I've been a nurse for more than half of my life. I've worked in many areas, from neonatal, pediatric, and adult ICUs to emergency and operating rooms. I've worked in hospitals, physician's offices, and long-term care facilities. I love my career and consider myself blessed to have found my calling. But we all experience times when our long hours and the rigorous demands of this job make us feel that we sacrifice too much of our personal and family time to care for strangers.
I had this feeling one Christmas Day a few years ago. I had been working my regular eight-hour shift, six-in-a-row stretch, with Christmas Eve, Christmas Day, and Boxing Day right at the end. I was in charge for the stretch and also was covering "on call for hearts" for three of the six shifts. I was low enough on the seniority roster that, for the third year in a row, I couldn't get any time off for the holidays, though at least this year it was day shifts instead of nights.
On Christmas Day, we had four back-to-back emergency CABGs starting at 8 am and stretching long past my scheduled 3 pm end of shift. I had called in the on-call team for a C-section at 8 am, and they had stayed all day doing emergency cases as well. Our two teams saw each other as we passed in the hallway, wishing "Merry Christmas" as we rolled our patients to and from the ORs. I called home several times that day to tell my husband not to wait for me, to go visit his family without me, to eat without me, and then to go home without me. Each time we were in the middle of one case we would get word that another was waiting. Finally, I told my husband not to wait up for me. I had missed another Christmas with my family.
At 10 minutes before midnight, the circulator wheeled our second heart transplant patient into the OR. He looked over at me behind the huge back table that I was setting up with all the instruments and gadgets required to perform the small miracle that is a heart transplant. I gave him a wave and reassured him that I was getting everything ready for him. He smiled, pointed to his head, and in a heavy French-Canadian accent, said "pumpkin."
I knew what he meant. He was referring to my brightly colored hat. It was my habit to wear a red hat whenever I worked in the heart rooms. I corrected him: "Not pumpkin[horizontal ellipsis] tomato." He smiled, nodding in agreement. Looking at the clock, I remarked that he must have been a very good boy this year for Santa to bring him a new heart. He started to cry.
"You know," he said, "I told my family today that this will be my last Christmas with them."
I stopped my busy hands and listened.
"I have been sick so long, and felt so bad for so long, and have been waiting for a heart for so long. I gave up hope. I told them that I cannot go on much longer feeling this bad. I told them that I will die soon."
I felt my throat get tight, my eyes fill with water. He looked so frail and tired. He sobbed, wiping his tears with the bedsheet.
"And then we got the call that you have my heart. Thank you. Thank you for being here in the middle of this Christmas night away from your family to do this for me. You are away from your family because of me," he sobbed.
The circulating nurse put her arms around him and held him. "We are here for you, not because of you," she said.
The surgery went smoothly. Our patient received his new heart and was sent to post-op, still asleep and on the ventilator. We still had one more heart transplant to do. I left to go home at around 4 am.
On Boxing Day, I came back to work. I never go to see our patients in the cardiac surgical ICU. Patients don't often remember nurses from the OR, and I don't want to make them feel uncomfortable or to intrude on them in any way. But on this day, at the end of my shift, I went in search of my French-Canadian patient.
He was right there as soon as I entered-awake, sitting up in bed, and off the ventilator. I was startled that he looked so great. He spotted me, pointed to his head, and mouthed "pumpkin." I corrected him: "Not pumpkin. Tomato."
He motioned for me to come closer, clasped my hand, and whispered, "I can never thank you enough for this gift you have given me." I held his hand tighter and whispered, "Me neither."