As charge nurse on a busy day in our PICU, I was the hub of traffic control. Two of our patients were stable enough to transfer out of the ICU to the medical/surgical floors. One patient in the ED had caught a bad respiratory virus and was struggling to breathe. One of our physicians went down to evaluate him, and I had to think about which room and nurse I might assign to that patient, as he would likely need ICU admission. In the meantime, another one of our physicians was fielding phone calls from two different outside hospitals about kids in their EDs who needed the pediatric speciality and higher level of care that our hospital could provide. I had just enough nurses to cover the needs, if the timing of movement out of and into our unit flowed just right. 

I was receiving and making endless calls and texts, to our physicians, my bedside nurses and respiratory therapists, the charge nurses in our ED and the med/surg floors, and our hospital supervisor, to keep tabs on and coordinate all these moving pieces.

In between, my pager was going off to alert me of the need for a Rapid Response Team to go see a patient teetering in stability, and to also alert me of a Level Two Trauma patient arriving in our ED. The central monitor next to me, which had all the vital signs of all our PICU patients, occasionally alarmed. “Oh, that patient isn’t really in V-tach…he gets a respiratory treatment that can look like a deadly arrhythmia. Ah the girl in room  3218 is dropping her oxygen saturation! Oh ok, someone paused the alarms already, so a staff member must be in the room tending to the patient. Now where was I…”

The new chaplain stopped by my desk to introduce himself. We got a few sentences into getting acquainted, when another nurse came to ask me a technical question about collecting a special type of lab sample, so the chaplain moved on.

Another phone buzzed in my other pocket. “Are my kids ok? Is my husband ok? Oh, that’s a friend asking if I can help pick up their kid from school tomorrow. I’ll need to confirm that soon.”

Needless to say, I was overstimulated. The technology we have is a blessing and a curse. We can touch base with people, or send them communication via text or email, more easily and quickly than ever. Monitors can communicate multiple levels of information about multiple patients, all at the same time. Personal phones can push texts and emails through to us, inserting voices from our personal lives into our work day. My brain was trying to filter, process, prioritize, keep tabs, make decisions, and occasionally breathe.

I stared at the paperwork in front of me, as I also tried to start wrapping my mind around which patients would still be in our unit for the next shift, and which night nurses I should assign to these patients. Were there orientees who needed specific patient experiences with their preceptors? Which nurses were trained in specialized therapies that a couple of our sickest patients were receiving?

Then a nurse rushed over to me with some heightened emotion. “My patient’s guardian has taken over our small family conference room! She’s not using that space to talk with any doctors. She’s got her legs stretched out on the couch, lights off, just lounging. She can’t be in there. I need you to go talk to her!”

I took a deep breath. My mind was still overloaded, but I didn’t have much time to pause. I was pulling this extra ball into the flurry of balls I was still actively juggling.

I went to the family conference room and knocked on the door. The guardian was sprawled out on the single sofa, her legs propped up on the end, scrolling through her phone. 

“Hi, I’m the charge nurse today.”

“Ummm, hi.”

“I’m really sorry, but we can’t have you reclining here in this room. We try to keep this room open for families when they need to have really sensitive or private conversations with the physicians.”

She stared at me impassively. 

“Does someone need this room right now?”

“Well… no, but it’s just not a space that we typically make available for family members to just recline. There are spaces in the patient room itself for family members.” 

“Yes, but I just need to tell you that anytime the physicians had sensitive conversations with me, it was always in my relative’s room. They never brought me into this room.”

My phone rang. It was the physician, surely wanting to talk to me about whether we had a bed and nurse available for one of the patients from the outside hospital. I ignored it and tried to stay focused on the family member in front of me. I had to be compassionate and also efficient.

“I understand. You’re right. Physicians can use both spaces. But what I’m trying to say is, we still just need to keep this room available in case of emergency situations.”

“Well, my family member is also critically ill.”

“…I know. I’m so sorry. The hospital just isn’t a perfect space for everyone’s needs and desires. I wish no one needed these spaces. It’s hard for everyone to be here.”

My phone rang again. I silenced it, but my stress was rising. I was trying to have an in-person conversation but there was so little room for focus and presence. I felt my personal phone buzz. Was my family ok?

“That’s fine, miss. I’ll leave this room. I get that you have to follow the rules and it’s not about humanization here.”

“My intent is not to make you feel dehumanized, I’m so sorry…”

My phone rang yet again. This time it was the House Supervisor, surely looking for me since the physician hadn’t been able to reach me after two phone calls. I silenced it.

“I’m so sorry. I don’t know what else to say, but my intent is not to make you feel dehumanized. I’m so sorry, I have to respond to these phone calls. I just need to ask you to leave this room.”

“It’s fine, miss. You know you all kept asking me over the past week what you could do to help me. Bring water? Send the chaplain? Give a parking pass? You all said you wanted to do anything you could to help me. Now you want me to leave this room. It’s fine. I’ll leave. I understand you’re not about humanizing, you just have to follow the rules.”

“I’m so sorry, that’s not how I meant to make you feel.”

I couldn’t help but wonder, if I had had more space to feel more present, more connected, less stretched by all the technology around me, if that conversation could have gone a different way.

Maybe not. 

But maybe it could have.