1. Ufema, Joy RN, MS

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I work with a nurse who thinks she needs to keep "emotionally distanced" from patients to remain professional. This hasn't been my experience. How can I help her understand the value of getting involved?-P.M., ILL.


I'm not sure how someone called to the art of nursing can suppress emotions, as they're as much a part of a person as thought. I believe your colleague has heartfelt emotions about her patients, but she's choosing to detach herself from those feelings.


Like you, I've found that I'm a better nurse when I get emotionally involved. For example, I'm more assertive with pain management-I'm not afraid to call a physician at 2 o'clock in the morning for a morphine order. I don't hesitate to speak up if a nursing assistant handles a patient too roughly. And I staunchly advocate honoring advance directives.

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Getting involved doesn't detract from my professional objectivity. It simply means I've tapped into my human capacity to empathize, to imagine how it feels to experience what another is feeling.


Recently, I was called to the ICU to help the family of a 49-year-old Chinese man believed to be brain dead following prolonged cardiac arrest. I sat quietly with his wife, children, and siblings. In spite of the language barrier, they understood my role. The patient's brother spoke a few words in Chinese, then silence.


I noticed that all had closed their eyes and bowed their weary heads. Tears fell on satin dresses and blue jeans. And then[horizontal ellipsis]above the ceiling, the sound of saws and hammers!!


The floor above the ICU waiting room was being renovated. Scraping sounds, screaming machinery, and yelling workmen sank into that sacred space like a barrage of shrapnel.


I bolted with as much dignity as possible to the nurses' station. I telephoned the administration office, identified myself, quickly explained the situation, and insisted that the crew be told to stop work immediately.


Returning to the family, I sat among them, once more in silence. I don't know if they noticed that the din above had ceased. It didn't matter. What mattered is that they'd had enough stress thrust upon them, and I was morally and professionally obliged to get involved.