1. Burke, Brenda Kelley MS, APRN, PMHCNS-BC


A nurse's injury costs her far more than mobility.


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Not so long ago, like the famous nursery rhyme character, I too had a great fall that left me broken.

Figure. Illustration... - Click to enlarge in new window Illustration by Jennifer Rodgers.

On a frigid winter night, my cries for help in an isolated parking lot went unheeded. I heard the bones in my ankles break even before pain receptors registered the injury. Almost simultaneously, the hope of a speedy rescue vanished when I fumbled for my phone and realized it had fallen out of my reach. I panicked, my thoughts racing through dreadful scenarios-hypothermia from lying on the frozen ground, impending shock, possible evildoings of a nefarious stranger. I was living the terror I'd only read about in thriller novels, the screams of pain and helplessness I heard echoing in the darkness not from characters created by a best-selling author, but mine.


As a registered nurse, I'm a good problem solver, but trauma and the incapacitating cold prevented me from forming logical plans to insure my safety. Like a light switched off at the end of a busy day, my rational mind went somewhere else to recover.


I thought of my loving family and how important they were to me, and though I was a mature woman, I cried the cry young children make for their mothers when frightened and alone. I'd clinically supervised nursing students during the day, then joined colleagues for a meeting of advanced practice nurses in the early evening. Businesses nearby were located in an area of old mill buildings that had closed for the day; it was one of those eerily quiet winter nights when the bitter cold forced people inside. As I lay there, I regretted my decision to leave the meeting early to make the long drive home. Dressed only for clinical work in a heated hospital environment, I was ill prepared for the elements beyond just a quick walk to my car. Movement in any direction caused extreme pain, so all I could do was keep screaming for someone to help me.


Finally, about 30 minutes later, a car engine revved and headlights swung in my direction. In that welcoming halogen glow came the hope of rescue. The resulting two broken ankles, surgery, and months of rehabilitation brought many losses-the loss of comfort, mobility, and self-confidence were just a few-but the most significant loss was that of a key relationship.


For a number of years, I'd made daily trips after work to a nursing home to visit my mother, someone whose gentle touch and approving smile I still craved. The roles of child and mother were now reversed because of her dementia. I felt acutely aware of the mother-child bond and how it transcends time and circumstance. How could I measure up to this wise and loving woman, who so many years ago would kiss my small feet before she put on my socks and whisper, "God, guide them to the safe places"? Since childhood she'd regularly told me that I was the "beat of her heart."


There was a lot of love to repay, and after my injury, the interruption in my once-daily visits cost us both dearly. Those who work with people experiencing cognitive decline point out that daily contact is important in preserving memory. By the time I was able to visit again, two months had lapsed, and my mother had no recollection of who I was. I suppose, to her, I looked like any other resident of the nursing home as I sat there in my wheelchair. I felt anonymous and motherless; what did she feel? Our visits continued over the next several months, mostly without words. We sat and held hands like old friends or caring strangers. All the years of love and affection that cemented our close relationship had been erased-like hitting "delete" on a keyboard, the proof of what had once been was simply gone.


We were, most likely, victims of circumstance. But with this loss, the quality of both of our lives had been changed. My mother died a short time after our visits resumed. There was no closure that came with her death. Did she feel abandoned by me? Did she wonder why this stranger who came and held her hand had replaced her daughter? Did she cry for me like I'd cried for her when I felt scared and alone? These painful thoughts complicate the grieving process. All of her memories had faded like an old photograph, including those of me, but I like to think that in their place new ones were created each day by the kindness and attention of others who were committed to providing her care. There is some comfort in this.