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Nicole’s Med Surg Wedding: Patient Centered Care

Nicole wanted to get married in the hospital Nicole had her Med Surg wedding

Nicole definitely turned heads. Feathery, streaked blond hair, blue eyes, fun-loving by nature. She was a hair stylist, and even in a hospital gown could rock her look with her tattoos and her rings and her style.

Nicole had not been well for some time.

Laurie's Med Surg Wedding meant patient centered care to her and Brad

Nicole had style

Nicole, the hair stylist rocker, was a frequent flyer, and we knew her well on Med Surg. Here’s her story and what patient-centered care means to me.


Nicole had been diagnosed almost five years earlier with idiopathic pulmonary fibrosis. Now she kept returning with lung infections that were increasingly resistant to antibiotics. She’d had lung biopsies, CTs, MRIs, and bronchoscopies. She’d been scanned, scoped, transfused and infused.

There weren’t any more tests to do. She was tired, and breathing was getting harder and harder. It took all her energy to breathe, with not much left over to eat, or talk at length. But she could speak with a flash of her blue eyes, to say she caught the joke, or disagreed with the speaker.

She was on oxygen 24 hours a day. She was losing weight, but recently she had developed swelling of the legs due to right sided heart failure. She hated having swollen calves and ankles. Of all the things she asked her doctor to fix, it was her swollen legs.

Alarmingly, now whenever she coughed, it was more like strangling, and her fingertips would almost instantly turn blue. We’d quickly put her on a non-rebreather and pray that this wasn’t the day and the time. She’d slowly recover, and we’d feel like we dodged the bullet once more.

She had decided not to go on a ventilator at the end. She had already refused dialysis once during a crisis.

When patient centered care means a Med Surg wedding

Nicole and Brad’s Med Surg Wedding

We skipped her night vital signs whenever possible to allow her to sleep six hours. Often she wanted to sleep propped up in the recliner chair, while her fiancee, Brad, slept in the bed.

Unorthodox, maybe, but we were more than happy to accommodate them. One early morning I peeked in and they were in the bed together, spooning. They were both snoring lightly, in rhythm. He had his arms around her with her back into him. I wondered if she felt bony to him. It was sad and happy.

Nicole had one thing left she wanted. She wanted to get married. Could that possibly happen in the hospital?

It had never been done, but..there was a full-time chaplain, and ..why not? Our nurse manager championed the idea, and worked out all the administrative details.

It was decided they could get married in the hospital. The date was set.

Nicole and Brad had limited finances, so without ado, some nurses got together and found a wedding gown on Ebay. Ashley, the Respiratory Therapist, offered to provide the music. Her pulmonologist chipped in generously. There’s nothing like women planning a wedding, and this wedding was no different.

The day before, we got Nicole up in the hall to practice walking in her gown. She used a walker, and a nurse walked behind her pushing her oxygen tank and a wheelchair just in case. She insisted on wearing heels, but she wobbled treacherously in them, so we switched them out for rubber bottomed patient socks.

The next day was the wedding day, a Saturday. It started to get exciting when a make up artist came in with her tackle box full of make up and applied Nicole’s make up. One of the nursing assistants

Nicole wanted to get married in the hospital

Nicole had her Med Surg wedding

styled Nicole’s blonde hair in a wispy up do, with softly curling side tendrils. Panic set in when she ran short of booby pins and everyone went scrambling through lockers and purses on a bobby pin hunt.

All dressed, Nicole was wheeled down to the chapel area. Her fiancee, Brad, was there with a big surprise- he was holding their dog, Axel.

The music cued. Nicole stood with help and walked slowly but steadily the short distance towards Brad and Axel. The sleeves of her gown covered her PICC line, and only her nasal prongs for oxygen said “patient”.

Our own Chaplain Rick conducted the ceremony. He knew to keep it short, and he left out “until death do us part.” Brad put a simple gold band on her finger, and they kissed.

Afterwards, sparkling apple cider and Ensure on ice was passed around in styrofoam cups. One talented nurse had even made red velvet cupcakes with edible swans on top.

Pictures were taken. For a few minutes, we were all transported away from our duties that awaited upstairs and swept up in the poignancy of the moment. No one wanted to return to work.

But soon Nicole was fatigued and she and Brad retired to the bridal suite, room 4112, where rose petals were strewn on the bed.

At five pm, the door was still closed and the nursing assistant cheerfully charted “vital signs refused”.

Incredibly, after the wedding, Nicole rallied for a few days. She had energy, she had the “look-good”, and we thought she may get to go home. Then her white count started climbing again.

It wasn’t long afterwards that Nicole went downhill fast. We kept her as comfortable as possible, with ice chips, and morphine, and pillows for her to rest on. Brad and the staff partnered in her care.

She never made it home.

Did we deliver patient centered care? Nicole would never fill out a patient satisfaction survey. But if she did, I hope she would say we gave her the care she needed at the time she needed it, the way she wanted it.

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Until next time friend,

Nurse Beth







About Beth Hawkes (146 Articles)
Nice to meet you! I'm a Nursing Professional Development Specialist in acute care, a writer, speaker and career columnist.

16 Comments on Nicole’s Med Surg Wedding: Patient Centered Care

  1. Dr Rachel Silva, NP // March 8, 2015 at 10:24 am // Reply

    Thanks for writing this article. It captures the essence of what nurses to best – balance the science of nursing for clinical care with the art of nursing for inner healing. I believe one of the key philosophical differences between medicine and nursing is our holistic approach to care for the patient as a whole. You and your nursing colleagues saw beneath the patient’s diagnosis and clinical needs to the core of her being, and what she needed most – love. It’s the one dose of medicine we surely can’t live happily without. As uncomfortable as death and dying can be to think or talk about, it encompasses the circle the life, and one of the most important aspects in nursing care. Having nurses and a healthcare team that envelope you with love and making that last wish come true is the beauty of a peaceful (as much as possible) death and dying experience. That’s the last gift of service as a nurse we can give as they complete their circle of life.

  2. Beth what a beautiful story that resonates the true meaning of patient and family centered care, taking care of both the nurses and the patients needs all in one, loved the read, so sweet. Leslie

  3. Hi Beth. This is such a beautiful story. What a privilege to be a part of such a wonderful day for your patient. I’m so happy she got the attention she needed on probably one of the most important days of her life. That is patient-centered care!

  4. Fabulous nursing care and team work

  5. bethboynton80539889 // March 2, 2015 at 4:54 pm // Reply

    What a wonderful story, Beth. It brings tears to my eyes along with a powerful sense of privilege in being a nurse to my heart. As Elizabeth Scala would say, or maybe did, this example of patient-centered care is what the ‘art of nursing’ is all about!

  6. Nicole, this is really patient-centered care. What a pity many units are loosing this human touch. Nursing is beginning to get mechanical. I hope we can forever keep being compassionate.

  7. What a powerful story. I am speechless by the beauty exhibited by everyone on the staff and involved with this patient’s care. This truly is the type of care that highlights the power of merging the art with the science of nursing. I loved it!

  8. Beth- Thank you so much for sharing your story. One of the reasons why I am so proud to be entering into this profession is because nurses have the incredible ability to make or break a patient’s experience, regardless of their stage of health. No matter how close to death, the nurse has the opportunity to facilitate the patient in achieving a higher level of the patient’s own unique definition of health. While there are so many difficult aspects of nursing, let us never forget what our potential is as a profession.

  9. Thanks for your great contribution to the Carnival, Beth. I’m told one of the best ways to make a point effectively starts with 6 words : “Let me tell you a strory.” I love yours! – Greg

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