Compassionate use: Method of providing experimental therapeutics prior to final FDA approval for use in humans. This procedure is used with very sick individuals who have no other treatment options.

Pain and suffering rears its ugly head countless times during a nurse's career. Nora Bertocci, BSN, RN, CHPN, a nurse for 16 years, remembers one patient in particular who suffered daily with the pain of cancer and the nausea associated with treatment. Her name was Tammy. She was only 34 years old - Bertocci's age at the time. She was dying from lung cancer that had metastasized throughout her body.

"While hospice could help with many things, such as shopping and household chores, we could not adequately take away Tammy's pain," Bertocci said. "Every movement brought a sharp twinge of pain that showed on her face, in spite of her efforts not to call out or grimace."

Unlikely Advocate

When the pain and nausea became unbearable Tammy sent her 17-year-old son out into the streets to buy marijuana for her.

The THC in marijuana is known to reduce the symptoms of nausea, pain and vomiting associated with cancer and chemotherapy, HIV/AIDS and multiple sclerosis. Currently in New Jersey, marijuana use for medical purposes is prohibited by law. Advocates like Bertocci support changing that.

"The only time Tammy was strong enough, hungry enough, pain-free enough, and not throwing up, was when she used marijuana to hide her symptoms," Bertocci said. "I, the law-abiding hospice nurse, often thought about going out into the streets to find a drug dealer. I was not going to buy an illegal drug; I was going to buy some peace for a very sick young woman and her family."

When the Compassionate Use Campaign launched by the Drug Policy Alliance New Jersey approached the New Jersey Hospice and Palliative Care Organization to testify for the use of medical marijuana, the organization's president, Donald Pendley, thought of Bertocci.

On May 22, she testified before the N.J. Assembly health and senior services committee in Trenton, urging its members to show compassion for people with cancer and other painful, untreatable conditions by legalizing medical marijuana. Assembly Bill No. 119 and Senate Bill No. 804 currently await approval.

ICU Nurse

Compassion: Sympathetic pity and concern for the suffering of other people.

The decision to testify for the legalization of medical marijuana to ease suffering reveals Bertocci's approach to nursing care, which she admits has changed over the years. As a young nurse recently graduated from Holy Name School of Nursing, Teaneck, NJ, Bertocci said she believed her role as a trained nurse was to heal people, and make them healthy again by providing any and all life-sustaining treatments. But it didn't take long in the ICU at Holy Name Hospital, Teaneck, NJ, where she worked from 1992-1995, to change her mind.

"We would have 90-something year old patients transferred from a nursing home in a non-responsive status," she said. "They were treated aggressively, resuscitated, subjected to invasive testing and procedures, with the goal of returning them to the nursing home in the same unresponsive status in which they had left."

The real turning point came when she was assigned to care for a 60-plus year old woman at Holy Name in 1992. The woman had an advanced directive stating she wanted no heroic measures undertaken if her life could not be restored to the level she was used to enjoying.

"I was so torn after reading her chart," Bertocci said. "As I slowly walked down the hall to her room, I could not imagine standing around waiting for her to die. This went against everything I thought I believed in. Boy, was I wrong."

After seeing the woman in person, happy and vivacious with her family around her, Bertocci said she decided quality of life is a unique individual decision that can far supersede quantity of life.

"While some people will choose all life-extending treatment options, regardless of their impact on their quality of life, many other people would prefer to enjoy their last days at home with their families rather than in a clinical setting undergoing painful treatment with sometimes debilitating side effects," she said.