Cale Wardell

A Small White Card

What does it mean to be a nurse? I did not know. Hidden in my wallet there was a small, white card issued from the State of Connecticut with six numbers on it. Those six numbers held the power to declare me a licensed registered nurse. I thought if I stared at the words on this card long enough maybe I would start to feel like the person it declared me to be. Yet, I knew that I kept that tattered piece of paper with me at all times as a subconscious and perilous attempt to quell an inner voice that told me I was not a real nurse. By December 3rd I had fully accepted that I would probably never feel like a ‘real nurse’ and that now faded card, still carefully guarded in my wallet, felt like a mere formality on the path to graduation. That cold December morning had begun with an ungodly early alarm, a train ride to Chicago’s O’Hare International Airport, and a disappointing middle seat assignment. As I sat squished between two strangers I began to read my neuroscience textbook. The chapter for the next day’s class was on sleep, something I desperately needed, and it felt like the book was almost mocking me. As I read about sleep stages and neurotransmitters my head fell rhythmically and I nodded off. I was abruptly awoken by an announcement over the plane’s intercom system. A panicked voice asked if any licensed health professionals were on board the plane? I felt a rush of fear fill my entire body as I listened to the words. Surely there would be a doctor or a ‘real nurse’ on board. Seconds dragged by and suddenly time seemed to stand still; no one had come forth. A second announcement was made “if there are any licensed health care professionals on board, please press your call button.” I knew I had a choice; I could cowardly hide in my middle seat and no one would even know about the tattered white card in my wallet or I could put aside myself-doubt and rise to much greater calling. In that moment I did not know if what I had to offer was enough, but I did know that I came to Yale in order to fulfil a lifelong desire to help others; and that was why I pushed the button. As the call button lit up above my seat, dozens of curious and apprehensive eyes made contact with mine. A final announcement was made “could the health care professional please report to the front of the plane.”

I stood up and made my way down the aisle from the second to last row. Heads turned and my face grew warm as I felt hundreds of glares sizing up my 5’0” frame walking to the front of the aircraft. My mind raced with scenarios with which I might face when I reached the end of the seemingly endless aisle. I rehearsed the acronym MONA as I desperately tried to recall other medical surgical knowledge that I had ground into my head that past year. As the front of the plane neared I heard cries of pain coming from a flight attendant sprawled across the jump seat, holding a blood soaked napkin over her left eye. The same panicked voice I had heard over the loud speaker explained to me that as we were preparing for take-off Briana had opened an overhead bin and a free-floating laptop fell and hit her directly in the eye. His voice began to quiver as he explained that Briana has corneal implants and the impact must have dislodged the implant. I think he sensed the confusion on my face because he handed me medical gloves and said “just go look at it and please tell us what we should do” I turned my attention to Briana as I introduced myself “My name is Cale Wardell and I am an RN”– even the words felt foreign and uncomfortable as I uttered them; however, the eerily silent plane and Briana’s pained whimpers left no space for self-doubt or hesitation. I began to feel a strange rush of energy and an instinct I did not even know existed begin to take over.

With a sense of authority words came out of my mouth: “Call 911 and taxi back to the gate immediately”. I peeled back the napkin she clutched over her eye as thoughts of incompetence were replaced by adrenaline fueled deliberation and focus. With each panicked exhalation her ruptured implant oozed further out of her eyeball. I heard a faint cough behind me that morphed into a sound of uncontrolled retching, as I peered to my right, I saw a first-class passenger vomit into a white, paper bag. I turned my focus back on Briana; the cut over her orbital bone was pouring blood. Before I was even cognizant of my plan I said, “Briana we are going to get through this, I will be here with you the whole time I just need you to keep your head as still as possible and take deep breaths.” I reached for the gauze pads from the first aid kit that had been placed at my feet and took hold of Briana’s face with both hands. I needed to stabilize her head—with each small movement the implant became more dislodged. With the other hand I began applying pressure on the wound to the left of her eye; the gauze pads changed from white to a bright red in seconds. Medical knowledge rattled in my head as I tried to sift through facts and bring them to the front of my mind. I took my left hand off her head and checked her pulse, 120. Ok, good, I thought. Facts flooded my mind: the head is extremely vascular and bleeds more than abrasions to other parts of the body. I began to regain a sense of mental clarity, as I trusted a unfamiliar intuition. With slightly more assurance in my voice, I explained that I wanted to check her vision in the other eye. I gently peeled apart her right eye lid; everything looked intact. Can you see me I asked? I could feel her head nod an in an affirmative gesture. “What do you think is going to happen to me? Am I going to lose my eye?, Briana asked desperately. The compression had stabilized the bleeding from the eye abrasion, yet I knew my most important training was now being called upon. Anyone can compress a wound or check a pulse; but Briana needed more than pure procedural knowledge; she needed me to hold her pain with her. To comfort and assure her on a deeper level than any words could convey. As I clutched her head with one hand and held her hand with the other, I felt her grip. It was a grip a grip of fear, a grip of trust, a grip between two strangers who needed each other.

The paramedics entered the plane. The tension began to ease in my body as I calmly explained what had happened and my belief that Briana needed emergency eye surgery. As Briana was carted off the plane, I gave her hand a final squeeze of reassurance before I let go. I returned to my seat and looked down to find Briana’s blood still clinging to my shirt. I sat through the rest of my flight in a shaky, stunned silence. Off the plane, a slew of phone calls with proud parents and confused friends didn’t help. They didn’t quite get “it.” But I’m not sure I did at that point either.

Three weeks later, I peeled the plastic film off my freshly dry-cleaned white shirt. Pure white. That was the last of the reminders. At this point, not much remained; the vivid flashbacks had ceased, the blood stains were washed away, and through a heartwarming inbox message I had learned that, two surgeries later, even Briana had recovered. I refolded the shirt, placed it back into the drawer, and flopped back onto my duvet. I scrolled through Netflix. The new episode of my favorite mindless reality series had not be released—probably a sign I should go to bed. I closed my eyes and before I could contemplate anything of substance my body was overcome with sleep.

“I was back to that cold December morning on the tarmac of O’Hare Airport. My call button was illuminated as I heard the announcement for the health care professional to present to the front of the plane. Yet, I could not move, my body was paralyzed. In sheer panic I fumbled around for the frayed, familiar edges of that card I prized so dearly. I pulled it out and set it down on my tray table—the worn edges were replaced by crisp, pointed corners and its soiled, gray color now gleamed a pure and assertive white. As I read the card I noticed the date of issue was different, it now read: Cale Wardell RN, December 3rd 2018.” I put the card back in my wallet with a sense of pride. I felt the control wash back into my limbs as I stood up and I confidently walked down the aisle; this time I knew what it meant to be a nurse.”

* name changed for confidentiality

About Cale 

Cale Wardell graduated Phi Beta Kappa in psychology; neuroscience from Colby College in 2013. At Colby College she played varsity field hockey, studied art and literature in St. Petersburg, Russia, and served as the president of Student Health On Campus. After graduation she worked in psychiatric research at Boston and Northwestern  Universities. It was during this time she discovered her passion resided in working directly with patients, rather than analyzing data behind her computer screen. She happily renounced her cubicle and moved to New Haven in order to attend Yale School of Nursing. In Chicago, she left behind her best friend Henry, but is eternally grateful for his unwavering support. She is currently in her 1st specialty year and will graduate as a Psychiatric Mental Health Nurse Practitioner in 2020.