When our daughter in Texas telephoned us late in the afternoon on June 16, 2013, we expected to hear happy Father’s Day greetings, not a frantic message of dire news about her second youngest daughter.
In this editorial, I’d like to share a very public message of gratitude to the critical care nurse who personified the epitome of family-centered, end-of-life nursing care as this tragedy came to closure.
Wimberly Melton, RN
Shock Trauma ICU
Memorial Hermann Texas Trauma Institute
A simple “Thank you” seems wholly inadequate to express our appreciation for the nursing care you provided when our 19-year-old granddaughter, Cherissa, was a patient in Memorial Hermann’s Shock Trauma ICU in June. From the moment that my husband and I arrived on the unit that rainy night in Houston, following a thunderstorm-delayed flight out of Baltimore, you provided us with everything we most needed to cope with the situation we faced.
Immediately after introducing yourself as Cherissa’s nurse, you welcomed us into her room and accompanied us to her bedside, where we joined other family members and had our first opportunity to see, touch, speak to, and kiss the grandchild who lay before us. We could see firsthand her lithe, suntanned countenance, those beautiful long eyelashes, and painted-for-summertime toenails, finding it difficult to reconcile that this endlessly effervescent young woman, completely devoid of any overt evidence of trauma on her anterior self, would never awaken from her silent state. Thank you for bathing and positioning Cherissa so that she looked as petite and pristine as always while family formed their final memories of her.
Once our immediate needs for visitation and physical contact were met, you helped us fill in some of the information voids created by fragmentary messages exchanged in haste and disbelief with Cherissa’s understandably distraught mother and 3 sisters, who themselves knew only bits of information on what had transpired and the injuries sustained. The information that our daughter was able to share over the previous 36 hours had been ominous from the outset: Cherissa was the passenger in a motor vehicle that had crashed and rolled over, was unresponsive and required full CPR support, was airlifted from the scene to a level I trauma center, where multiple definitive neurologic assessments evidenced brain death. As we disclosed our backgrounds as a former trauma clinical nurse specialist and radiologist who had seen considerable severe head trauma in civilian and military settings, you related to us as colleagues, provided us with a synopsis of relevant clinical findings, confirmed her prognosis, and introduced us to Mary, the LifeGift Family Care Specialist, who would coordinate the organ donation procedures.
Over the next several hours, as family members, including Cherissa’s father, another of our daughters—a geriatric nurse—and 3 of her adult children, converged at Cherissa’s bedside to grieve and comfort one another, you quietly and unobtrusively monitored Cherissa’s condition and infusions while frequently lending assistance to family members in whatever form it was indicated: directions to the nearest coffee and food, words of encouragement and understanding, or locating a chair when someone was tiring. Thank you for the many kindnesses you bestowed on us over so many long hours and for your skilled facility in ministering simultaneously to both Cherissa’s as well as her family’s needs for maintenance and support.
As the evening hours passed, you and Mary reviewed the timeline of procedures that would be implemented for organ retrieval and donation every time a different family member reentered Cherissa’s room and inquired of you as others had done earlier. Thank you for your endless empathy when giving us information as well as your implicit recognition that individuals who have not slept, eaten normally, or had a stress-free moment in the past 72 hours do not remember much of what you say to them.
When the time drew near for transporting Cherissa to the operating room (OR), you followed through on your promise to give us sufficient notice so that each of us would have a few moments to say our final goodbye. Thank you for keeping your promise and for remaining with us during these emotionally wrenching moments as each of 13 family members slowly whispered and kissed their final goodbyes to this child.
Before Cherissa was moved from her room, thank you for introducing us to the surgeon and OR nurses who would be coordinating with Mary for the organ donation. It felt so much better than handing off our daughter, sister, granddaughter, niece, sister-in-law, and cousin to complete strangers, especially when we knew we would never see her again.
Somehow I doubt that you are accustomed to transporting patients to the OR with a 13-member family entourage. In my 44 years as a nurse, I can’t recall anything even close to that scenario, so when Cherissa’s eldest sister inquired as to whether it would be possible to accompany Cherissa as she was transported to the elevator that would deliver her to the OR, we continued to marvel that this request was honored as well. It may only have amounted to a brief walk down 2 hospital corridors, but it created a lifetime memory that every member of her family remained by her baby sister’s side until the very last moment. Thank you for your exquisite sensitivity to responding to one family member’s needs.
After the family relocated to the waiting room, lingering for notification that surgery and all final dispositions were complete, you joined us once more with Mary and the surgeon to share the sad statistic of Cherissa’s official time of death, to inform us that the funeral home had already retrieved her remains, and to blunt the sharp edge of those cold hard facts by notifying us that a number of families were already overjoyed to have received or scheduled gifts of life and sight and freedom from dialysis from Cherissa’s gifts to them. Genuine joy had been a rare commodity over the past few days, so thank you for communicating both the painful and the joyful in whatever quantities they warranted. By this time, tears of sadness and tears of joy were nearly indistinguishable amidst the individual and group hugs that lasted until all of us were truly exhausted.
At that point, when it appeared that 4 or 5 family groups would disperse to drive their separate routes for the 40 or 50 miles to their home or hotel, instead of just waving and wishing us well, you interceded with the parking authorities on duty at 2:15 AM to help 2 family members get their parking vouchers validated and, for those of us who had amply demonstrated that we were unaware the medical center had multiple adjacent garages and were incapable of successfully locating our parked cars, you and Mary decoded our vouchers and led us in diverging processions to the entrance doors of each respective garage so we could begin our journey home. Thank you for never just walking away and letting us fend for ourselves, but remaining with us to ensure that not just some, but all of our needs were met to the fullest extent possible. It isn’t that we couldn’t get by or maybe done pretty well in taking care of ourselves. But when families are physically exhausted, emotionally spent, and weary from the burden that trauma and tragedy impose, your exquisite level of true family-centered care is such a godsend that brings healing to such hurt.
I hope to never experience this type of acute family health crisis again, but will forever remember the kindness, sensitivity, responsiveness, respect, and support you provided every moment throughout that day into the night. I don’t know how we were so fortunate to have you as Cherissa’s nurse, but please know that every member of our family was touched by your compassion and innate sense of knowing how and when we needed you to be our nurse, too. And you provided that care so gently, effortlessly, and unobtrusively that some families, overwhelmed in their grief, might not even notice or ever tell you so. But from one critical care nurse to another, from one trauma nurse to another, you were beyond the best, Wimberly, so thank you.
With deepest gratitude,
JoAnn Grif Alspach, RN, MSN, EdD
Editor, Critical Care Nurse
PS: While we were awaiting your return from the OR, one of the themes that surfaced often in our reflections was how wonderful each of Cherissa’s nurses had been. Our younger members described Luke Riley, RN, on Sunday (Cherissa’s night of admission), Barbara Lamb, RN, on Monday, and you on Tuesday as awesome, incredible, and amazing, while their parents concurred with empathetic, helpful, and consistently supportive professionals. In either lexicon, the Shock Trauma ICU nurses never acted as though the patient’s family was a burden to them, but that they were there to lift any burden that family members might experience. We felt truly blessed to have had your help along this journey.