When I worked as a visiting nurse, I cared for many different patients, who all have unique and special needs. Each one I experience challenges me to new heights, each one reminds me of why I became a nurse. But one, in particular, has left an imprint in my mind that will be there for a very long time, I’ll call him Jack.

Jack is a 51-year-old male that came to the infusion team after being in the hospital for what he thought was difficulty with his Crohn’s disease, he was vomiting and his last bowel movement had been three days earlier. What he had was a small bowel obstruction that later after a CAT scan showed peritoneal carcinomatosis with malignant ascites.

The plan was to place a port, which is a central line that goes directly into the heart and start Chemotherapy. He regained his bowel function and was discharged home to await therapy. He had to go back the next day for worsening abdomen pain with bilious emesis. He had a Peripheral Implanted Central Catheter (PICC) placement and was sent home not only on Total Peripheral Nutrition (TPN) but hydration as well. Jack also was sent home with a Nasal Gastric (NG) tube for bowel decompression. Chemotherapy was on hold for now.

It was my job to teach Jack and his wife how to manage the TPN infusions and the intravenous (IV) hydration. Jack was sent home on TPN for 16 hours/day and 2 liters of fluid to infuse over 7 hours that left Jack with only 1 hour a day free from infusions.

I went to teach Jack and his wife his TPN infusions as well as hydration; they both caught on very quickly and became independent within a week, which was our goal, to make Jack as independent as possible so he could continue on with his life. They were pleased with themselves as was I. We continued our visits for routine care and soon enough we were sharing stories of each other’s lives. Jack knew that I was a cyclist and fundraiser for the Jimmy Fund through the Pan-Mass Challenge and I learned all about Jack’s three small children.

Something, however, was missing from Jack’s life…Time. He felt like he was always connected to something, it was either his TPN or his hydration…Jack only had an hour of free time a day, not enough time to do much of anything. He was too embarrassed to go out with all his connections, as well as the NG tube while dragging around an IV pole. This made life difficult for Jack. This, in turn, made it difficult for him to cope with his illness.

Jack had young children and a poor diagnosis; I quickly involved a Medical Social Worker (MSW) to assist with coping and financial issues. But I felt Jack was still frustrated and I was evenly getting frustrated that no matter what I did I could not help him. So we sat down, with just Jack and I, on a day that I had to do his labs and asked him bluntly what more could I do for him to help him.

He said, “nothing, you have done it all; nature has to take its course.” I pushed Jack a little further, by asking him what he wanted most.

He replied, “to see my son’s baseball game, but I am always connected to the TPN or the Hydration, I cannot make it out in 1 hour a day, it’s impossible.” I could see his eyes well up with tears. I thought I was going to lose my composure. Instead, I thought long and hard about what I could do for this man, who just wants to see his son play ball.

I looked up at his IV pole and said to myself, he isn’t going far with that, and then it hit me. “Jack, I have an idea!” I asked to use his phone and called the IV vendor, that company that supplies his medicines and equipment and asked if we could put his IV hydration into an elastomeric; a small plastic ball-like device that works on negative pressure, he could carry it with him, put it in his pocket and would be able to go to his son’s ballgame.

The pharmacist at first said no they do not do that with hydration and I pushed her to explain herself. She told me that the elastomeric only holds 250cc of fluid and infuses at a rate of 90 minutes to two hours and that it would be too expensive to do so. I pushed even harder telling her about Jack and that this would be perfect for him he could go out for four hours and bring two elastomeric with him and stay for a whole game. She agreed, she would send him 4 to start off with and see how he did with that.

After I got off the phone, I explained to Jack all about the elastomeric and what he would have to do, he was so excited. He was now able to focus more clearly and be part of his family’s lives. Jack was now more independent, that is what a community nurse thrives on, giving independence to someone who feels hopeless.

Jack later was transferred to the Oncology team, after beginning his chemotherapy; he later went to Hospice and sadly, succumbed to his illness. I knew that this was the course that Jack would take; I think he knew it as well. Somehow doing this “little” thing for Jack helped me cope with what I realized was going to eventually happen.

We often get caught up in assessing the physical aspects of a Patient; we forget that there is an emotional side as well that often affects the physical. I learned through Jack that both must be assessed and treated. It is not just rushing in and doing the IV and getting out, but listen, really listening to your patient and if you have to, feel his pain.

I have often heard “we cannot save them all.” But I feel we can learn from all of them. This is a memorable moment in my practice that I will not forget; I will not forget Jack or what I did for him and in turn what he did for me. It may seem like a simple thought or maybe not, but for one man it made the difference of a lifetime.

This clinical situation was important to me because it made me aware of what community nursing means to patients. To have that one person who at the time is thinking of only you and your needs and how to make your life easier and more manageable. It’s what we do for our patients, it’s who we are and I am proud to be part of that team.

We often get together, whether it is a team meeting or a gathering for a team function. Often we share what is bothering us or how the to make the job better. I didn’t share my story of Jack, I felt it was too personal, too deep and I thought it would be bragging.

Although on several occasions I have said to my colleagues “Hey, do you know that they can put Hydration into an elastomeric so your Patient can travel, now isn’t that cool.” Someday I know when this story is old and I have moved on, I will share it all with my teammates but for now, it is a secret between me and Jack.

I share this today, not because I want people to know what I did as a nurse but to show that if we all put in the effort and think of what we can do for each other we could all watch those important games together. That is what makes life so important.