Nijole Hunter, RN

As soon as I entered her room, I noticed, that she was so upset. She looked withdrawn with a blank stare and emotionally detached from her surrounding. She was motionless and silent. Her eyes were squinted and forehead looked creased.

What happened? I begun to wonder. This hospice patient is usually in good spirits and vibrant despite of her health condition. I stood and observed her, trying to get a better understanding, but did not notice anything particular. Her facial expression or body language did not reflect any sort of discomfort, but she avoided eye contact with me. Emotionally she was detached, obviously trying to gain insight into whatever it was that was disturbing her.

“Good morning,” – my voice pierced through the silence – greeting her with a smile.

She did not respond to any of my efforts to start a conversation, which put me into an awkward situation. I felt embarrassed and guilty for no reason. As her nurse, we had established a good friendship but she remained silent. I figured that I should give her some space.

I left temporarily and came back thirty minutes later to find the reason for her sadness. This time, she was more engaging.  

She asked me to move the greeting card that she had received from a friend. The card had been placed on the night table but she wanted me to put it in the drawer away from her view.

I found that the card was the reason for her sadness. The words; “Get Better, or get well” hard hit her like a storm. She knew that she was not ever going to get well.

What did the words mean? Get less of pain, because her terminal illness was accompanied with a daily chronic pain. Get rid of unpleasant feeling? Or less mental and physical stress? Or just get stronger over the illness?

I believe that the sender of the card did not mean to hurt the patient, but it was clear that the words hurt her deeply today.

Cards are generally good. Research indicates that receiving cards increases self‐esteem, helps to stave off feelings of loneliness and isolation and even to ward off the early stages of depression. But this card was not good for her.

After I removed the card and put it in the drawer, I tried to switch her attention to something else by changing the subject and turning the TV on. But she preferred to sleep. Thinking about the card, I realized, that the words and the meaning can be interpreted by hospice patients differently, because they are more vulnerable. They cannot resist their illness mentally and physically anymore, and this kind of card actually communicates their weakness.

When I returned home from work, the patient and that card was still on my mind. So I decided to make her a different kind of card. I think cards have amazing therapeutic value so I wanted to make a therapeutic card.

Drawing from my knitting skills, I decided to create a card without words but that could provoke pleasant thoughts just by looking at it. I went to the store and bought a lot of supplies not knowing what I am going to make. I started with a simple elements such a flower and a leaf, moving towards to all conception.  She was happy to receive this card. All in all cards do matter but only the right kind of card.