The biggest challenge or at least the one of possibly three since it would be a close tie that I shall write about is of course, nursing related. The ICU is a place for the critically ill who will either improve and move out to a regular floor or succumb to their illness or disease and die.

The gentleman I am writing about was involved in a severe automobile accident and after several hours of touch and go surgery was brought to the ICU unit that I worked in. It was a normal Saturday, in fact, a normal day for unit activity. This gentleman was one of my four patients. I was relatively new to the position, which does not mean I was new to nursing; I had several years of experience under my belt.

His wife, his son, and daughter-in-law were visiting, hovering at his bedside. He would awaken, mumble something and drift off, only to repeat the action in a couple of minutes over and over. He kept mumbling a name, so I suggested that the family should contact this person and advise them of his critical condition. I learned that the person was not a person but his beloved dog. An undersized spaniel that was 13 years old and very devoted to his 'daddy', who was likewise devoted to the dog.

It was evident from my nursing experience that this gentleman was not going to make it, and also that his family were aware and doing everything they could to make his remaining time the best it could be. My new concern was the love and bond between this man and his dog. My challenge was how to let the two say their goodbyes.

Hospitals have specific rules and guidelines when it comes to animals of any type. Germs are known to be carried on animals. So I was left with a double challenge, perhaps triple. I would be breaking the rules, I would be potentially spreading germs but I would be allowing the love.

I spoke with the family about the dog's size and discovered it was actually a tiny thing that would easily fit in an extra large bag or a small duffle bag. They were delighted at the idea of the reunion. Since my patient pod was next to an exit door, there was hope that my plan would work. I arranged for the son to go home and retrieve the dog. When he returned to the parking lot he was to call the unit and asked to be transferred to me. Upon receiving the call, I asked his wife to go down the two flights of stairs and open the exit door which was normally locked. They would then wait at the top of the stairs for me to clear them onto the unit floor and into the gentleman's room.

We had succeeded. The dog was so happy to be with her daddy. There was no barking but a lot of tail wagging as she crept up the side of the bed to snuggle next to him. I interlaced my fingers with his and moved his hand in a petting motion. He was calmer. He opened his eyes and whispered the dogs' name 'Sam' (short for Samantha). She whimpered and snuggled closer. His wife and family mouthed 'Thank you.'

I left the room to give them privacy and put a notice on the door for everyone to check with me before entering the room. The gentleman died 17 minutes later. The family left about an hour after he died, through the regular entry with the dog hidden in the bag.

The following Monday I came in on my days off to report to the nursing administrator of the unit what I had done, rather than wait for someone to catch on and report me. After a few minutes of silence, she commented, "I hope this made you feel good because it sure makes me feel good that you figured out how to do this. But still, dogs are not allowed, normally."