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The promise

Critchfield, Deanna RN, CCRN, CPNP, BSN, MS

CRITICAL care
Free

I admired my colleagues for their technical skills. Then I found out what really made them special.

As a recent graduate working in the pediatric intensive care unit (PICU), I focused on ways to improve my nursing skills. Caring for a mechanically ventilated child was challenging; caring for a child with critical brain injuries overwhelmed me. But one sunny day, I learned a lesson that had nothing to do with performing procedures. It was a lesson that's provided the foundation and philosophy for my nursing career.

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Family's heartbreak

That morning, I arrived for my 12-hour shift, took report on my patients, and began to plan my day. One of my colleagues, Debbie, was a veteran pediatric nurse. Debbie was assigned to the patient in room 510, a chronically ill child who was dying.

Peeking into the room, I saw a pale, blond toddler in a clean white bed, his parents hovering nearby. He wasn't intubated, and his breathing was labored and slow despite supplemental oxygen.

I looked at the young parents standing uncomfortably at his bedside, tearful and obviously in pain. I wondered what the day would bring for them.

For me, the morning passed as usual. Nothing seemed to change in room 510—until I saw the child's parents leaving. Wait! I wanted to shout. Where are you going? Your child is dying! But I said nothing as I watched them leave.

How could they just leave? I didn't understand.

I walked to room 510 and looked in. The child's breathing was even slower, but he was alive. Debbie was standing next to his bed, speaking softly as she began to bathe his small body. When she finished, she slowly and gently scooped him up and situated herself in the rocking chair next to his bed. She covered him with a small blanket and began to rock.

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A measure of peace

Thirty minutes passed, then an hour. Returning to room 510, I peered through the crack in the barely opened door and asked Debbie if she wanted a break. Tearfully, she shook her head and told me that it wouldn't be long. I watched her quietly for a moment and was startled when she began to speak. “No one should die alone. His parents couldn't bear to watch anymore and I promised them that I would stay with him.”

In two sentences, this nurse taught me the essence of nursing. I realized that the lessons I had to learn in the PICU weren't all technical. What made Debbie and my other colleagues such exceptional nurses wasn't just their mastery of the technical; it was also these intangible skills. They cared for patients and families physically, spiritually, and emotionally during the most difficult periods of their lives. And they did so respectfully, without passing judgment. In this way, they offered patients and families a small measure of peace during times riddled with uncertainty and pain.

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Deanna Critchfield is a pediatric nurse practitioner in pediatric surgery at Tampa (Fla.) General Hospital.

© 2005 Lippincott Williams & Wilkins, Inc.