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Jim Hettinger, Nu’21

“I spent a summer as an extern in a hospital’s progressive care unit and had a patient who was a four-year-old girl on the autism spectrum. She also had a problem with her airway that made her nonverbal. I cared for her for three days straight and on the morning of the third day I came in to find her crying. We keep patients like her in “bubble-top” cribs to prevent them from climbing out and injuring themselves, so I came in and opened up the top. I was trying to figure out why she was crying. No signs of being in pain, and her diaper wasn’t wet. I offered her favorite toy but she kept crying. So the question became, what did she want?

Because she was nonverbal she had learned a “hand over hand” technique for communication, meaning that when we wanted her to pick something up, we placed our hand over her hand and moved it to the object. She, being particularly clever, had started doing the opposite, grabbing our hands and moving them to objects she wanted us to grab. So, as she was crying in the crib she reached out between the bars and grabbed my hands, placing them on the handles of the crib. I got the message: she wanted me to drop the crib rails. I figured she wanted to walk and stretch her legs, but I was wrong. As I dropped the rails, she immediately wrapped her arms around me, burying her head in my chest. Finally, I understood, what she wanted was me.

This may not seem like a big deal (and probably sounds obvious to any parent) but to someone who was just learning how to be a nurse, this was a defining moment. So often we are taught as nurses that patients need something—like a medication, education, or therapy—but we can neglect the human side of things. The idea that, especially in pediatrics, the most beneficial thing I can offer my patients is myself is what made me choose the field. As much as children need the medicines and therapies that we give, they also need a person.”

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