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Mr. Smith, a sixty-three-year-old man, was admitted to the medical unit to rule out a left-sided CVA. He was a tall, muscular man and clearly a strong figure in his household. His wife and adult son and daughter followed the stretcher, distraught. Mr. Smith was awake but could not speak. He desperately tried to communicate with his family, particularly his son. He seemed to know it was his time to die.


I checked the admission board; he was assigned to me. It was clear that I was not only caring for Mr. Smith, but also for his family. Like every nurse, I knew what I needed to do-have been doing for years: transfer him to the bed, perform the physical assessment, check and carry out the doctor's orders and document the physical care.