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Nurse helps to recognize anger as true fear Editor’s note: The following story was contributed by an anonymous author and was reprinted with permission from the booklet, “The Many Faces of Nursing” for the MUSC Medical Center. My 10-year nursing career has provided me with many memorable experiences in addition to giving me an opportunity to meet and care for interesting people. Early in my career, I learned that although the clinical aspects of nursing are essential, providing emotional support and genuine concern for patients can make a significant difference in their ability and desire to heal and cope with their illnesses.  I believe that through positive mental reinforcement, people are able to gain physical strength and heal themselves. While working on a medical/surgical unit, I was assigned to Mrs. R. She was a 60-year-old patient who had been diagnosed with breast cancer, undergone a double mastectomy, and received her final dose of chemotherapy two days prior to my assignment.  Mrs. R. was admitted with dehydration, anorexia and anemia. Abnormalities noted on initial assessments of her condition were hypertension, 30 pounds underweight, pale complexion, dry mucous membranes, malaise, and a flat affect. I was somewhat unsure of how to relate to Mrs. R. because of a lack of experience in caring for a cancer patient. I set about carrying out her many orders, with reassurance from the experienced staff. I used my clinical resource manuals to review the care plan for the oncology patient receiving chemotherapy as well as the care plan for her other diagnoses.  Before I started the teaching plan, I went to Mrs. R.’s room to see if she would participate, along with her daughter, in the development of her plan of care. At the stage of her illness, they both agreed, feeling that her plan of care was the most important thing in trying to get her back to her vibrant self. Mrs. R.’s daughter made me aware that until eight months ago, Mrs. R. was a healthy, vibrant woman who taught high school and aerobics classes, played bridge, and volunteered with a multitude of civic organizations.  The daughter stayed with Mrs. R. during the day and I noticed that she never spoke to her mother directly or touched her. She referred to Mrs. R.’s condition only in negative terms that focused only on what was wrong. After suggesting that Mrs. R. try to feed herself a full liquid dinner, her daughter became angry and said, “My mother is too weak to do anything for herself. Can’t you see that? She is dying, please let her do so in peace.”  After asking to speak with the daughter outside the room, I apologized for upsetting her and asked her if she had a support system of her own in place.  “No, I’m an only child and my father died 10 years ago,” she stated. I realized that she was scared and shouldering her illnesses alone. With her permission, I contacted the psychiatric liaison nurse and chaplain and provided a private place for them to sit and talk. The next day after speaking with Mrs. R.’s doctors, I found out that Mrs. R. had a good prognosis for survival and would probably be able to go home in five to six days.  The plan was to stabilize her blood pressure, improve her appetite, decrease her diarrhea and vomiting, increase her hemoglobin and hematocrit, and to increase her weight and muscle strength. Daily visits from the chaplain proved to be beneficial to Mrs. R.’s daughter. She began to assist with Mrs. R. and displayed a more positive attitude when dealing with her mother’s illness. I prepared a teaching packet with the assistance of the oncology nurse specialist and psychiatric liaison. I provided them both with a list of local and national support groups and their numbers. During this time of clinical care, I also began talking with Mrs. R. about the activities she was involved in at home and asked questions about her work as a teacher. At my suggestion, her daughter brought in a few books by her favorite authors.  Mrs. R. began to accept visits from friends, co-workers, and church members. She was more talkative and planned things to do when she was feeling stronger. By day seven Mrs. R. was ambulating with minimal assistance, eating a regular high protein diet with supplements, and her hemoglobin and hematocrit were within normal limits. She no longer had complaints of nausea or vomiting and gained two pounds. The next day Mrs. R. was discharged home with her daughter. Before they left, they both thanked me for being instrumental in Mrs. R.’s care.  I can’t begin to express the feelings I have for my role in Mrs. R’s recovery. I learned that nursing is much more than carrying out the doctor’s orders.  It’s a giving profession that has the power to touch people and move them to do amazing things.     Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.