1. Christaldi, Alice Mary BSN, RN, CRRN

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I reach for your hand, now cooler than an hour ago. Rough calluses reflect your years of hard manual labor. Subconsciously, I count your respirations and reach up to brush aside a wisp of grayed hair from your brow. The room is hushed; the other patient moved somewhere else. Death steals in quietly.

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I sit with you, as I have sat all afternoon. I am 21 years old, recently graduated from nursing school. My second day on my first nursing job finds me with a dying patient. With no family nearby, my manager didn't want this patient to die alone and asked for a volunteer to stay with him. How could I not do so?


As I reach for your hand, the only tangible thing that I can find to do is daydream about my future. The year is 1974, and the world is my oyster.


I couldn't have imagined that day what life had mapped out for me. I never would have guessed that my father would be dead in 2 years, felled quickly by asbestosis that filled his lungs with carcinogens. I knew after 2 days that I wasn't cut out to work on a medical-surgical floor, and I needed to find someplace else to work. This would lead me, with 3 weeks of experience, to run a small, three-bed postanesthesia care unit. It was a temporary job while the regular RN had a nephrectomy. The only other staff member there was an LPN, who showed me the ropes.


The room had no monitors, no I.V. pumps, and no windows. We extubated patients, recovered them, and delivered them to their rooms. Once they wanted us to recover a patient who needed heart monitoring-no such machinery in the room. They brought in a big monitor with leads that were attached to the patient with small subcutaneous needles. Luckily, I had taught myself how to read rhythm strips in nursing school. I was a puzzle junkie, and ECG strips were one big puzzle to me-I relished figuring them out. Good thing!


When the RN came back from her surgery 7 months later, I was transferred to the OR. A door opened for me the following year, and I decided to take a job at an inner city, 12-bed medical-surgical ICU. Rapes, stabbings, and gunshot wounds were routine. I had to watch in horror as a 25-year-old police officer was taken off life support because there was no life left to support. A young girl was gang raped and left for dead in an alley behind a church on a frigid New Year's Eve. A man needed to be on a ventilator for the rest of his days, but there was no place to send him, so he stayed in our ICU for months. This was too much for a young 22-year-old to deal with. I left the big city and returned home.


My path along the highway of nursing has led me through many curves and hills. I explored home health, long-term-care facilities, and ended up in progressive care units for many years. I lasted for one day in an outpatient psychiatric home, and 3 months in an assisted living facility. I also worked in a monastery of cloistered nuns, caring for their elderly sisters. My mother developed breast cancer 1 year after my father's death, but was in and out of remission for 15 years.


Moving to Virginia during a time of midlife insanity, I happened upon the world of physical rehabilitation, and knew I discovered a field of nursing that truly excited me. After 12 years, it still does! I get to teach, watch my patients regain use of their minds and bodies, and work as part of a team. All the experiences and knowledge I've gained over the years are now reaching their pinnacle in my practice.


Your hands now limp, with skin more dusky and heart rate slowing. Soon I'll leave for the day, will you be here in the morning? Will your family appear, or are you alone in this world?


I reach for your hand, this once strong hand. As life slowly ebbs from you, I gain strength from this time spent in the quiet of waiting. Even as a new nurse, I know that my place is by my patient's side. I understand the intrinsic value of human life and dying with dignity, even at my young age. I realize the value of touch, the healing quality of a smile, and the need for humor in many situations.


My time with you is over, and I leave you in the care of another young nurse. We reposition you, and I look at your face one last time. Those eyes that don't see me any longer will soon look upon the angels. The limbs crippled by arthritis will find strength again and those hands, those hands will grasp eternity. My hands remember...