By Rachel Basham, RN, CCRN

I became a nurse at the age of 23. I was pregnant with my first son and dove into nursing headfirst, accepting a job in the pediatric ICU of the hospital where I worked. I still remember the call when I received the job offer. I hung up and jumped up and down, screaming in excitement. I couldn’t believe that I got my dream job, the job that wove my two loves together: pediatrics and critical care. How lucky was I? When I arrived fresh-faced and eager on my first day, I found out my preceptor was Deb. She seemed to know everything. How would I ever know what she knew? How do you even learn this stuff? She had an ability to shrug things off that left me in awe. Her skin was tough, but her heart was still soft.

After a grueling orientation that involved so much knowledge-acquiring that it made my head spin, the proverbial cord was cut, and I was off on my own. Oh, the weight of caring for those little ones with so much less knowledge than my experienced colleagues! My shoulders were heavy with the responsibility. As a new nurse, I was so nervous that I would miss something or not know something and it would impact my patient negatively. I remember one intensivist who would walk up and down the ICU hallways with a strut that communicated his attitude: “Question me. I dare you.” I struggled to stand my ground, advocating for my patient and sometimes disagreeing with him, realizing that I had only a cup to his ocean of experience. He would refuse to do things simply because I suggested it. One charge nurse pulled me aside and encouraged me to “find a way to make him think it’s his idea” so I could get appropriate orders for my patient. I think she was kindly trying to help me cross over from the idealistic world of a new grad nurse to the real world of nursing in the trenches.

When I began my nursing journey, I dreamed of helping children in critical care by titrating drips and applying vast and skilled clinical knowledge to save lives. My heart beat wildly at the thought that I could blend the art and science of nursing, saving lives like a hero with the anonymity of a nurse. I needed no thanks. I just wanted to help. I wanted to relieve suffering. I wanted to provide gentle and thoughtful end-of-life care. I wanted to be great because being great would mean my patients would have good outcomes, and I wanted that most of all. I washed children’s dead bodies so their mothers could see them before we put them in a plastic bag and sent them to the morgue. I walked those long halls for those 13+ hour shifts without breaks with a huge pregnant belly and puffy feet, exhaustion pouring out of every surface on my body. I missed Christmases, birthdays, and playdates, and lost friendships and hobbies. I came in for classes on my days off and spent late nights at home researching information to improve my skills.

I vividly remember one holiday when we had two patients arrive on the unit who were victims of a horrible assault. Two young children, innocence in the flesh, found almost dead by a neighbor. We worked so hard to save them. I stood in one boy’s room pushing blood into his IV using a large syringe because it was the fastest way to do it. My whole body wished I could do more, work faster, do something, anything to save him. We were packed in his room like sardines, everyone rushing and hoping, frantic to save him. In attempting to stop his bleeding, I wrapped every roll of ace bandage we had on our unit around his sweet, little head. His mother stood outside his room; she could do nothing but cry. His father went to our chapel to plead with God for his boy’s life. I am a woman of God, a firm believer in God’s presence all around us and His love for human beings. I experienced a spiritual crisis that Christmas. Why? Why? Why? Those two sweet boys flew away to Heaven two days later. We couldn’t do a thing to stop it.

I moved onto emergency nursing some time after that night. As an ED nurse, I continued to experience frustrations that only those who have been in the trenches with me seem to really understand. The indescribable flutter that goes through your chest when a woman runs into the lobby with her blue baby in her arms, shoving him into yours, “Help my baby! Please, help my baby!”

It’s hard to explain how it feels when you find out the patient in acute psychosis threatening to kill you actually had a knife on him. “I could have died today,” you think to yourself later when the chaos has passed. It’s the heaviness in your chest when your recently mentored new grad comes to you crying because she just took part in her first infant code and it didn’t go well.

“Maybe if we had done better, that baby would still be alive,” she sobs. Some of these memories keep you awake in bed at night and mentally weigh on you long after you clock out. There are moments it occurs to me that I could have picked a much easier career. But, I’m not sure if an “easier” career would be better. I have prayed with my patients. I have laughed with them and held their hands in tough moments. I have served my patients with all of myself. I have been a first-hand witness to the beginning and the end of life itself. Oh, to be a nurse. Yes, that would be the hardest and the best job of all.