Nurse Jackie!

I've worked in nursing since I was 18, taught nurses, worked as a nurse practitioner for the past decade, experienced my first hospitalization (that I really remember) when having my babies, and spent the past ten years as a melanoma patient! You know what all that means? I've known a lot of nurses!

There are certainly stand-outs along the way! If I am a decent pediatric provider at all, it is due to the training, kindness and examples so generously shared with me: the newly graduated, newly hired, teen, (YIKES!!), fresh off the farm, "charge nurse" for 3-11 at our local Children's Hospital....by the two LPN's I worked most shifts with...Jackie McCabe and Delana Treadwell.  I have thanked them in person, but many zillion times more in my head and heart over the years. You two are at the tip top of my great nurses list, you guys!

Sadly, I've met nurses that fall to the bottom. Laziness is the cause of many failings! Lack of knowledge and a disinterest in learning...medicine changes daily!...is another.  A focus on yourself, disorganization, lack of respect....and the absence of "heart"...comes through to co-workers and patients alike.

Nursing is hard. If a nurse is really doing her job....no matter the setting....she (or he) is not sitting around! There are ALWAYS tasks to be done, patients to sit with and check on, new medicines and treatments to learn about, providers needing assistance. The physical demands of changing beds, even for babies, pushing equipment, moving patients who may or may not be ambulatory, running back and forth, and back and forth again, is physically demanding. It is emotionally draining. Parents of sick babies are not happy people. Families are anxious, if not downright angry that their loved one is in this position. Having to tell families bad news will break your heart, then, and later, when you remember. Patients you come to love and care for like your own, will die. In pediatrics you WILL take care of abused children. And, if that is not enough, the person who is, by all evidence and report the perpetrator, may be allowed to continue to visit the child...until proven guilty. Nurses may say nothing, nor exhibit any disrespect. Hard....does not even begin to describe that challenge. Patients will be non-compliant. They will not take their meds. They will not eat and exercise properly. They will not be clean. They will not all be nice. Nurses are to offer help, education, and acceptance...always. Nurses are not to judge...ever.

As a patient, I have seen the best and worst in nursing. Once in my room after the delivery of my first child, my nurse told me about how important it was to empty my bladder within the next hour, that she would be massaging my fundus every couple hours, and that checking my bleeding was very important, blah, blah, blah.  Stuff I already knew....luckily....as it turned out! Twelve hours later...her first reappearance since her sermon at 0700...with a bit of a panic on her face and no preamble blurted, "Did you ever get up and pee?"  You have no idea how close I was to saying, "No, ma'am. Is that a problem?"

Post lung surgery, some idgit nurse decided that 2 in the morning was the perfect time to rattle papers around, put his weight on my mattress, and tape a sign above my bed with a statement about blood pressures....only to return an hour later and change it.  There was the nurse who kept her back to me and my husband as she did an intake interview before surgery. When he answered a history question with a date I was unsure of, she told him that he was not to speak! It is a wonder that woman is alive today!!

Luckily, I have been witness to a great deal of wonderful care, given gladly and expertly by many good nurses. The girls I work with today impress me daily with the care and concern they give our families. Nurses from my time in NICU and PICU were some of the smartest and most hard working I have known. I saw a great deal of strength in many of my students and am certain that at least a few of them have lived up to their potential. The nurses at Moffitt have been amazing. Always busy, dealing with new trials and complicated patients everyday.

But, the all time best nurse in my whole world? Nurse Jackie! She knew her shit. She knew the trials and what was happening with the patients in them. She knew the side effects, what the doctors were thinking, and how to take a history. She remembered her patients. She was organized and had created a tray to simultaneously carry and label the peptide vaccines that the other nurses happily utilized. She shared enough of herself to make her likable and human, but not so much that it became the Jackie Show. She always kept the focus on the patient. And, it wasn't just for me.  Sorry, guys...but yes, we can hear what you are saying to other patients through those curtains!!!  She was clearly a valuable resource for her coworkers. She was expert at starting IV's, drawing blood, and giving those horrible peptide injections.

The peptide vaccines were a painful nightmare, one which poor Ruthie may have dreaded more than I did! The great solution Weber had adopted for pain control, was ice applied to the injection site...20 minutes or so before the injections.  This is total bullshit, by the way.  You just end up shivering for the duration with a minor freezer burn to the affected area and vaccines that still hurt like a mother.  At any rate...that was the deal.  So, after vital signs, an IV start, lab draw and pee in a cup, it was off to see Weber.  He would give the ok to send up the meds after checking my scans and labs.  Then, it was back over to the CRU (Clinical Research Unit) for the infusion and vaccines.  We would be sent to a room and await the ice packs.  Once, as Jackie came in with them, Ruthie began...."Ding da da ding ding ding ding.  Ding da da ding ding ding ding."  Jackie never batted an eye.  Just began a conga line around the bed with her ice bags moving in time, and joined in..."Ice, ice, baby!  Ice, ice baby!!!"  Now, that's what I'm talking about!!!

On top of that, she always sent the med order to pharmacy with the label "PTC!!!!"  (Plane to catch!)  It really did make such a difference.  But....back to the vaccines.  Ruthie saved up stories throughout the two prior weeks to tell me while I was getting them to take my mind off of them.  Sometimes there were even notes!!  Her sweet boys even contributed!  On one occasion, as Jackie began to give the injections...Ruthie grabbed my hand and started...."So....OK....this was crazy!  I had to go to this funeral..."  Jackie, never looking up, said, "Oh, a happy story!"  She was great.

When I mentioned once that I thought I smelled and tasted weird after the infusions.  She didn't act like I was insane.  She said, "Oh, I bet that's from the DMSO they use as a preservative.  Canned corn, don't you think?"  When I began to develop vitiligo, rather than look at it with distaste, as one of the asinine techs did, she said, "That is a really great sign!  Dr. Weber's little bow tie spins round and round when he sees things like that!"  On one of my last infusion visits, I overheard a nurse telling a patient about the trial she was apparently just starting with anti-PD1, and while her report wasn't exactly inaccurate, it certainly left a lot out, and she added, "Yeah, this is so new we don't really know much about it and it doesn't even have a name yet!"  WRONG!  Yes, it did. Nivolumab!  Not the worst transgression in the world I suppose, but still.  Woman, YOU are supposed to KNOW this stuff!!!  And...again...we can hear you through curtains!!!!  But, never fear...a little later, Jackie was at the newbie's side...explaining the trial, telling her about her newly named drug.  Being herself.  Being the best nurse ever.

So, Jackie.  You mean so much to so many.  You make a difference.  You helped me more than you will ever know.  You even noticed that Ruth and Brent called me Celeste, then, you did, too.  Thank you. Love - c