It felt like it was just yesterday that I was an eager nursing student in clinical looking at all the registered nurses who I could possibly be paired with thinking, "man I cannot wait to be them and have the letters RN behind my name". Eventually, the day came when I accomplished all my goals and was finally a critical care registered nurse. Shortly, it felt too real and the reality of being a nurse hit me. During my first month of orientation, I found myself caring for a patient who eventually became a story I would never forget. This 72-year-old female patient came into the emergency room following an episode of stroke-like symptoms while out shopping with her husband. She was unable to move her right side and had accompanying weakness. By the time my first shift had started to take care of her, she was already scheduled for surgery to coil her aneurysm. I took her last neurological assessment before she went down to surgery. It was a brief, less than one-hour interaction, but I was able to see that she had returned to full function. She had clear and normal speech, full range of motion, and strength of all limbs. I saw her kiss her husband at the bedside right before anesthesia rolled her down to the operating room. My preceptor and I told the husband where the waiting room was and where he can grab coffee and food. He seemed at ease with the surgery as he stated, "She worked here for over 20 years as a nurse, I know she is in great hands". He then left the room and it would be around 8 hours until I would see either of them again.

I went on with my day, taking care of the other patient I was assigned to. Finally, in the evening, around 5 pm, we received a call from the OR nurse for the report. I saw my preceptor a couple of minutes into the phone call let out a sigh. It was said that the patient was intubated and we had to wait for handoff report from the physician to know what happened during the surgery. Eventually, my patient came back up to the floor with an EVD and was intubated as expected. Handoff report from the physician started with, "This is a sad case". We soon found out that her aneurysm had ruptured in surgery and one of the coils used had traveled contra laterally and caused an infarct in the opposite side of the brain. This patient now has suffered a massive bleed and an ischemic infarct. It was likely that she was never going to wake up. My preceptor and I got her settled from surgery and then gave handoff report to the next nurse before we left for the day.

The next two weeks of caring for this patient have merged together. As I rotated sets of patients within the time that she was here, I kept an ear out for her and always asked the nurse for updates. At this point, we were waiting for the days to pass to see if there was going to be improvement, as well as trying our best to prevent vasospasms. I made sure I stopped in every day that I worked, as I had become familiar with the family and spent about an hour each shift talking to them. I always thought that being a nurse meant that the hardest part of the job would be taking care of the patients. This assignment made me realize that nursing is more complex than just caring for the patient. I witnessed the husband go from hopeful and eager, to over the course of two weeks, looking depressed and malnourished. This is when I realized that I have to care for him as he has forgotten to do it himself. By the end of the two weeks, he asked questions to the providers with the underlying tone in his voice that he knew she was never going to wake up. I prayed every night, hoping for improvement, but unfortunately, a family meeting was held, and we planned a day for compassionate extubation, as there were no signs of possible improvement. This moment crushed me, and not in the way I once thought it would. I was worried about the husband. I witnessed the husband hit a wall of depression and sadness. I knew I had to be his support system. I made sure I spent time with him. He didn't look like he was eating, and I knew he loved soup, so I told him one of my favorite spots down the road and encouraged him to go eat, and he did.

After that day, I made sure I always checked the cafeteria menu for the soups of the day and brought them to him if I knew he would like one. I had extra warm blankets in the room on the chair waiting for him, a cup of coffee, and a glass of water before he came in every morning. I encouraged him to go out with family and made him feel safe to leave his wife in my hands. I planned his wife's care plan and activities around his chemotherapy treatment to make sure he still went to his own medical treatments. It was hard witnessing a spouse experience loss and watch it from start to end. Eventually, the day came, and it was time to extubate. I had a four-hour education block on the unit that day. I wore a sunflower shirt under my scrubs as I knew it was the patient's favorite and the family would also be wearing sunflower clothing. I headed into the room before they extubated and helped the family set up a slideshow they made of the patient's life in photos. I sat for about an hour talking about her life and listening to all the stories about her that they wanted to share with someone. They didn't have any children, so to the husband, his wife was his whole world. I did everything in my power to care for him while he was there so he didn't have to think about himself during that time. This case made me realize that being a nurse meant caring for my patient and their family and that is something I will carry with me forever.

After the extubation, I never saw him again. The room was cleaned, and the next day another patient was in there. I still think about the husband to this day, wondering if he is doing okay, eating, and going to his treatments. This is the part where nursing is a never-ending circle of caring. Sometimes it's painful, sometimes you feel defeated, and sometimes it's rewarding. In this case, it was my first time that I felt that the reality of nursing had hit me. You care for more than just the patient. We watch families go through the hardest parts of their lives and try to support them the best we can. The hardest part is wondering if they ended up okay after the last day you saw them in the hospital. This story has been one of the reasons I changed my way of giving care to be more compassionate and mindful of how to care for families going through a hard part of their life.