Once upon a nightshift, an overworked and uninspired RN looked up from charting to see her elderly patient trying to get out of bed... again. "Ugh... I seriously can't even right now." She muttered as she grumpily marched to her patient, Mr. Quagmire's room. With her attitude as strong as her Starbucks coffee, she took hold of Mr. Quagmire's arm and guided him

back into bed.

"Confused as ever, eh?"

Nellie asked the elderly man.

Mr. Quagmire looked up at her

with a blank expression,

wordlessly confirming

her question.

After her long shift, Nellie was finally home and tucked into her bed. As Nellie slept, she found herself immersed in a dream.

She awoke to the jingling sounds of tea cups and the smell of baked goods. Nellie opened her eyes to see a beautiful friendly woman offering her a cup of tea. "Would you like to talk?" she said in a comfortable voice that felt like a warm hug. "Who are you and how did you get in my room?" asked Nellie. "I am the spirit of Knowing through Inquiry. You have a lot to learn my dear, and it begins with knowing yourself. Tonight you will be visited by three spirits. Listen to them, and you will recognize the privileged role you play in the patient's experience." Nellie blinked her eyes and the spirit was gone. She thought she must be dreaming but the smell of earl grey tea lingered in the air.

Before she could make any sense of the situation, Nellie

was transported to the nurse’s station at her own workplace.

The unit was quieter than usual.

There was an eerie stillness in the air.

A shrill “ding!” interrupted the stillness of the unit and Nellie jumped out of her chair in surprise. She turned to the elevator in time to see a mysterious figure emerge from behind the metal doors. Their face was covered by a hooded cloak, so Nellie could not see who was underneath. Nellie’s heart started to race nervously as the figure started to move closer to the station.

The figure approached the nurse’s station and stopped in front of Nellie, who was now paralyzed with fear. Only the desk separated them. Slowly, the figures hands crept up to the hood of the cloak and slipped off the hood, revealing a beautiful woman underneath. Nellie knew she had seen this woman’s face many times before...

“Hello Nellie”, the woman said. “You must know who I am”. The woman’s composure was warm and friendly, but she carried herself with an air confidence. Something told Nellie that she did not want to get on this woman’s bad side. Nellie remained silent, and the woman laughed lightly. “Maybe this will help; I am the lady with the lamp”. Nellie couldn’t believe it. She recognized this woman from her nursing textbooks! It was Florence Nightingale, one of Nellie’s heroes.

“Come now, we’ve got work to do,” Florence said, taking Nellie’s hand. Nellie was in awe as she blindly followed Florence’s brisk lead to Mr. Quagmire’s room. “Now tell me Nellie, what is wrong

with this room?” Nellie scratched her head.

To her, it was just a

regular hospital room. “I

don’t know, Miss

Nightingale. It seems okay to me.”  .

“My dear!” cried Florence.

“It’s a disaster! Look here,

there is garbage on the

patient’s table, there is

not a single glimpse of the sun through those curtains, and that toilet doesn’t look like it has been cleaned since the patient’s admission! And don’t get me started on the cleanliness of Mr. Quagmire, I can smell him from the doorway!” Nellie looked down at her feet out of embarrassment. She knew Florence Nightingale was right, but she kept making excuses for neglecting the patient.

“I guess I just was too busy for that stuff, I-“ Nellie started, but was interrupted.  

“I don’t want to hear any of that nonsense!” Florence declared,obviously annoyed. “It’s as though you paid no attention to what you were taught in nursing school! Remember, my 5 key components of environmental health are these: pure air, pure water, light, cleanliness, and proper drainage. These aspects are absolutely necessary for a patient’s health! Ensuring these 5 components was how I reduced the mortality rate of the soldiers in hospital from fifty to two percent! Now think, what can you do for Mr. Quagmire to better his care right now in this room?” Nellie realized that a lot could be fixed, since Florence had mentioned it.  

Nellie started by opening the curtains and letting the golden sunbeams stream into the once dark and dreary room. After opening the window to allow the entrance of fresh air, she picked up all the garbage off Mr. Quagmire’s table and threw it away. Nellie also got him a fresh cup of water to keep next to him.  

“You’re off to a great start my dear”, Florence took Nellie’s hand in hers. “Now keep it up. I just know that you will be an exceptional nurse”. And with a final smile, Florence Nightingale vanished.

“Nellie... Nellie... Nellie”

“No...no this can’t be happening again.” With hesitation, Nellie peeked from beneath the pillow

propped over her head - strategically placed to block

out all possibility of another ‘visit’.  “Oh yeah it was

. happening again.”

Nellie sighed.

This one was

different from the other

one though. She seemed

feisty. Grey haired

with a twinkle in her eye. Nellie didn’t recognize her, but something about her was compelling.“Nellie I am Katharine Kolcaba. I got a message from my dear friend Florence that you had a little trouble today. Not to worry love, I know exactly what you need . Chop chop let’s go - we’ve got a lot to cover.” And just like that, we were back on the medicine ward of New Hope Hospital.

“AHHHHHHHH WAAAAAAAA beep...beep beep CRASH nurse to room 50A STAT!!!” Nellie was immediately assaulted by a cacophony of sounds. “What in the world is going on here?” “Deafening isn’t it Nellie?” Katharine said knowingly. “Imagine how this overwhelming stimuli impacted the wellbeing of Mr. Quagmire this afternoon.” Katharine drew Nellie closer to his room. “Take a good look. What do you see? Nellie's mind raced as she took in the sites,sounds, and smells. Beneath the clamour she could hear soft sobs and sniffling. “Was that Mr. Quagmire?” She wondered. “No no.. of course not. I never noticed him crying today”. But yes... it was undeniable. “Why is he so sad?” Nellie asked with concern. “He’s an accomplished pianist you know and now that his hand has been broken in three places he

fears he may never be able to play again. But

that's not all, the nasty knock to his head from

his fall may in fact cause memory loss so when

he asked “ will I forget everything,” it was a cry

for reassurance Nellie.” Katharine paused

momentarily to search the depths of Nellie’s

eyes.“Everytime he attempted to get out of bed

was an attempt to satisfy an unmet need.”