Bride on the Floor

Physicians may diagnose the illness and write the prescriptions, but in my heart I know that it's nurses that make the patient better. We're the ones that take the written orders and help the patients make sense out of them in the context of their own lives. Who else goes right into the patient's home, makes sure that they're safe, and then finds a way to get the supplies for their dressing changes? Nurses know that the world doesn't come only in black and white. We sift our way through shades of gray every day, knowing that what we do and how we do it makes a difference in the well-being of our patients.

Many years ago, I worked on a Labor and Delivery unit. By "years ago," I mean before my hair was gray, and before I worried if my malpractice insurance was paid up. Things seemed easier then, and Labor and Delivery was deemed a clean unit, limited to the mothers in labor, and to the people that accompanied them – as long as those people agreed to wear scrubs, cover their feet with booties, and leave their clothes from home in the locker room. Occasionally we had mothers-to-be in preterm labor, and then our job was to prolong the pregnancy as long as possible with whatever means we had – IV magnesium sulfate, or sometimes simply bed rest. A full term pregnancy is 40 weeks; we hoped for 32 then, although now it sometimes seems that you'll soon be able to grow a baby in a petri dish. Sometimes we could hold those babies off for weeks, and we always hoped for long enough for them to be able to breathe on their own.

I remember a very young, very glum antepartum patient who had an additional reason for her sad face. She was supposed to be preparing to be the maid of honor in her older sister's wedding. The dress was ready and so was she, but because of her premature contractions, her doctor wouldn't allow her to leave her bed. She spent her time sulking, talking on the phone and picking at the bedclothes, putting on the call light, and generally making our lives miserable just because she was.

On the day the wedding was to take place, I got an early morning phone call from the equally unhappy bride. Her wish was to bring the entire wedding party up to our floor after the ceremony. Told that this was out of the question, she started to cry. She didn't want her sister to feel left out, and she argued with me that this was crucial to our young patient's well being, as well as that of the infant on the way. As charge nurse, I had to weigh the risks to the other patients against the benefits to this particular mother-to-be and her baby. I decided it was worth it, and decision made, I enlisted the other nurses on the floor to help me move our young patient to the room nearest the elevator while we closed all of the other patient doors on the floor. We swore the staff to secrecy, hoped that the supervisor wouldn't pick that hour to make rounds, and then put the lobby staff on alert for the arrival of a limousine.

From our third floor windows we watched and waited.

Soon enough, the elevator doors opened and the entire wedding parted arrived – the bride in dazzling white with her train swishing on the tile floor, accompanied by her groom, handsome men in tuxedos, and lovely young bridesmaids in matching long gowns. They quietly crowded into the small room and then the happy sounds began. All around there were smiles, tears, and flowers. With them was a photographer, and this tight-knit family had a reunion that left all of us, the speechless scrub-dressed staff, watching the scene ready for tears. Slices of wedding cake were served on paper plates. Everyone posed, flashbulbs went off, and just as quickly they all left. Obediently, our little mom never left the bed, and the result for this family was simply priceless.

Our patient perked up and waited for the arrival of her baby in an altogether different frame of mind, and was willing to rest and cooperate. We'd accomplished something important that could have been lost if we'd merely bowed to protocol.

And it's because nurses are so creative that our story had a happy ending. We know when protocol is hard and fast, and we can figure out when it's more a suggestion of correct form. We're able to evaluate and assess, not just our patient's physical status, but their emotional well-being as well. We feel empathy for them and then do what it takes to help them improve. We find transportation for their appointments, we manage groceries and Christmas gifts, and we do it because we want to. Never forget that a great part of what goes on in hospitals is nursing care. Technicians run the tests, doctors interpret the results and give the patients the news, good or bad. But it's only when this is done that the real work starts, and I believe that nurses are the ones that are willing to do it.

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