REFLECTIONS

By Danielle Allen, RN

m I going to be
patient turns violent,
okay? Ami
when a frustrated staff
gasps. Her breath
member yells, when
hitches, her chest rising
youve made a mistake.
and falling in spasms. One
Still, that moment
of my hands holds a mask
sits like a rock on my
to her face; the other hand
heart. Should you tell a
holds hers. Pain has made
patient it will be okay,
her strongmy fingers are
when you know it
almost as white as her pale
wont? Some patients
face, radiant with fear.
find the phrase comShes in dangerbut I
forting, even when they
dont think she will die. The
know the prognosis is
doctor is on her way and I
bleak. Others may lose
think we can save Ami. But
trust. As a health care
although nurses and physiprovider, it can be difficians pride themselves on
cult to guess how these
fixing people, Amis life is
common words of comabout to change once again,
fort will be received. And
and her future is uncertain.
if you dont say it will
Ami stares at me, her
be okay, what do you
brown eyes like river pebsay? I want my patients
bles as tears wash over them.
to trust me, but I also
I know she is waiting for
want them to feel safe
my answerso is her husand reassured.
band, standing behind me,
Wheres the line?
watching as I crouch at her
I look into Amis
bedside.
wide eyes, dilated with
My instinct is to tell
panic. Shes desperate
Keeping the trust of patients at critical moments. for me to answer her
them yes, everything is
going to be okay. I dont
question.
want Ami to panic, and
I open my mouth
keeping her calm will help the outcome. But I also dont want
to lie, but different words come out. I dont know exactly
to lie. During the last week, Ive built a relationship of trust
what will happen, but Ill stay with you.
with Ami through patience and compassion, but most imporAmi closes her eyes and lays her head back on the pillow.
tantly, through honesty.
Tendrils of wet hair cling to her gown. I dont know if her hair
Ami has been in and out of hospitals her whole life. A geis wet from tears, or from when I helped her wash her hair in
netic disease has committed her to frequent-flier status, and
the sink this morning. That feels like a long time ago now.
she has spent years of her young adult life struggling to breathe,
Every word is a struggle for Ami, but she forces them out.
eat, and live like a normal person. The accumulated pain and
The last time I asked a nurse if Id be okay, she said yes. But
fear from her hospital stays seems to have manifested as severe
I wasnt. Ami turns to me. Thank you for not lying to me.
anxiety and a desperate need for control.
Her grip loosens on my hand, so I squeeze it gently.
Lying to Ami now would reinforce her feelings of mistrust
Can we breathe together? I ask.
for nurses and physicians, but I want to do it anyway. I want
Ami nods. We did this earlier today when she struggled to
to tell her it will be okay, because I want it to be true. And I
catch her breath. In slowly through the nose, visualizing the
think she wants me to say it. She trusts meif I promise it
lungs inflating like a balloon. Out slowly through the mouth,
will be okay, shell believe me. Then maybe shell feel that
like blowing through a straw.
this whole emergency will soon be over.
In, I say, and our lungs open together. Out, I say, and
My mind returns to a time Ill never forget, when I heard
we both release.
a nurse tell a patient it would be okay. It was during a code.
In, out. In, out. In, out.
Blood sprayed with every heartbeat. While one nurse applied
Amis breath is slower, almost comfortable for the first time
pressure, the primary nurse suctioned blood and kept repeating, since the emergency started. Still, it will probably not be okay.
Its okay, youll be okay, long after hed lost consciousness.
But I do the only thing I can, the one thing I could promise.
Im sure she didnt intend for the last thing hed ever hear
I stay with her.
to be a lie. Probably, she was saying the only thing she thought
Danielle Allen is a nurse at Stanford Health Care, Stanford, CA. Contact
might help. And who knows, she might not have even been
author: danielle.christine.allen@gmail.com. Reflections is coordinated by
talking to him, but to herself. Its okay, youll be okay is
Madeleine Mysko, MA, RN: mmysko@comcast.net. Illustration by McClain
many nurses mantra in moments of stresswhen a confused
Moore.

Am I Going to Be Okay?

72

AJN March 2015

Vol. 115, No. 3

ajnonline.com