Whenever home care nurses begin telling patient stories, I always think of Frannie. Even after 25 years of home health nursing, she is the first patient I remember.

Frannie, in her late 40s, had a husband, 3 daughters, grandchildren, and terminal ovarian cancer. She had come home from the hospital with a nasogastric tube, total parenteral nutrition, and a colostomy. Her youngest daughter was the primary caregiver and she was every home care nurse's dream. If she called, which was rare, she had already completed several of the things I would mention to solve the problem.

Frannie had a sense of humor. She was allowed to drink coffee. After drinking it, she would hook up the suction to remove the liquid because her bowels were no longer functioning.

Once when I came for a visit, she said, "I was bad."

I asked, "What did you do?"

"I ate fruit cocktail."

Luckily, it did not cause a problem.

Another time, after she had been in the hospital, she really wanted to come home on a Saturday night. I received a telephone call from the hospital staff about her desire to come home that day. However, she would come home only if I said I could come. Otherwise, she would wait until the next day. Of course, I agreed. When I arrived, she said, "I didn't take you from a promise, did I?"

I also remember, and this occurred 22 years ago, some of her friends, over to visit, were looking through their yearbook, commenting on various classmates' lives and about any who had died. I could not help but think that the next time they did this, they would remember that Frannie had died.

On the day she died, Frannie's daughter paged me to report that she was vomiting bright red blood. As I sped to the house, I wondered if the nasogastric tube, now in place for a considerable time, had perforated her stomach. I quickly told Frannie and her daughter that she would need to go to the hospital or she would die soon. They called Frannie's husband and conferenced. All declined to have her hospitalized. She said to me, "I'm so scared," and all I could think of was to hold her hand and encourage her to focus on telling her stomach to stop bleeding. She quickly became unresponsive and died.

At that time (1985), nurses did not pronounce, and her physician could not come for hours. I called my coordinator and said, "Please fix this!!" A short time later, the medical examiner called and asked me whether she was deceased and agreed to allow her body to be removed to the funeral home.

The family gave me a heart, which I wear on a necklace and have rarely removed all these years. When I said, "I will never forget you, Frannie," I meant it.