A patient of fistulizing Crohn’s Disease with depressive disorder, admitted one day; 23-yo female, weight- 30kg, bedridden, unable to turn on sides, uncooperative, non-compliant, non-conversant. She is on Quetiapine HS and pain meds ; with stoma, on osteoporosis, (+++)pseudomonas aeruginosa/MDRO/carbapenem resistant, on contact isolation. On colostomy (oozing fistula/s) with CAPI stage 3 on sacral. Bony prominences were evident. I will call her R.

For less than a week, the mother served as the watcher and stayed with her. But after some time, she was left alone. Our story begins with a question: Who/ What and Why are we, nurses, here for? Days, weeks, months passed by, despite the treatments/interventions she received, R stayed with us, in A1. On the same general condition, depression still shows (she even closes her eyes when being talked to, refuses bed bathing at night, refuses q2 hourly turning to sides; simple weight-taking through our Hoister lift and she shouts and cries even already on pain meds).

Only one or two relatives paid her a visit but most of the time no one did. Our Nurse Manager, out of concern, (as we always have for all our patients), during one of our unit staff meetings, together with our CNs, came up with a nursing plan to allot extra time, care, and attention for her. Upon which we collaborated our forces ( medical) with the primary GI team, and medical allied multi-disciplinary team (physio/ occupational therapists, psychology consults, dieticians, social worker et al). In alliance, we pooled our resources to work jointly, involving the family. As a team, we merged together for a CAUSE. The Primary GI team, especially the female residents and interns, were seen conversing and staying longer at the bedside, providing extra time, even at night, and providing sweets and goodies like ice cream (her favorite). This brings a smile to her face.

Family members, through SW on family meetings, were advised and encouraged to visit R more often and be involved even more. Their role and participation matter. From then on, her family was coming and they provide not just for the needs of R but her wishes as well, bringing her flowers, chocolates, storybooks, drawing pads/pencils, and other fancy things like a box of beads to work on and to keep her engrossed, busy, and occupied. We can say at this point in time, good interpersonal rapport with R was developed among us all. Doing the right thing, we respect her well-being and in turn, she trusts us. The patient’s positive outcome achieved.

Eventually, R is, little by little, seen recuperating from depression and that is our primary concern. She is talking and conversing with everyone. Without hesitance, she welcomes treatment and interventions. She is now well-groomed, slightly red-lipped, with nail polish (nurses provide to make her happy) on both fingers and toes in the pink shade (her favorite color) on supplements by the dietician, taking Quetiapine meds by the Psych team, allows weight-taking, turning to sides, and complains of less or even no pain at all. From bed to wheelchair. The Physiotherapist is extending her extra time to take R outdoors to broaden her horizon. Everybody is going Above and Beyond the Call of Duty. –(ABCD)

R reciprocates and appreciates merely by saying “SUKRAN sister” (by name) every time we do something for her. And by names, she assembled her fancy beads, which were brought by her family, into bracelets and handed to each one of us as her way of gratitude. And as her way of gratitude, we received an appreciation letter, and the entire multidisciplinary team of A1 is very pleased for the accomplishment and recognition. Another feather on our cap.

She was happily discharged, oftentimes coming to A1 with her mother, and brings more personalized fancy bracelets which she herself made at home. Now, again… we will end up with these questions... Who? What? ..and Why are we, nurses, here for? Who are we here for? We are here for the patients; not just treating them as patients but Individuals, considering their well–being as well. What are we here for? We are here not just for nursing care but we can go above and beyond the call of duty—ABCD by extending our extra time, care, and attention. Why are we here? We support and we are One with the mission and vision of KFSHD and its Values.

We practice integrity by working diligently and whole-heartedly towards one goal with honesty. Through respect and good interpersonal rapport, we build Trust; we advance accountability to ourselves, to our patients, our co-nurses, and to the nursing profession, accepting responsibilities and consequences for our actions. We care and radiate compassion and concern by not simply relieving the pain or suffering but “entering” into the patient’s experience and enabling them to retain their independence and dignity. We embrace collaboration, Inter-professional and inter-multidisciplinary teams’ participation and involvement for positive patient outcomes. We lead with a Commitment to stay and work as a nurse embracing the values of KFSHD, doing what we say we do.