Working Christmas Day

I was triage nurse that day and had just been out to the waiting room to clean up. Since there were no patients waiting to be seen at the time, I came back to the nurses' station for a cup of hot cider from the crockpot someone had brought in for Christmas. Just then an admitting clerk came back and told me I had five patients waiting to be evaluated.

I whined, "Five, how did I get five; I was just out there and no one was in the waiting room."

"Well, there are five signed in." So I went straight out and called the first name. Five bodies showed up at my triage desk, a pale petite woman and four small children in somewhat rumpled clothing.

"Are you all sick?" I asked suspiciously.

"Yes," she said weakly, and lowered her head.

"Okay," I replied, unconvinced, "who's first?" One by one they sat down, and I asked the usual preliminary questions. When it came to descriptions of their presenting problems, things got a little vague.

Two of the children had headaches, but the headaches weren't accompanied by the normal body language of holding the head or trying to keep it still or squinting or grimacing. Two children had earaches, but only one could tell me which ear was affected. The mother complained of a cough, but seemed to work to produce it.

Something was wrong with the picture. Our hospital policy, however, was not to turn away any patient, so we would see them.

When I explained to the mother that it might be a little while before a doctor saw her because, even though the waiting room was empty, ambulances had brought in several, more critical patients, in the back, she responded, "Take your time, it's warm in here." She turned and, with a smile, guided her brood into the waiting room.

On a hunch (call it nursing judgment), I checked the chart after the admitting clerk had finished registering the family. No address - they were homeless. The waiting room was warm.

I looked out at the family huddled by the Christmas tree. The littlest one was pointing at the television and exclaiming something to her mother. The oldest one was looking at her reflection in an ornament on the Christmas tree.

I went back to the nurses station and mentioned we had a homeless family in the waiting room - a mother and four children between four and ten years of age.

The nurses, grumbling about working Christmas, turned to compassion for a family just trying to get warm on Christmas. The team went into action, much as we do when there's a medical emergency. But this one was a Christmas emergency.

We were all offered a free meal in the hospital cafeteria on Christmas Day, so we claimed that meal and prepared a banquet for our Christmas guests.

We needed presents. We put together oranges and apples in a basket one of our vendors had brought the department for Christmas.

We made little goodie bags of stickers we borrowed from the X-ray department, candy that one of the doctors had brought the nurses, crayons the hospital had from a recent coloring contest, nurse bear buttons the hospital had given the nurses at annual training day and little fuzzy bears that nurses clipped onto their stethoscopes.

We also found a mug, a package of powdered cocoa, and a few other odds and ends. We pulled ribbon and wrapping paper and bells off the department's decorations that we had all contributed to.

As seriously as we met physical needs of the patients that came to us that day, our team worked to meet the needs, and exceed the expectations, of a family who just wanted to be warm on Christmas Day.

We took turns joining the Christmas party in the waiting room. Each nurse took his or her lunch break with the family, choosing to spend their "off duty" time with these people whose laughter and delightful chatter became quite contagious.

When it was my turn, I sat with them at the little banquet table we had created in the waiting room. We talked for a while about dreams. The four children were telling me about what they would like to be when they grow up. The six-year-old started the conversation. "I want to be a nurse and help people," she declared.

After the four children had shared their dreams, I looked at the Mom. She smiled and said, "I just want my family to be safe, warm and content - just like they are right now."

The "party" lasted most of the shift, before we were able to locate a shelter that would take the family in on Christmas Day. The mother had asked that their charts be pulled, so these patients were not seen that day in the emergency department. But they were treated.

As they walked to the door to leave, the four-year-old came running back, gave me a hug and whispered, "Thanks for being our angels today." As she ran back to join her family, they all waved one more time before the door closed. I turned around slowly to get back to work, a little embarrassed for the tears in my eyes.

There stood a group of my coworkers, one with a box of tissues, which she passed around to each nurse who worked a Christmas Day she will never forget.