By Lisa Lockhart, MHA, MSN, RN
Early in my nursing career I learned that I had to do a much better job of holding back my tears. I remember hearing repeatedly that nurses should convey “empathy, not sympathy” when caring for patients. So I spent many moments in the bathroom or in my car having a good cry. There are numerous experiences and events that have shaped who I am today as a professional nurse and as a human being, but one of the most memorable encounters is the story of Sadie.
When I worked as a critical care nurse on a neurologic trauma unit in south Florida, I marveled every day at the strength and resiliency of my patients and their loved ones. It was early spring in south Florida, a beautiful time of the year. The area was still “in season” and the traffic was congested and horrible. The snowbirds, as we called the retirees who spend their winters in Florida, would be returning north soon and our beautiful, sleepy little town would soon shrink down to its normal size.
I was working my usual 12-hour shift when I heard the trauma alert paged overhead. It was about 3 p.m. in the afternoon, and school was letting out for the day. A 16-year-old named Amanda had been t-boned in a motor vehicle accident. I quickly took report from the ED nurse and listened intently to the care plan for this patient, who had a C2-3 fracture and Brown-Séquard syndrome. She was in a cervical collar and securely strapped to a backboard. My favorite neurosurgeon was on his way in to place her in skull tong traction. There was uncertainty about Amanda's projected recovery and potential residual neurologic loss.
I was always careful to speak softly and slowly as I instructed Amanda on every movement we made with her now unresponsive body. The funny thing about Amanda was that it seemed her only concern was for someone named Sadie. But according to the report I received, this was a single victim accident. As we worked feverishly to stabilize Amanda, she continued to cry, asking “How's Sadie? Is she okay? I have to know how Sadie is!” I asked Amanda “Who's Sadie?” She replied, “Sadie is my best friend. I lost her when the accident happened.”
As the neurosurgeon and I attempted to explain to Amanda and her mother the severity of Amanda's injuries and the planned interventions, she appeared focused on only one thing: “Mom has anyone found Sadie?” As I listened to the conversation between mother and daughter, I found out that this accident did indeed have two casualties: Amanda and her black Labrador retriever named Sadie who had been a gift from Amanda's father when he departed for active duty overseas. The two were inseparable. Sadie must have been traumatized by the collision and bolted out of the broken car window on the passenger side of the vehicle. Family, neighbors, schoolmates, and emergency care workers were all out looking for the frightened dog.
I was on my first day of a long 3-day stretch and the next 2 days were spent consoling Amanda. She wasn't concerned that she was facing the possibility of permanent loss of sensation and motor function on one side of her body. No—her only concern was “Where's Sadie? Someone has to find Sadie.” I spent countless hours consoling her mother regarding Amanda's prognosis and the many unanswered questions. While her mother pondered whether her child would walk again, Amanda's question was always the same: “Has anyone found my Sadie?”
On the third day of my stretch, all I could think about during my drive in was that I hoped someone had found Sadie; otherwise, there would be no progress in Amanda's therapy and the day would be spent wiping her tears. When I arrived at work, I sadly learned that Sadie was still missing in action. We were struggling to get this young patient to focus on anything; all of her emotions were centered on her missing best friend. As lunchtime passed, Amanda looked blankly out the window and said, “She'll be scared if she's outside another night, she's used to sleeping with me every night and I know she was scared last night all alone.”
All of the staff members were hoping for a safe return of the dog. Every so often a fellow nurse, physician, or therapist would stop by the desk just to ask, “Have they found Sadie yet?” It was about 2 p.m. when I received a call from a police officer—Sadie had been found! She was alive and well, nearly six blocks from the accident site, hiding in someone's backyard. I was so excited I could hardly wait to share the good news with Amanda's mother and my coworkers.
As we talked, the plan was hatched. We would give Amanda the surprise of her life—the best of all gifts—we would sneak Sadie in to see her. As Amanda's mother called the police officer back, we concocted a way to sneak this large dog into our ICU. Yes, we had a pact—the nurses, surgeons, and therapists—we were breaking all the rules and none of us cared.
That afternoon we snuck Sadie up the back steps from the employee parking lot, through the fire door, and into the ICU. As Amanda's mother securely held Sadie's mouth closed to prevent the overjoyed dog from barking, we made our way into Amanda's room. I presented myself at Amanda's bedside and bit my lip as I watched Sadie's large tail excitedly wagging. I told Amanda that it was time to check her skin and do her assessment. She quietly said “okay.” I braced her and turned her immobility bed all the way over on her left side. As we turned Amanda on her side, she found herself nose to snout with Sadie.
There wasn't a dry eye in the room when that black Lab raced up, tail wagging so hard her body shook. Sadie gave Amanda a complete check over with kisses from head to toe. Amanda couldn't speak, she just cried. We all cried—the nurses, the receptionist, the stoic neurosurgeons, and the therapists. You see, that moment was special for all of us. In that moment we reconfirmed exactly why we were there, why we do what we do. It isn't about empathy versus sympathy; it's about being human, kind, compassionate, and, most of all, humane.
Amanda's recovery moved along at a much faster pace from that day on. She was engaged, energized, and participated in her rehab with full attention and a renewed zeal. On the day we sent Amanda to the rehab unit, I made her promise that she would return—walking—and bring me a doughnut. The following Christmas she did just that! Amanda came in with leg braces and on crutches, Sadie by her side, and her mother carrying a box of doughnuts for the ICU staff they spent so many long days with.
This experience taught me that sometimes we have to think outside the box to heal the patient's spirit so that we can heal her body.
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