Intensive Care Nurse Quotes

Van Houten, I’m a good person but a shitty writer. You’re a shitty person but a good writer. We’d make a good team. I don’t want to ask you any favors, but if you have time – and from what I saw, you have plenty – I was wondering if you could write a eulogy for Hazel. I’ve got notes and everything, but if you could just make it into a coherent whole or whatever? Or even just tell me what I should say differently. Here’s the thing about Hazel: Almost everyone is obsessed with leaving a mark upon the world. Bequeathing a legacy. Outlasting death. We all want to be remembered. I do, too. That’s what bothers me most, is being another unremembered casualty in the ancient and inglorious war against disease. I want to leave a mark. But Van Houten: The marks humans leave are too often scars. You build a hideous minimall or start a coup or try to become a rock star and you think, “They’ll remember me now,” but (a) they don’t remember you, and (b) all you leave behind are more scars. Your coup becomes a dictatorship. Your minimall becomes a lesion. (Okay, maybe I’m not such a shitty writer. But I can’t pull my ideas together, Van Houten. My thoughts are stars I can’t fathom into constellations.) We are like a bunch of dogs squirting on fire hydrants. We poison the groundwater with our toxic piss, marking everything MINE in a ridiculous attempt to survive our deaths. I can’t stop pissing on fire hydrants. I know it’s silly and useless – epically useless in my current state – but I am an animal like any other. Hazel is different. She walks lightly, old man. She walks lightly upon the earth. Hazel knows the truth: We’re as likely to hurt the universe as we are to help it, and we’re not likely to do either. People will say it’s sad that she leaves a lesser scar, that fewer remember her, that she was loved deeply but not widely. But it’s not sad, Van Houten. It’s triumphant. It’s heroic. Isn’t that the real heroism? Like the doctors say: First, do no harm. The real heroes anyway aren’t the people doing things; the real heroes are the people NOTICING things, paying attention. The guy who invented the smallpox vaccine didn’t actually invented anything. He just noticed that people with cowpox didn’t get smallpox. After my PET scan lit up, I snuck into the ICU and saw her while she was unconscious. I just walked in behind a nurse with a badge and I got to sit next to her for like ten minutes before I got caught. I really thought she was going to die, too. It was brutal: the incessant mechanized haranguing of intensive care. She had this dark cancer water dripping out of her chest. Eyes closed. Intubated. But her hand was still her hand, still warm and the nails painted this almost black dark blue and I just held her hand and tried to imagine the world without us and for about one second I was a good enough person to hope she died so she would never know that I was going, too. But then I wanted more time so we could fall in love. I got my wish, I suppose. I left my scar. A nurse guy came in and told me I had to leave, that visitors weren’t allowed, and I asked if she was doing okay, and the guy said, “She’s still taking on water.” A desert blessing, an ocean curse. What else? She is so beautiful. You don’t get tired of looking at her. You never worry if she is smarter than you: You know she is. She is funny without ever being mean. I love her. I am so lucky to love her, Van Houten. You don’t get to choose if you get hurt in this world, old man, but you do have some say in who hurts you. I like my choices. I hope she likes hers.

The hospital will never be healthy for patients if it's not a healthy environment for nurses, where their voices are heard and where they can care for their patients and use the full extent of their knowledge, abilities, and skills. After all, hospitals today have become one big intensive care unit: all patients need intensive caring.

In Plaster I shall never get out of this! There are two of me now: This new absolutely white person and the old yellow one, And the white person is certainly the superior one. She doesn't need food, she is one of the real saints. 
At the beginning I hated her, she had no personality -- She lay in bed with me like a dead body 
And I was scared, because she was shaped just the way I was 
 Only much whiter and unbreakable and with no complaints. I couldn't sleep for a week, she was so cold. I blamed her for everything, but she didn't answer. 
I couldn't understand her stupid behavior! 
When I hit her she held still, like a true pacifist. 
Then I realized what she wanted was for me to love her: She began to warm up, and I saw her advantages. 

Without me, she wouldn't exist, so of course she was grateful. 
I gave her a soul, I bloomed out of her as a rose 
Blooms out of a vase of not very valuable porcelain, And it was I who attracted everybody's attention, 
Not her whiteness and beauty, as I had at first supposed. 
I patronized her a little, and she lapped it up -- 
You could tell almost at once she had a slave mentality. 

I didn't mind her waiting on me, and she adored it. 
In the morning she woke me early, reflecting the sun 
From her amazingly white torso, and I couldn't help but notice 
Her tidiness and her calmness and her patience: She humored my weakness like the best of nurses, 
Holding my bones in place so they would mend properly. In time our relationship grew more intense. 

She stopped fitting me so closely and seemed offish. 
I felt her criticizing me in spite of herself, 
As if my habits offended her in some way. She let in the drafts and became more and more absent-minded. 
And my skin itched and flaked away in soft pieces 
Simply because she looked after me so badly. Then I saw what the trouble was: she thought she was immortal. She wanted to leave me, she thought she was superior, 
And I'd been keeping her in the dark, and she was resentful -- Wasting her days waiting on a half-corpse! 
And secretly she began to hope I'd die. Then she could cover my mouth and eyes, cover me entirely, 
And wear my painted face the way a mummy-case Wears the face of a pharaoh, though it's made of mud and water. 

I wasn't in any position to get rid of her. She'd supported me for so long I was quite limp -- I had forgotten how to walk or sit, So I was careful not to upset her in any way 
Or brag ahead of time how I'd avenge myself. Living with her was like living with my own coffin: Yet I still depended on her, though I did it regretfully. I used to think we might make a go of it together -- 
After all, it was a kind of marriage, being so close. 
Now I see it must be one or the other of us. She may be a saint, and I may be ugly and hairy, 
But she'll soon find out that that doesn't matter a bit. I'm collecting my strength; one day I shall manage without her, 
And she'll perish with emptiness then, and begin to miss me. --written 26 Feburary 1961

She was a woman who conquered herself so that she could serve others.

You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. These days are spent in institutions—nursing homes and intensive-care units—where regimented, anonymous routines cut us off from all the things that matter to us in life.

To those you care for, a nurse is a person of many faces: You are a warrior against death and suffering, a technician of the highest degree; you are a mother, a sister, a best friend, a psychiatrist; you are a teacher, a magician, a sounding board, a secretary, a fortuneteller, a politician, but most of all, you are a loving human being who has chosen to give that love in one of the best ways you can.

In this country, we think of dying primarily as a medical event. It’s much more than that. It’s about relationships: to ourselves, those we may be caring for, or those caring for us. Caring for the dying can be an intense, intimate, and deeply enlivening experience. Death can be an extraordinary mirror through which we see ourselves.

Can you tell me which is yours?" Standing at Bird's side, the nurse spoke as if she were addressing the father of the hospital's healthiest and most beautiful baby. But she wasn't smiling, she didn't even seem sympathetic; Bird decided this must be the standard intensive care ward quiz. Not only the nurse who had asked the question but two young nurses who were rinsing baby bottles beneath a huge water heater on the far wall, and the older nurse measuring powdered milk next to them, and the doctor studying file cards at a cramped desk against the smudgy poster-cluttered wall, and the doctor on this side of him, conversing with a stubby little man who seemed, like Bird, to be the father of one of the seeds of calamity gathered here—everybody in the room stopped what he was doing and turned in expectant silence to look at Bird.

The nurse smiled and gestured to two cameras pointing at each patient—one to monitor the patient himself, the other to observe the charts. The nurse told us that these were fed by Skype directly into the intensive care unit in one of the hospitals in Washington, DC, where there was a Syrian-American ICU specialist looking at the monitors twenty-four hours a day, and adjusting the patient’s medication and ventilation based on the clinical parameters.

The ITU had had a busy week and there were ten patients in the large and brightly-lit warehouse of a room, all but one of them unconscious, lying on their backs and attached to a forest of machinery with flashing lights and digital read-outs the colour of rubies and emeralds. Each patient has their own nurse, and in the middle of the room there is a large desk with computer monitors and many members of staff talking on the phone or working on the computers or snatching a plastic cup of tea in between carrying out the constant tasks that are needed in intensive care.

Klein studied nurses, intensive care units, firefighters, and other people who make decision under pressure, and one of his conclusions is that when experts make decisions, they don't logically and systematically compare all available options. That is the way people are taught to make decisions, but in real life it is much too slow. Klein's nurses and firefighters would size up a situation almost immediately and act, drawing on experience and intuition and a kind of rough mental simulation. To Van Riper, that seemed to describe much more accurately how people make decisions on the battlefield.

You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. They are spent in institutions—nursing homes and intensive care units—where regimented, anonymous routines cut us off from all the things that matter to us in life. Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need.

Anyway, he saw death as a magnetic field that every living thing must enter. He was ready for it. He had even thought that since he had been unconscious under the respirator for an entire month, he might just as well have died in the hospital and avoided further trouble. Yet here he was in his birthplace. Intensive-care nurses had told him that the electronic screens monitoring his heart had run out of graphs, squiggles, and symbols at last and, foundering, flashed out nothing but question marks. That would have been the way to go, with all the machines confounded, from unconsciousness to unconsciousness.

Anyway, he saw death as a magnetic field that every living thing must enter. He was ready for it. He had even thought that since he had been unconscious under the respirator for an entire month, he might just as well have died in the hospital and avoided further trouble. Yet here he was in his birthplace. Intensive-care nurses had told him that the electronic screens monitoring his heart had run out of graphs, squiggles, and symbols at last and, foundering, flashed out nothing but question marks. That would have been the way to go, with all the machines confounded, from unconsciousness to nonconsciousness.

Our study of psychoneurotic disturbances points to a more comprehensive explanation, which includes that of Westermarck. When a wife loses her husband, or a daughter her mother, it not infrequently happens that the survivor is afflicted with tormenting scruples, called ‘obsessive reproaches’ which raises the question whether she herself has not been guilty through carelessness or neglect, of the death of the beloved person. No recalling of the care with which she nursed the invalid, or direct refutation of the asserted guilt can put an end to the torture, which is the pathological expression of mourning and which in time slowly subsides. Psychoanalytic investigation of such cases has made us acquainted with the secret mainsprings of this affliction. We have ascertained that these obsessive reproaches are in a certain sense justified and therefore are immune to refutation or objections. Not that the mourner has really been guilty of the death or that she has really been careless, as the obsessive reproach asserts; but still there was something in her, a wish of which she herself was unaware, which was not displeased with the fact that death came, and which would have brought it about sooner had it been strong enough. The reproach now reacts against this unconscious wish after the death of the beloved person. Such hostility, hidden in the unconscious behind tender love, exists in almost all cases of intensive emotional allegiance to a particular person, indeed it represents the classic case, the prototype of the ambivalence of human emotions. There is always more or less of this ambivalence in everybody’s disposition; normally it is not strong enough to give rise to the obsessive reproaches we have described. But where there is abundant predisposition for it, it manifests itself in the relation to those we love most, precisely where you would least expect it. The disposition to compulsion neurosis which we have so often taken for comparison with taboo problems, is distinguished by a particularly high degree of this original ambivalence of emotions.

fear of death.” Our study of psychoneurotic disturbances points to a more comprehensive explanation, which includes that of Westermarck. When a wife loses her husband, or a daughter her mother, it not infrequently happens that the survivor is afflicted with tormenting scruples, called ‘obsessive reproaches’ which raises the question whether she herself has not been guilty through carelessness or neglect, of the death of the beloved person. No recalling of the care with which she nursed the invalid, or direct refutation of the asserted guilt can put an end to the torture, which is the pathological expression of mourning and which in time slowly subsides. Psychoanalytic investigation of such cases has made us acquainted with the secret mainsprings of this affliction. We have ascertained that these obsessive reproaches are in a certain sense justified and therefore are immune to refutation or objections. Not that the mourner has really been guilty of the death or that she has really been careless, as the obsessive reproach asserts; but still there was something in her, a wish of which she herself was unaware, which was not displeased with the fact that death came, and which would have brought it about sooner had it been strong enough. The reproach now reacts against this unconscious wish after the death of the beloved person. Such hostility, hidden in the unconscious behind tender love, exists in almost all cases of intensive emotional allegiance to a particular person, indeed it represents the classic case, the prototype of the ambivalence of human emotions. There is always more or less of this ambivalence in everybody’s disposition; normally it is not strong enough to give rise to the obsessive reproaches we have described. But where there is abundant predisposition for it, it manifests itself in the relation to those we love most, precisely where you would least expect it. The disposition to compulsion neurosis which we have so often taken for comparison with taboo problems, is distinguished by a particularly high degree of this original ambivalence of emotions.

Fifteen years ago, Israeli scientists published a study in which engineers observed patient care in ICUs for twenty-four-hour stretches. They found that the average patient required 178 individual actions per day, ranging from administering a drug to suctioning the lungs, and every one of them posed risks. Remarkably, the nurses and doctors were observed to make an error in just 1 percent of these actions—but that still amounted to an average of two errors a day with every patient. Intensive care succeeds only when we hold the odds of doing harm low enough for the odds of doing good to prevail. This is hard. There are dangers simply in lying unconscious in bed for a few days. Muscles atrophy. Bones lose mass. Pressure ulcers form. Veins begin to clot. You have to stretch and exercise patients’ flaccid limbs daily to avoid contractures; you have to give subcutaneous injections of blood thinners at least twice a day, turn patients in bed every few hours, bathe them and change their sheets without knocking out a tube or a line, brush their teeth twice a day to avoid pneumonia from bacterial buildup in their mouths. Add a ventilator, dialysis, and the care of open wounds, and the difficulties only accumulate.

1980s, when a study of Intensive Care Units revealed that “the most significant factor associated with excessive mortality was the degree of nurse-physician communication

In Berridge and Robinson’s view, pleasure is divided into “wanting” (hunt) and “liking” (feast). As we’ll see, the distinction is especially important in addiction because each type has a different influence on learning. Like many discoveries in science, this one was made when the researchers were trying to understand why an experiment didn’t work out as they’d predicted. They’d used a chemical that selectively destroys dopamine cells in the nucleus accumbens of rats to eliminate their “pleasure centers.” Not surprisingly, after these key dopamine cells were eliminated, the rodents became so amotivated that if the researchers hadn’t manually fed them, they would have starved to death. “They wouldn’t want to eat. They wouldn’t want to drink,” Berridge says. “We’d have to artificially nurse them and artificially feed them, the way you would in a hospital intensive care ward.” The rats behaved as though they had extremely severe Parkinson’s, which they essentially did. Destroying their dopamine cells had taken away their motivation, leaving them with no desire or will to do anything at all, even what was necessary for survival.

Medicine is becoming a business, and if people choose medicine as a way to make money, they should go to the States because there, health care is a commodity for sale and you can shop around for the best product. Patients are the customers and if you're rich you get better health care than if you're poor. In Canada, health care is a basic human right, a service that every human being deserves. Tell me, have any of you ever seen someone get preferential treatment? A Canadian over a non-resident? A white person over one of color? A VIP over an ordinary citizen?

That is what nursing has taught me above all: compassion is the greatest wisdom.

Dad and I follow the quick-footed nurse across the car park to the Garrett Anderson Centre and upstairs to the intensive care unit.

intensive care. A nurse can take you to the waiting area. If he remains stable you can see him, one at a time, but for only a few minutes.” Dr. Jones said, “A nurse will be with you soon.” He disappeared

not the difference between treating and doing nothing, she explained. The difference was in the priorities. In ordinary medicine, the goal is to extend life. We’ll sacrifice the quality of your existence now—by performing surgery, providing chemotherapy, putting you in intensive care—for the chance of gaining time later. Hospice deploys nurses, doctors, chaplains, and social workers to help people with a fatal illness have the fullest possible lives right now—

With every interaction with Maggie, they would treat her as if she was the only patient in the ward, and all their attention was directed only  her. They demonstrated special and impressive personal care. I do not remember feeling a similar attitude, with these intensities, in any other hospital. I did not feel it, even in other wards. Sometimes it seemed to me that a nurse would have a reason for going to work in a particular ward. Her choice in the ward she would work in, eventually, was a derivative of her character. The impression was that the nurses there were bonded around a clear and indisputable target - to protect patients, no matter what, to help them and their families as much as possible. I remember several incidents of violence by visitors towards the medical and nursing staff in other hospitals. It was mainly verbal, although sometimes there was also physical violence. Most cases concerned the displeasure of family over the treatment of patients, or so felt the patients or their companions. Perhaps their expectations were different from the possible reality. Maybe they thought that with the magic formula that was the nursing staff, all the pains would suddenly disappear and the patients would return home safe and sound. The reality was not like that.

It was her concern and commitment to a friend which last year involved her in perhaps the most emotional period of her life. For five months she secretly helped to care for Adrian Ward-Jackson who had discovered that he was suffering from AIDS. It was a time of laughter, joy and much sorrow as Adrian, a prominent figure in the world of art, ballet and opera, gradually succumbed to his illness. A man of great charisma and energy, Adrian initially found it difficult to come to terms with his fate when in the mid-1980s he was diagnosed as HIV positive. His word as deputy chairman of the Aids Crisis Trust, where he first met the Princess, had made him fully aware of the reality of the disease. Finally he broke the news in 1987 to his great friend Angela Serota, a dancer with the Royal Ballet until a leg injury cut short her career and now prominent in promoting dance and ballet. For much of the time, Angela, a woman of serenity and calm practicality, nursed Adrian, always with the support of her two teenage daughters. He was well enough to receive a CBE at Buckingham Palace in March 1991 for his work in the arts--he was a governor of the Royal Ballet, chairman of the Contemporary Arts Society and a director of the Theatre Museum Association--and it was at a celebratory lunch held at the Tate Gallery that Angela first met the Princess. In April 1991 Adrian’s condition deteriorated and he was confined to his Mayfair apartment where Angela was in almost constant attendance. It was from that time that Diana made regular visits, once even brining her children Princes Willian and Harry. From that time Angela and the Princess began to forge a supportive bond as they cared for their friend. Angela recalls: “I thought she was utterly beautiful in a very profound way. She has an inner spirit which shines forth though there was also a sense of pervasive unhappiness about her. I remember loving the way she never wanted me to be formal.” When Diana brought the boys to see her friends, a reflection of her firmly held belief that her role as mother is to bring them up in a way that equips them for every aspect of life and death, Angela saw in William a boy much older and more sensitive than his years. She recalls: “He had a mature view of illness, a perspective which showed awareness of love and commitment.” At first Angela kept in the background, leaving Diana alone in Adrian’s room where they chatted about mutual friends and other aspects of life. Often she brought Angela, whom she calls “Dame A”, a gift of flowers or similar token. She recalls: “Adrian loved to hear about her day-to-day work and he loved too the social side of life. She made him laugh but there was always the perfect degree of understanding, care and solicitude. This is the point about her, she is not just a decorative figurehead who floats around on a cloud of perfume.” The mood in Mount Street was invariably joyous, that sense of happiness that understands about pain. As Angela says: “I don’t see death as sad or depressing. It was a great journey he was going on. The Princess was very much in tune with that spirit. She also loved coming for herself, it was an intense experience. At the same time Adrian was revitalized by the healing quality of her presence.” Angela read from a number of works by St. Francis of Assisi, Kahil Gibran and the Bible as well as giving Adrian frequent aromatherapy treatments. A high spot was a telephone call from Mother Teresa of Calcutta who also sent a medallion via Indian friends. At his funeral they passed Diana a letter from Mother Teresa saying how much she was looking forward to meeting her when she visited India. Unfortunately Mother Teresa was ill at that time so the Princess made a special journey to Rome where she was recuperating. Nonetheless that affectionate note meant a great deal to the Princess.

Ow! Son of a—” Before she could complete the expletive, Baird was there, staring at her with concern. “What happened? Are you hurt?” he demanded even as he scanned the area with those inhumanly golden eyes, obviously searching for a threat. “I’m fine. I just…” Liv gestured to her wounded foot with irritation. “I dropped my orange juice when those goons came to get me and I stepped on a shard of glass.” His face fell. “You were hurt all this time and I didn’t notice?” “I didn’t notice half the time myself,” Liv assured him. “I had, uh, other things on my mind.” Like finding out exactly what I was getting myself into with you. “I’ve stopped bleeding so I guess I forgot until I stepped on it out here.” “You’re bleeding?” He looked even more alarmed. Getting down on one knee he gestured her forward. “Let me see.” “No, honestly, it’s all right.” Liv felt both annoyed and shy. Why was he making such a big deal out of this? She’d seen people with foreign objects imbedded in their bodies every day of the week as a nursing student in the Tampa General ER. Didn’t they ever step on sharp things where he came from? “Olivia, come here.” His voice was a low growl—not menacing so much as stern. To her intense irritation, Liv found herself obeying him. “It’s just a piece of glass,” she protested even as she allowed him to settle her on his knee and lift her foot. “If you’ll just give me a first aid kit I can take care of it myself.” “No you won’t.” He examined the heel of her foot with care as though assessing a grave and dangerous injury. “Wait until we get up to the ship and let Sylvan look at it. He’s a medic.” “And I’m a nurse,” Liv protested, feeling even more irritated. “I can handle myself, thank you.” “Even a small injury like this can get infected and it’s hard to work on yourself.” The growl had come back to his voice again and his eyes flashed from dark amber to pale gold in a second. “You need a medic and that’s what you’ll get, Lilenta.” “My

We established an investigative team at each hospital and selected 11 nursing units for the study at the 2 hospitals: 5 intensive care units and 6 general, non-obstetric care units. David Bates was the leader of the Brigham team and David Cullen led the MGH team.

The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a silver’s chance of benefit. They are spent in institutions-nursing homes and intensive care units-where regimented, anonymous routines cut us off from all the things that matter in life. Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need. Lacking a coherent view of how people might live successfully all the way to their very end, we have allowed our fates to be controlled by the imperatives of medicine, technology, and strangers.

The difference between standard medical care and hospice is not the difference between treating and doing nothing, she explained. The difference was in the priorities. In ordinary medicine, the goal is to extend life. We’ll sacrifice the quality of your existence now—by performing surgery, providing chemotherapy, putting you in intensive care—for the chance of gaining time later. Hospice deploys nurses, doctors, chaplains, and social workers to help people with a fatal illness have the fullest possible lives right now—much as

A whole hospital ward seemed to be crossdressing, nurses pretending to be mothers playing like boys with Tinkertoy babies.

Arguing with ER nurses is like wiping your ass with a hula-hoop.

And a severe influenza pandemic would hit like a tsunami, inundating intensive-care units even as doctors and nurses fall ill themselves and generally pushing the health care system to the point of collapse and possibly beyond it. Hospitals, like every other industry, have gotten more efficient by cutting costs, which means virtually no excess capacity—on a per capita basis the United States has far fewer hospital beds than a few decades ago.

Aisha belonged to that rare breed of people, kind and gentle people, I think they are born that way. They’re more visible in certain professions, in education, or in health care, like the nurses who draw blood. These people often work indoors, they work long, intensive hours, sometimes night shifts. There aren’t many of them these days, because our culture socializes us against kindness. I know this because you rarely come across them in the street.

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