The following narrative was written by one of Felicia's favorite nurses, Melissa Stobart, for her professional development portfolio at Hershey Medical Center in Hershey, Pennsylvania

When I woke up this morning, I turned on a CD entitled, "Dreams of Angels," and started to get ready for work when I realized that a calm had suddenly settled over me and my life. All of the fears, frustrations, uncertainty, and concerns that I had three months ago as I stepped off orientation as a new graduate nurse, were now gone. Instead, there were feelings of confidence, love, and most of all, a tremendous desire to pursue and continue growing as a pediatric oncology nurse. If you are anything like a lot of people I talk with, you will ask me why I want to work with kids who have cancer. Well, I never really had a good answer. That was before I met Felicia.

When I first met Felicia, I was answering random call bells and trying to quiet beeping IV poles when her room's call light happened to go on. I walked in the door to her room and she was in the bathroom. I called in quietly, because it was late at night and asked if she was alright. In between some cries of discomfort, she said she was fine. I squeezed through the two doors to try and stop her IV pump from that annoying beep when I got my first glance at the child who was going to, in the next two months, change my life forever. She had short brown hair with the most beautiful eyes I have ever seen. She looked up at me and smiled, eve though she was experiencing terrible belly pain. I asked if she wanted some help and her answer was a confident no. All I did was push her IV pumps to her bed and once she climbed in, she thanked me and I walked out into the hall.

A few days later I found myself looking at my assignment and her name was on my list. In report, I learned all about Felicia's history and what she had been through in her life. I learned of her bout with a brain tumor and how this awful secondary leukemia had recently appeared as a result of her first treatment. I also learned of her social situation and how she had been neglected by her biological family and was now adopted into a large family. Her current problem discussed in report was nausea, vomiting, and belly pain, the stomach difficulties that led her to her hospital visit. At this point, she had finished her first round of chemotherapy and we were awaiting her counts to recover, so she could undergo a bone marrow transplant. At this time, she also had this strange spot on her arm that seemed to be getting larger and larger as days went by. my heart was pounding as I learned that I would have to change hyper alimentation/lipid tubing, PCA tubing, and regular med line tubing all at once, as well as give, what I considered at the time, a ton of medications. I was scared to death that first night taking care of her. I remember listening to report and beginning to feel all sorts of pity for Felicia and her family. Depressing was the way I put it. As I walked into the room to introduce myself as her nurse that evening, I walked into a room, which I realized much later, was a room full of incredible love and support. There were cards, balloons, and gifts all over. "Felicia rules, cancer drools" was spelled out on her bulletin board. Felicia was sitting in her bed holding a baby, who was her brother Lawrence. All around her were other children who I found out to be her brothers and sisters, all of various ages and personality. They did share one thing in common - they all loved Felicia.

Time went by and I began to learn things Felicia enjoyed like Hanson, Tweety Bird, Backstreet Boys, Shania Twain, and sports, as well as many other things like when her brothers and sisters would come to the hospital. Felicia loved company of any sorts. Well, the pity I felt at first started to lift and I fell into a little routine of taking care of her. I always knew her father, who I later got to know as Kevin, would always be laying on the seat next to Felicia's bed reading, watching TV, or doing seek and find puzzles. I learned of the spunk Felicia had and the courage she had as a thirteen year old girl fighting a deadly disease. As time did go by, Felicia started to feel worse and worse. her belly pain and throwing up progressed until she couldn't even move without becoming nauseous. I remember when I walked in one day and she could no longer make the short walk to the bathroom, a bedside commode now replaced the walk. Her pain medicine pump didn't even seem to help the situation anymore. Through it all though, Felicia remained independent. She wanted as little help as possible when she was up, but she did begin to get frustrated. I remember and can still feel her head on my should one day when she just got so upset after being so sick when she got up to go to the bathroom. I kept thinking to myself - this isn't fair for a child to go through. Why is she suffering so bad? Why can't the doctors fix her? Also at that time, her blood counts were not recovering, she had developed an infection in her PICC line, and it was discovered that her arm, now a large, black circle was found to be fungus and that added to Felicia's pain.

As all this was occurring, the fevers began. Nothing seemed to break them. I tried everything from ice baths to combining Tylenol and Trillisate to try and get rid of them, but the fevers wouldn't go away. The pain in Felicia's arm was tremendous and the dressing changes I had to do were like torture treatments. I dreaded moving her arm at all and the solution I had to use to do her wet to dry dressing, 1/2 strength Dakon's solution, was awful smelling and Felicia hated it, but I had to do it. I was very quick with the dressing change, or tried to be on most occasions. It killed me to hear her cry and yell in pain. The first time I ever changed her dressing was a day she had a high fever and I had just brought in a bucket of ice to soak washcloths in. Well, the entire family was in to visit Felicia and I felt very nervous. I tripped a bit and dumped the ice water all over. I remember laughing nervously and saying something along the lines of, "oops, I guess I am fired now." her mom and dad chuckled and Felicia said, "no, she's my friend." At that point, i stopped and looked at her thinking that was the neatest thing I had ever heard. Any nervousness I had that night was gone. Felicia hadn't been out of bed for the past few days because of her high fevers and her arm bothering her. About an hour after I dumped the bucket of ice in her room, her family went for a walk. When they were gone, Felicia's fever broke and she became a different person. Her bubbly, talkative self appeared and we turned Shania Twain on and played with playdoh for a while having a great time. I looked at her and remember this warm feeling I got seeing her feel so much better. i grabbed out PCA, Penny, who ran and got a wheelchair and we helped her into the hallway, just as her family was coming back. Perfect timing, I thought to myself. Her brothers and sisters lit up when they saw her, ran down the hall, and happily volunteered to push her to the playroom. I walked with the family and left them at the playroom to spend some time together. Later that night, when the family returned Felicia to her room, I took some pictures of her and her family, pictures that I now look at every day and cherish. And in between taking all of that in, I managed to keep all of her meds on time, hang her hyperalimentation, and see my other patients. My organization skills and confidence were definitely improving. I left work that night feeling really good.

Two days later I came into work after visiting a little girl, Codie, who was currently in the PICU. I had known Codie since she was diagnosed with B cell leukemia in April when I worked as a nurse extern. She loved to sing, do hair and nails and was a joy to take care of. She had come to the hospital a few days before this night in septic shock and high fevers as a result of her chemotherapy. I had known her family quite well so I was visiting with them and Codie each day. Today was no different. Anyway, after getting report from Amy on Felicia, I went in to see her and she was having a terrible time. Her fever was high and she was crying with every movement. I helped her out of bed to her bedside commode as quickly as I could and sat and stroked her arm while she heaved and got sick. I kept telling her to fight it as hard as she could, but the waves of nausea still came. I helped her back to bed when I noticed her flop down, full weight on her left arm, the arm that you couldn't even brush with a finger from the fungal infection. I looked at Kevin and asked if she'd been like this all day. Something was definitely wrong. My heart started pounding as I ran out in the hall to grab the oxygen saturation monitor and blood pressure cuff. After getting it to track on her finger, the reading was a little too low for my liking. Her blood pressure was also low. I looked around her room quickly, saw no oxygen setup and ran in the hall to get one. The residents, as well as, Dr. Miller were standing there and I grabbed them to come in to see Felicia. The next hour or so became a blur to me. I started to give a fluid bolus, stopped the bolus, attempted to get a nasal canula on Felicia, held her up for X-rays and tried to calm her all at once. Thank goodness Felicia was my only patient today, I kept thinking to myself. At one point during an x-ray, Felicia had a hold of my stethoscope for support not realizing she was choking me and a doctor was telling me to quit worrying about her nasal canula. I remember snapping back at him because I wasn't worrying about that - I was trying to breathe! During this time, all of the doctors were deciding what to do for Felicia, and the decision was made to move her to the PICU. I got her ready and knew the rest of her family would be up in a few minutes, so I sat at her bedside with her and waited for them to come. I stroked Felicia's head and told her everything was going to be OK, she needed to have special monitors for a little while, but then she'd be back to us before she would know it. At this point Felicia would just moan and call out for her mom. Deanna, Felicia's mom came in and saw her before we had to begin our walk back to the PICU. Felicia's brothers and sisters were all standing in the lobby waiting to see her and all had scared looks on their faces, some with tears. They waved to Felicia as we walked by and got her back to the PICU. As soon as I saw the doors open, I felt sick. I felt even worse as we were directed to take Felicia to the room next to Codie. I kept thinking to myself, how can I do this? My whole body just felt so weak and after I gave an update to the PICU nurse, I gave Felicia a little kiss and told her to hurry back to us soon. When I walked out of the PICU, I started to cry. I was having the hardest time accepting the fact that two kids I was close to were so sick. The other hard part of the night was hearing Kevin and Deanna say, as they took down the hundreds of cards down from Felicia's room, "we knew we'd have to do this some day, but we didn't think it would be like this."

Well, each day Felicia and Codie spent in the PICU I tried to get back and see them. All of the nurses in the PICU began to recognize my face and would joke around with me and ask me not to send anyone else to them. God knows I wish I never had to. As Felicia started to show some signs of improvement, Codie passed away. I stood at her bedside with her family when she was extubated and as she took her last breath. It was absolutely awful. The tears just would not stop. Codie was the first child I really was close to that died. I thought I was crazy for crying so much, but all of my coworkers told me that it was OK, and it really never got truly easy to deal with. It took a couple of days before I could bring myself to go back and see Felicia, because I was afraid of losing another child.

Felicia, at this time, was still not herself, but she was stable enough to come back out to us on the floor. At this point, she was receiving white blood cell transfusions daily because her counts still had not recovered. She was also receiving platelets pretty much every day because they were dropping too. New results showed that she had aspergillus in her lungs now, this fungus that started on her arm was now spreading. Her arm now had a hug necrotic hole in it from the fungus. Not even ampho-terrible was helping her. She was on every single antibiotic and antifungal medication possible, so she was very busy to take care of. Most of the time, I had her and one other patient, and was running the entire shift. Mentally, Felicia was not really able to talk, but she was wide eyed and obviously, uncomfortable. Her fevers still continued and I believe part of her mental deterioration was due to the fact she ran high fevers for so long. I still loved taking care of her and believed that she knew we were all fighting for her. One night, we got her out of bed into her chair when her cousin was staying with her. She smiled, but it didn't last long. I remember calling Deanna who was at a skating rink with the other kids just to tell her Felicia was up out of bed. Something that small became that exciting. I sat her down by the playroom windows so she could look out over Hershey. This was the last night she was out of bed. Each day seemed to get worse for Felicia and she was becoming what seemed to me, more in pain and general discomfort. She was in diapers by this point (ever since the PICU) which was horrible for her. She hated being changed more than anything. There was one day that I will remember as long as I live. Tracie Dawson was in with me helping change Felicia and get her bathed after physical therapy was in working with her. Felicia was extremely fussy this day and I kept trying to get her to calm down, but nothing seemed to console her. When we were all finished she made out the words, "I'm sorry." I looked at her and could not understand why she said that. She then lifted her right arm, which I hadn't seen her do in a very long time, and motioned for me to put my head down and she kissed me on the cheek. I felt my eyes fill with tears as they are now writing this, looked at Tracie and said to Kevin, "your daughter is amazing." No one has ever done anything to make me feel so good before.

After a day off, I came in to find out that Felicia was back in the PICU again because her blood pressure had dropped and she needed more oxygen. I went back to see her and her parents, who were both extremely positive and hopeful. They started to tell me about this new idea Dr. Freiberg had about getting rid of this fungus and I became very leery. They were planning to do maggot therapy, which meant maggots would be placed in her arm and they would eat the dead tissue away to save her arm. This maggot therapy became the talk of the floor. I looked it up on the Internet and read some articles and thought to myself, if this is going to help her, why not? They day Felicia was to come back out to me on the floor was the day the maggots were to be placed. I went back to PICU to observe this being done and I must admit, it was very funny watching Dr. Freiberg do this procedure and ask every 2 minutes, "Am I right? Right?" Like we knew if he was right or not. Kevin and Deanna, with Lawrence in hand, watched on and you could just see how much they wanted this to work. Kevin even mentioned wishing he had his video camera.

Well, Felicia, at this point, was not really with it. She would open her eyes on and off, but did a lot of moaning. It was hard to tell whether or not she was in pain or what was going on. When it was time to take the maggots out, they were all dead and didn't work. More were placed in her arm, but Kevin and Deanna, at this point, had a meeting with the doctors and made some limited support decisions. I knew this had to be hard for them. At first, they wanted a ventilator, but a few days later, they decided to stop everything. I believe it was a Monday night, Sept. 29. We were no longer giving antibiotics to Felicia, so she wasn't that busy, in a clinical sense, to take care of. We put a foley catheter in, on of the best things Kevin thought of, so we didn't have to move her around and get her upset. However, she would still open her eyes on and off. I sat on her bed this night when Kevin went to get some dinner, and talked to her. I told her I loved her and told her that she had taught me so much about life and what it's like to fight. I also told her how proud of her I was and how amazing she was. Of course this was upsetting, but I knew that this DNR status was the best thing for her. She was extremely aggitated the rest of the night. I was on the phone nonstop trying to get orders for pain medication. It was very frustrating to try and persuade residents to give more pain medication, because she was already on a pretty decent amount. But, I felt I needed to continue to be her advocate. I left work crying that night because I felt Felicia was really suffering.

The next day was my birthday. I went into work in a really good mood, but was approached by someone who gave me a talk about professionalism and not showing so much emotion in caring for my patients. I was extremely irritated and upset about this. I doubted my ability to be a good nurse and asked fellow nurses what they thought. I tried to put it behind me and went about my night. Felicia seemed more comfortable and that made me feel a lot better. I painted and cut her toe nails this night and put another coat of sparkle polish on her fingers, something her mom had wanted done. Felicia wasn't really agitated. Around 8 o'clock I went in to take her blood pressure and saw that it was 90/60, which was low for her. I wrote it down and sat and wondered to myself, is this what happens when a body starts to shut down? I couldn't help but wonder and I began to get scared. When I left work that night, the residents were trying to decide whether or not to fluid bolus her because of her low BP, but I truly felt at peace when I left her. Her parents had given me a balloon that said I Wuv You on it, from Felicia, that meant the world to me. I kissed her on the forehead and said good night to her before I left. Little did I know that was the last thing I would say to her.

The next day I had off and thought about Felicia a lot. I called work around 7 or 8 to see how she was and Jen said she was hanging in there. Around 9, Jen called and told me she had gone. I got in my car and saw Kevin as soon as I got off the elevator. I couldn't believe that it was all over. I asked him if she went peacefully and he told me how her breathing started to get further apart, how he got in bed with her, and how he told her, "Felicia, if the angels are here, you better get going." I had no response to that, it was one of the most intense and powerful things I had ever heard. Jen and the other nurses got Felicia all unhooked and Amy and I washed her up with her raspberry soap I had gotten her. It was the most natural and peaceful thing to see her lying there with her purple Afghan over her. She looked comfortable, a look that we hadn't seen in a really long time. Amy and I sat with Kevin until the rest of the family came. I think seeing the rest of the kids and Deanna walk down the hallway and meet their dad was the hardest thing for me that night. This was the hallway we surprised her family in when Felicia's fevers broke...This was the hallway we walked quickly up transferring Felicia to the PICU. Now this was the hallway her family was walking down to say good-bye to their sibling/daughter.

The next day Kevin and Deanna asked me to be one of Felicia's pallbearers. It was an honor to be asked that and something I will never forget. Felicia's actual services, the celebration of her life, was the hardest part for me. Her family had put together pictures and a video of her life, all of which were so neat to look at. The people that spoke about her had nothing but admiration and love for her. She truly touched so many lives and that was so apparent with the hundreds of people that came to her service. When Kevin spoke about Felicia, I truly realized what an impact she, and her entire family, had on my life. Kevin shared the story about the last movement and words Felicia spoke before she died. It was when Felicia reached up, kissed my cheek and said, "I'm sorry." I now understood that Felicia didn't want us to be sad for her. I can't even explain how I felt sitting there listening to this being said, and relived for me. I hadn't even realized Kevin noticed all of this. When he finished speaking about her, the entire group of people celebrating her life listened to the song, "Angels Among Us." Kevin came over to Amy, Chris and I, and told each of us, "Thank you for being one of Felicia's angels." I was at that moment that I realized that I was definitely working in the right area of nursing. All of those nights when I stood there looking at Felicia's plan of care wondering where to even start and how in the world I was going to get through the night with her, as well as having 2-3 more patients...all of those nights from hell were all worth it. I improved my clinical nursing skills, medication knowledge, and organization skills greatly from taking care of Felicia. I also learned the importance of involving the family in a patient's care, especially in the field of oncology nursing. These patients spend so much time in the hospital that you do become like a family. Felicia and her family were so strong, at all times, and taught me the importance of strength and perseverance. Through taking care of Felicia, I learned about myself and the qualities I needed, and didn't need to possess, to be a good nurse. I also got the opportunity to see how taking five or ten minutes out of my night to sit and talk to a patient, hug a patient, or just offering some words of encouragement could make a world of difference. Through all I have learned and experienced with Felicia over the past few months, I am thankful. She is now my angel watching over me as I take care of many more special kids like her every single day.

Felicia with Melissa in her hospital room