It’s Like Riding A Bike…. by Melissa Morgan (MSN 2017) I began my caregiving role in life even before I actively knew what it was all about. As a child, my dolls were all triaged and stripped down on cookie sheets so I could tend to their bumps and bruises. I worked at summer camps caring for developmentally disabled adults during college. I began my journey to becoming a nurse as a direct care provider on a psychiatric unit in a major teaching institution. After nursing school, I completed a residency program with a specialty in intensive care. In a span of 5 years from my NCLEX to just a few months ago, my experience ranged from ICU’s to Emergency Room care. I knew how to start a difficult IV without giving it a second thought. I certainly knew how to do a 4-point take down and how to calculate the proper dosage and dispensing of medications. While studying for my advanced degree I also accepted a position with the local university’s pediatric unit, caring for young children. My most valuable lesson came from Ben, whose name has been changed to protect his privacy. "I see my brother and dog...over there in the doorway." Ben had begun to hallucinate from all of the chemotherapy, anti-nausea, and anxiety medications. Ben had cancer, a rare form affecting his bones; he chose chemotherapy and limb-salvage over amputation in an effort to fend the disease. I was familiar with Ben’s care and had taken care of him several times since he was admitted to the hospital. My initial assessment of Ben that day told me this delirium was a change in his mental state. I had to get Ben out of the four walled darkened room, laced with "get well soon, you are a rock star!" cards. It was at that moment a profound intervention was needed, one that didn't require more medications, more IV starts or more discussions on whether a tumor had spread or not. I felt like I was packing up a family of eight for a family road trip and it would ultimately take three to four nurses to successfully pull it off. We unplugged his bed and wheeled him into the hallway, IV pumps, oxygen tank, tubes, lines, and drains in tow. “What on earth are you doing?!?!" asked a panicky nurse at the station. If even for a second, Ben would see sunshine, the outside life. I was Ben’s advocate and we were going to live! We stood near the window with sunlight beaming through the glass pane while Ben soaked the rays of daylight. Looking out, snow began to fall, Ben muttered, "I'm at the beach and can hear the waves." "Me too” I agreed. A moment of luminescence, a smile from him meant more to know my unconventional efforts allowed an instant of peace and relaxation. This moment, this task exceeded any drills, treatments, or interventions I learned as a novice. Starting IV’s, priming tubing, dropping a nasal gastric tube, titrating critical medications, all of which were important but, I realized then maybe I was able to visualize the holistic piece of nursing I had always admired in my fellow more experienced peers. We had celebrated Ben’s last day of chemotherapy in December not because his cancer was gone and treatment was complete but because Ben’s body was no longer able to withstand the poisonous agents we were instilling through his veins. Instead of balloons and cake, multiple drips infusing through his already fragile veins were keeping his heart from stopping and a yellow feeding tube from his nose to his stomach was sustaining enough nutrition to feed his brain, to keep him alive. The doctors began to use words like “hospice care” and “multi-organ failure.” Although Ben was increasingly withdrawn, I offered him a warm bath, washed his hair and provided a hand massage while doing my best to preserve his dignity. Sensing in my heart, it may be the last chance I would have to care for him, I covered his frail, jaundiced body with warmed blankets as he drifted in and out of lucidity. The crystal moment of clarity occurred when I announced that I would be off for three days, and that I’d miss him. It was a casual remark directed to him to let him know what to expect during my absence. His mother had been at his side throughout his whole ordeal. She was very attentive and caring, and yet, not one to mingle and engage much with the staff. Her primary focus was her son. She was grieving at the potential of losing her child. I respected this relationship and never prompted her for conversation or small talk. When he said “I’ll miss you,” his mother quietly said: “he will miss you…he means that…he trusts you.” These three words, “he trusts you” were words that I will never forget and will stay with me. They represent the whole essence of what I do every day as a nurse, and how I want to be perceived. When I came back to work after three days, Ben and his family were no longer on the unit. His wishes were to find peace at home away from drips, tubes, and alarms. I remember thinking how brave and inspiring his decision was. Five years ago as a new nurse, my perception of his resolution may have been different. Early in my nursing career, I likely would have been overwhelmed by sadness and defeat. Now, I have learned to accept the process of suffering and loss, is as important as knowing the right way to start an IV or titrate medications. This deeper journey required my experience to act as my guide. Through knowledge, I now appreciate and honor the value of finding comfort in letting patients decide what is best for them regardless if the potential outcome means dying. Do I miss the adrenaline rush the sound of sirens, alarms and focused attention an emergency room brings? Absolutely. Praises, “great IV start”, “wow, where did you learn how to put on 4-point restraints?" for sure, but these all pale in comparison to "he trusts you." Have I found my forever home? I'm not quite sure I'm ready to answer but I know one thing for sure, those three words, "he trusts you" meant that I had arrived where I had wanted to be for five years, and even before. I compare it to the time I was learning to ride a bicycle. At first all the mechanics involved, arms on the handlebars, feet turning, eyes straight ahead…don’t wobble. Practice, falling, trying different tactics to stay aloft. Then, somehow something magical happened, and I was riding and it all made sense.