Many times on our unit, we are confronted with situations in patient care that challenge us beyond general nursing knowledge. They reach out to our compassion for the human spirit. My unit, 9NT, specializes in flolan and remodulin medication management for acute care of the pulmonary hypertension patient. These patients suffer from chronic lung changes and symptoms including severe shortness of breath. The use of these medications is often a terminal/palliative treatment for pulmonary hypertension. Although they are not used to alter or "remodel" the lungs for gas exchange, they have not been proven to change mortality in patient use.

One of our longstanding patients, AR, has been receiving care at Froedtert for over two years. She was started on a continuous infusion of IV remodulin. During that time, Stephanie has come to care for her numerous times and spent time with the patient and her husband quite often. During this hospital stay her breathing worsened, requiring an opti-haler machine. Attempts at weaning from the opti-haler were made but unsuccessful. During the last attempt AR, with great reserve and stoicism, simply stated "I know it's my time." And who was there at her side but Stephanie. She offered kind words and a gentle presence during that difficult time. The pulmonary team discussed options with AR and her husband and it was decided that remodulin would be weaned and hospice care would be discussed.

In the meantime, Stephanie was busy with a plan of her own. Knowing AR and the family well, she knew that the 45th wedding anniversary was just days away. Stephanie organized, with other nurses with care for AR, a small gathering of family to be there for that special time. One nurse was thoughtful and purchased a bouquet of flowers for her bedside. Stephanie, being so kind, had a small, designer cake made for the occasion made special for the couple. She also hired a manicurist to come into the hospital to do AR's nails. She had only one request on her anniversary; a glass of wine. Stephanie contacted the pulmonary team with the request to get an official order. The family gathered and good times remembered with a slice of cake and a glass of port wine.

I know that AR will be thinking of these moments when her time has come. It's exemplary that Stephanie, who has been so caring of this woman and her family, should think of her and their needs during this time.