Monica Watts is an exceptional nurse who constantly strives to support parents and families going through extremely difficult times in the PICU. In her effort to care for them, she often strives to put herself in their situation mentally so that she can better understand how they might be feeling. She often comes to me and shares her observations of a family, asking for insight onto why they may be acting a certain way if their behavior differs from what is "expected". By talking through what they are doing, their situation, and what feelings they have expressed, Monica is often able to go into even the most difficult family interactions with a positive attitude.

One of Monica's other great strengths, most likely fed by this empathy she is always able to find, is her ability to support a family in a crisis. From trauma patients to those facing the end of life she is able to keep her emotions in check and meet the needs of the family in a compassionate, loving way. We have worked with her on several patients where the parents have decided to withdraw no longer beneficial medical care. For each of these families, Monica has been a quiet presence who can provide patient care with one hand while wiping tears with the other.

For one such family, that meant losing their son soon after the death of Mom. Dad was very clear with his family about what he wanted from them, and Monica supported him in this. As he talked to teammates and family in the room, she quietly performed her cares for the patient all around everyone in the gentlest, quietest way. When the family stepped out, she counseled Dad about what she would be doing in the room and how she would do her best to be a companion for both child and father, guiding them through this tragedy. For this family, Monica was able to meet Dad's need for support in the room while others worked with his parents outside of the room. She was able to provide them the best death possible.

In another, similar case, both Mom and child were severely injured in an accident and were patients at CMC and LCH, respectively. Having lost another child several years before, and now facing the prospect of having both a wife and a child with severe brain injuries, Dad was extremely overwhelmed by many things that came his way. Throughout the course of the child's hospitalization, as his brain slowly healed, he became more irritable and inconsolable, adding to Dad's stress and pain. Through Monica's quiet presence, she was able to convey presence and empathy. She alternated between giving Dad space to feel what he was feeling and giving him permission to find joy in interactions with his healthy child. She also made sure to seek support and advice from others serving this Dad and child, and she remained a trusted support to Dad even after his child transferred to the rehabilitation unit.

Her empathy and ability to provide support have both been put to the test recently with one particular patient. She is currently working with a widowed parent who is faced with a difficult decision. One of his children is critically ill and in our PICU after a long hospitalization at another facility including placement on ECMO. Because of her underlying disease and the subsequent problems she has, she just isn't getting better and he has been presented with the option of putting her through a surgery that may or may not make her any better, but will definitely make her extremely sick immediately following and she may not even survive the surgery, but she will likely die without it. Add to the decision that Dad had to make medical decisions about Mom who died about a year ago and he has his own current health issues, besides working night-shift. When Monica had this family, she clearly made a connection.

One day when she was not working with them, Dad came up to her and asked for a hug. As they hugged, he broke down in her arms, cried for a while and then he talked about how difficult this decision was for him and how he just didn't know what to do. He told her that he didn't have any support up here (they live several hours away) and that he was alone in making this decision. He wanted guidance and support in his decision. Monica listened and was fully present. She validated that this was a tough decision but that Dad could and should ask the medical team for their advice. And then she told him that if that advice didn't sit right with him and he still needed more guidance than we could involve the Ethics Committee for further guidance and feedback on his thoughts. This reassurance that he was not, in fact, alone and that he would make the right decision for his child and his family was exactly what he needed in that moment. It comforted him and allowed him to come to a decision that he and his child agreed upon and he felt confident in.

Monica has many strengths as a PICU nurse but the biggest one is her ability to provide compassionate presence to parents and patients. Her reassurance helped this father when he was caught in a tragic situation. At a time when she likely needed to be charting or providing cares, she was able to give someone her heart when he needed it most, exemplifying the values of caring for a family member and commitment to the patient and family.