A nurse named Jackie, the ultimate bully

By: Debbie Moore-Black, ICU RN

She was oil. I was vinegar.
We didn’t mix. Ever.
Even though we wanted the best outcome for our ICU patients, we stood on opposite poles of the earth.
Sometimes there’s only room for one alpha dog. One ultimate bully.
And that wasn’t me.

Mr. Williams, 68 years old, received the tragic news from his physician. He was having strange and unusual symptoms like slurred speech, muscle weakness and lack of coordination, muscle spasms, weight loss, difficulty swallowing. Tripping and falling. And the worst: difficulty breathing.

His death sentence. ALS: amyotrophic lateral sclerosis. Also known as Lou Gehrig’s Disease. That famous baseball player from days gone by.

Mr. Williams gathered his loving family together upon his diagnosis. It wasn’t one of those cook-out family get togethers.
The family knew something was wrong.
Mr. Williams called the meeting. He explained that he had an unusual deadly diagnosis. It would be progressive deterioration of his body.
There was no cure.
Mr. Williams did not want to be put on a ventilator when the time came. He requested that he be made a DNR/DNI.
He wanted his family together when the time came.
No heroics.
Just a peaceful passageway to his hereafter.

He was admitted to our ICU. His physician wanted the ultimate care for this patient. He wanted Mr. Williams to have that last gathering with his family. And so per the physicians request, there was no EKG monitor. No loud beeping noises. Just IV fluids slowly infusing in his vein. And his entire family in a semi- circle surrounding his bed.
At times, you could see Mr. Williams looking up. As if he saw the gates to heaven. He smiled.
His wife, his children. His grandchildren. A priest all at his side.
I was given orders by his ICU physician to give this patient morphine IVP prn.
There would be no suffering.

I stood in a corner hoping to not be visible.
The family stood close together. Holding hands. Laughing about the fun times they all had growing up. The family man. The neighborhood father.  The loving husband. The perfect granddaddy.
Laughing turned to intermittent tears.
I tried to stay strong though I was ready to crumble.
But my job was to prevent any suffering.

As I gave Mr. Williams morphine IVPush as needed, I made sure he was not gasping for air. That he was comfortable. That the family was comfortable.
I had prepped the family on what my role was. But told them to freely talk, laugh. Cry.
It was a beautiful passageway.

But then Jackie came barging through his ICU room. I was dismissed and told in front of the family members that I could not give morphine prn. That I was creating “euthanasia”. That despite my orders from the ICU physician, I could not do this anymore and I was told to leave the room. And Jackie took over.

Jackie told the patient, who was in and out of consciousness, that he would soon be in heaven with his wife.
His wife was actually present in room. She was very much alive.
Jackie had  such a negative affect on this family. On this situation.

Mr. Williams died two hours later. But the family was in shock over the turmoil that Jackie created.
The family reported her to supervision.
But nothing was done.
Jackie was a workhorse and would clock-in to work at any given time when needed by our manager.

I’ll never forget the beauty of this family. The togetherness. The love.
And the shattered moment of when a fellow nurse had to be in control.
The ultimate bully.
Her ego rode on the expense of a dying patient surrounded by his loving family.

Some things we can’t forget. As hard as we try.

(Fictitious names and Google stock photo)