I am writing this letter to recognize the outstanding care, service, and support provided by the nurses on the 3 East Transplant Unit to my sister during her stay at Jefferson. I would also like to acknowledge Carol Ann Howard, PA, who was a critical and supportive presence during this time.

My sister received a live donor liver transplant from her daughter and faced a challenging recovery over the following six months. Her journey came to an end on her birthday. Of those six months, she spent approximately four in the hospital, under the dedicated care of the nurses on 3 East.

It is important to know that their care and attention to her (and to me) as she endured her final struggle was nothing short of heroic, demonstrating the perfect mix of necessary interventions, with proactive caring and attention to her every need, emotional and physical. From her first night in the hospital back in July until her final night in January, we both knew that "we weren't in this alone" due to the nurses' ongoing services of welcome and support. They went the distance and beyond each and every day to provide my sister with the assistance she needed, even when we didn't always realize we needed the help ourselves.
Examples:

The charge nurse, Bridget Kelly, proactively checked my sister to see if her skin was breaking down during her long hospitalization. At the first indication that intervention was needed, she ordered and helped to set up an air mattress in her hospital bed. When my sister was being discharged, she secured an extra seat cushion for her to use at home, assuring that we already had all the other equipment she would need. She had her eyes on us, and most importantly my sister, who had been so vulnerable for the past few months.

I often spent the greater part of each week sitting in the chair by my sister's bed. In conversation, I mentioned that the chair was very uncomfortable. Bridget immediately mentioned that they had another chair that might work better. Although these chairs are upholstered and heavy, she found another chair and wrestled the old one out of the room and rolled the substitute one in. This was no small feat, as the hospital rooms are very small and most of the available space is taken up with medical equipment. It is difficult to navigate with even only two people in the room with the patient. The new chair made a world of difference to me (and my back), only surpassed by the thought and care Bridget demonstrated to ensure my comfort.

The nurses on 3 East responded every time to any need she (and I) expressed, from getting another pillow, to checking on her skin breaking down, and even ordering a slice of pizza when my sister had a craving one day ... (she couldn't eat it, but it was delivered just as she wished...). Towards the end of her struggle, my niece and I stayed later than usual. The nurse on duty ordered out to get sandwiches for us as it was close to dinner time.

My sister had to swallow many pills and endure being pierced with many needles for blood tests, IVs, and gastric infusions. In the end, her arms were purple, resulting in her finally needing access through her groin. I admired the skill and sensitivity the nurses showed to her in negotiating how she took her pills. She always had trouble swallowing them: "Take two now, and in 15 minutes, you can take two then, okay?" Eventually, she would get them all down. I learned from their negotiating skills, which gave her a little bit of control as her condition was sweeping her away.

My sister had a great sense of humor, and they matched it ... I watched them banter back and forth with her as they conscientiously went about their daily tasks, always accomplishing everything they needed to do for her care.

"I am a rule breaker!" my sister told them. She was a fall risk and would get annoyed with me when I called the nurses to help her get to the bathroom, as she prized her independence. At the time, she was hooked to IVs and poles, so I couldn't move her without risking causing some harm. She would try to get out of the bed at times, and the alarm would go off. I told the nurse at the desk, "You have to keep an eye on her; she will just get up and go if she has the chance." "She will cut corners and tell you what you want to hear. She always has, from the time she was in nursery school!" The nurse said, "Oh, I know ... that's why I have her right across from the nurses' station. They were going to put her in a room with a window to the outside, but we knew it would be better to have her in a room where we could keep an eye on her." They were so smart. I immediately felt a sense of peace, knowing my sister would be safe there.

Towards the very end, when my sister was in the ICU, each nurse made a point to come and say goodbye to her. She was unconscious on a ventilator and dialysis and hooked up to a heart monitor. They came in both small groups and individually up to the 4th floor each day to pay their respects. I don't know if she knew they were there, but I did. It meant the world to me that they "saw" and loved her. They validated her life and her person at a time when she was most vulnerable and dying. That was a great comfort to me at a time when I was distraught watching her suffer out of this life.

After my sister was removed from life support, she was kept in ICU overnight. The next day, she was transferred back to 3 East to keep vigil until she passed. I was deeply comforted to get this news, as 3 East was the closest she would get to "being home" and supported by those who loved her.

The night of my sister's passing, I had left earlier, but my niece had stayed on. She was there when she passed. As she was getting ready to go home, one of the nurses came to her and told her that when she had finished her duties with the other patients on the floor, she would come and sit with my sister through the night. There are just no words to describe how touched I was to hear that.

Her service was held a week later. She was popular, and the chapel was packed with people who knew her from grammar school, high school, college, her neighborhood, pet-sitting clients, and family. As I addressed the group, I saw an entire pew filled with the nurses and Carol Ann. I asked them to stand and told the congregation how they sustained both my sister and me during her final days. I stated, "I don't know what comes after this life, but one thing I do know for sure is that there are Angels that walk this earth. They are the transplant nurses at Jefferson, and they are right back there." I asked them to stand and be recognized. The chapel broke out in a long-sustained applause for them. Because of them, my grief was pierced with rays of light and knowledge that goodness exists in this world.

In conclusion, from the response the nurses gave to my expressions of gratitude during my sister's hospital stay, I'm guessing that they don't hear enough of just how important their care and support are, not only to the patient but to the families, as well. They are heroic and brought deep comfort to both me and my sister every single day. There are really no words that capture how deeply I am grateful to each of them for their witness of her last days. They made both my sister and me feel a sense of stability and security during a time of upset, uncertainty, and illness. Every day, they bring goodness and comfort during times of upset and grief to their patients and families.