly man, quiet and soft-spoken, and kept mostly to himself. I asked him how he felt after receiving this terrible diagnosis. "I'm getting older," he said, "and I expected this to happen sooner or later. I just wish I could talk with my family. It's been nine years."

I'd been prepared to encounter feelings of anger and depression, but not this yearning to reach out to scattered loved ones. His chronic mental illness had contributed to his separation and estrangement from his family as well as to his ending up on a forensics unit at the long-term care facility. He told me he didn't have any of their phone numbers or addresses. All he knew was a few of their names. I wrote the names down and promised him I would try to find his family for him. He smiled and his face was bright with hope.

After informing the treatment team of my intentions to locate Samir's family, I looked through his chart but couldn't find any contact information. Then I began sifting through the tangled web of names and people on the Internet. I finally found a telephone number for his sister. I gave the number to him and waited while he dialed, hoping it would reconnect him with the sibling he hadn't spoken to in nine years.

Samir hung up the phone and shook his head. The telephone number was no longer in service. He told me that several people had already tried to find his family but had failed. I saw his previously bright hope diminish. With renewed determination, I went back to my search. This time I found an address for his sister. Samir accepted it gratefully and told me he'd write to the address. I knew this would be a difficult task for him because he'd never mastered the skills of reading or writing, but he said he had a friend who would write the letter for him. I wished him luck and asked him to keep me updated.

Several weeks went by, during which I accepted a position on another floor. Shortly after my transfer, a letter came for me. It was from Samir and contained the news that the letter to his sister had been successful. She'd received his letter and called him at the telephone number he'd included in the letter. Then, through her, Samir had reconnected with the other members of his family. The letter he sent me was written in pencil and the writing zigzagged haphazardly across the page, with misspelled words and backwards-facing letters. Samir thanked me and told me how much it meant to him to be with his family again. He wrote that nine years of pressure had been relieved. It was the finest letter I'd ever seen.

I felt like I'd done something very special for Samir and perhaps made his remaining days easier to bear. Fulfilling this dying man's wish went beyond the normal duties required of nurses. Nursing isn't only about healing the body; it's also about healing the spirit. It felt amazing to realize I had the ability to do that. The imaginary line I'd been searching for didn't actually exist. What does exist is compassion, courage, and hope. These are what I now use to guide me in nursing.

Recently, I was saddened to learn that Samir's cancer had progressed to the final stages and he was added to our facility's failing list. But I felt happiness when I heard that he'd had a very special last visit with a large group of family members. I'm honored to have been a part of Samir's life, and proud to have been his nurse.

© 2011 Lippincott Williams & Wilkins, Inc.

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