It was one of my first nights back and I was flying. My brain felt like it wasn't totally connected to my head, which I suppose is natural after three months of my three month old being the person I was mostly communicating with, but my heart was so very happy to be running around again. I was remembering how to be a nurse again and renewed with energy, compassion, and a love for my profession. There is something very rejuvenating about time away to help you remember why you do what you do and why you love it.
I took report and assumed care of a woman who I was familiar with from her visit to our ER two nights before. She was not a pleasant woman, and we had assessed that she kept calling an ambulance for the same non-emergent ailments because she craved some human interaction. Unfortunately, she chose to spend her time interacting with staff by barking commands and pressing her call light every 10 minutes for endless reasons. She was not the ideal ER patient and my coworker had gone to great lengths to appease her many requests only to get yelled at about how the patient still was not satisfied.
I set a goal to kill this woman with kindness. If my theory was correct and she truly was lonely then her spiteful words only came from a place that lacked control. She could no longer walk or move herself well and her life revolved around her medical problems. She was frustrated, tired and completely out of control. She loved the control she gained from the call light and people coming in to her room to ask how they could assist her. She held that control tighter by choosing to be mean to every person who entered the room.
I will not let her get to me. I entered the room with a smile only to receive barking orders to give her the phone in addition to a few snarky comments. I set my limits hard and firm.
"Ma'am, I am here to help you and be your advocate. You will be kind to me and will not speak to me that way," I insisted kindly, but firmly.
She snarled at me and gave a long, exasperated "Pllleeeeaaaassseeeee" to appease my request. I handed her the phone. As I walked around the bed I tripped over the cord to her sarcastic remark of, "What are ya trying to kill yourself?"
I laughed, again thinking, You will not get to me!
" I better not," I smiled. "I have a three month old at home!"
"You doooo????!!" She exclaimed with genuine interest.
Bingo. I had found a way in. I pulled out my phone and showed her a few pictures of my baby and we chatted about kids, families, and she opened up to me about her life. She was simply yearning for a connection. She was human. Don't we all yearn for personal connection in some way? We left the night on good terms, both smiling and better off than when we started.
As a nurse I am present to help. This means I have a responsibility to my patients, but also a responsibility to myself. I am not a doormat for someone to yell and take out their frustrations on, but I can choose not to return attitude or hurtful words. Sometimes the best way to save a patient is to kill them with kindness and help them realize that you too yearn for connection in hopes to aid in their healing process. I have yet to meet a nurse who has a goal of making patient's lives miserable. It is not in our nature.
I will always remember this patient. Not because she was mean, but because she reminded me of the power and beauty that is found in genuine care and compassion for another.
Monday, September 10, 2018
Friday, June 22, 2018
On the Other Side-My Birthing Experience
I have now been away from work for seven weeks, thus the lack of posting, and my sweet son is now 3.5 weeks old. I typically reflect on my experiences as a nurse and a caregiver, but today want to reflect on my experience as a patient...what it felt like to be on the other side.
Labor and Delivery is like the ER unit for birth and ER nurses cringe at the thought of delivering a baby and have very limited knowledge and experience in the realm of OB. When they found out I was a nurse I had to preface it with "Please don't assume I know anything because this realm of medicine is totally foreign to me!" What's your birth plan? "To have a baby and hopefully not need meds to get there". Naive? Yes. Ignorant? Probably. Optimistic? Always.
Culture of excellence plays a large part in the care provided where I work, and as a nurse leader I hold myself and others accountable to practices like filling out patient white boards, keeping families updated, and making intentional connections while caring for others. I have always found value in these things, but until being a patient myself never fully appreciated the value in these practices.
"How has our staff made you feel cared for as a person?" I have never experienced compassion and caring quite like I did from the nurses who cared for me on labor and delivery. They sat down at eye level to explain what my options were. They took a genuine interest in me and who I was. They asked me about my preference of nurse presence and family in the room. What was going to make me most comfortable? One nurse asked if she could use touch to help my pain and massaged my shoulders through a round of contractions. They gave my husband a job so he was empowered to be a part of the experience. This empowered him to walk with me and assist through each contraction as opposed to watching helplessly. They took the time to teach me how to breathe, and kept me informed about the plan and my options each step of the way. They empathized with my pain and cheered me on through every hour. The little things they did each step of the way validated my feelings, encouraged me, and reminded me that I no point was I alone.
"Has your pain been managed?" Being the stubborn nurse I am, I was convinced I didn't need pain meds. I'm tough and have a high pain tolerance...so I thought... When I first went in to labor the nurse asked what my pain was. I laughed. "I don't know what a 10 is," I told her. "Maybe I'm at a 2/10 on the pain scale but it comes and goes over 30 seconds and I can handle that". NO I DO NOT want an epidural. No one pressured me. They gave me a room with a tub so the hot water could soothe some of the pain, gave me and my husband tools to breathe through each contraction, and let me know I could always change my mind. In the meantime they held my hand and told me I was amazing and doing a wonderful job. They truly made me feel good and I really thought I could do it... until hour 18 of labor when I discovered what 10/10 pain really felt like and opted for an epidural before I passed out from pain and exhaustion. I have a whole new empathy for patients in pain, as before I had never experienced anything painful to be able to relate. But boy when I said the magic words they jumped on that pain management as quickly as possible to help meet my needs.
I have never felt so supported and close to complete strangers. These are women who came to work that day because they like to care for others and chose to participate in one of the most memorable and life-changing days of my life. That is pretty remarkable. They didn't just go through the motions, but genuinely expressed caring and compassion in every touch, word, and action. They genuinely wanted to know about me and my story. Who was I? How did I feel about this experience? How could they help make it better?
I knew what I should expect from their care and the hospital's expectations, and I was blown away by how I felt as the patient seeing these standards executed so well. It's the little things that add up, like filling out my whiteboard and sitting down to talk to me at eye level. These little things combined with genuine compassion and caring from another human being made for an incredible and touching experience. It is human nature to want to feel loved, cared for, and respected, but I never realized that kind of caring could be so profound in a nurse-patient relationship. I may or may not see those nurses ever again, but walked away with a new understanding of the weight my role as a nurse carries. I always knew I had the ability to extend kindness, compassion, and care to those I cared for, but now I understand the magnitude of influence my presence can have on the patient experience.
I nurse because I love to care for others. I love the ER because it is new, fast-paced, and ever changing. That being said, our best trauma is often someone's worst day. No one plans to go to the ER, and often those days are life-changing for many. This experience gave me a new perspective in my own practice. I hope each and every patient I care for walks away with the same feeling of caring I felt from those who cared for me in one of the hardest, most life-changing moments of my life.
Labor and Delivery is like the ER unit for birth and ER nurses cringe at the thought of delivering a baby and have very limited knowledge and experience in the realm of OB. When they found out I was a nurse I had to preface it with "Please don't assume I know anything because this realm of medicine is totally foreign to me!" What's your birth plan? "To have a baby and hopefully not need meds to get there". Naive? Yes. Ignorant? Probably. Optimistic? Always.
Culture of excellence plays a large part in the care provided where I work, and as a nurse leader I hold myself and others accountable to practices like filling out patient white boards, keeping families updated, and making intentional connections while caring for others. I have always found value in these things, but until being a patient myself never fully appreciated the value in these practices.
"How has our staff made you feel cared for as a person?" I have never experienced compassion and caring quite like I did from the nurses who cared for me on labor and delivery. They sat down at eye level to explain what my options were. They took a genuine interest in me and who I was. They asked me about my preference of nurse presence and family in the room. What was going to make me most comfortable? One nurse asked if she could use touch to help my pain and massaged my shoulders through a round of contractions. They gave my husband a job so he was empowered to be a part of the experience. This empowered him to walk with me and assist through each contraction as opposed to watching helplessly. They took the time to teach me how to breathe, and kept me informed about the plan and my options each step of the way. They empathized with my pain and cheered me on through every hour. The little things they did each step of the way validated my feelings, encouraged me, and reminded me that I no point was I alone.
"Has your pain been managed?" Being the stubborn nurse I am, I was convinced I didn't need pain meds. I'm tough and have a high pain tolerance...so I thought... When I first went in to labor the nurse asked what my pain was. I laughed. "I don't know what a 10 is," I told her. "Maybe I'm at a 2/10 on the pain scale but it comes and goes over 30 seconds and I can handle that". NO I DO NOT want an epidural. No one pressured me. They gave me a room with a tub so the hot water could soothe some of the pain, gave me and my husband tools to breathe through each contraction, and let me know I could always change my mind. In the meantime they held my hand and told me I was amazing and doing a wonderful job. They truly made me feel good and I really thought I could do it... until hour 18 of labor when I discovered what 10/10 pain really felt like and opted for an epidural before I passed out from pain and exhaustion. I have a whole new empathy for patients in pain, as before I had never experienced anything painful to be able to relate. But boy when I said the magic words they jumped on that pain management as quickly as possible to help meet my needs.
I have never felt so supported and close to complete strangers. These are women who came to work that day because they like to care for others and chose to participate in one of the most memorable and life-changing days of my life. That is pretty remarkable. They didn't just go through the motions, but genuinely expressed caring and compassion in every touch, word, and action. They genuinely wanted to know about me and my story. Who was I? How did I feel about this experience? How could they help make it better?
I knew what I should expect from their care and the hospital's expectations, and I was blown away by how I felt as the patient seeing these standards executed so well. It's the little things that add up, like filling out my whiteboard and sitting down to talk to me at eye level. These little things combined with genuine compassion and caring from another human being made for an incredible and touching experience. It is human nature to want to feel loved, cared for, and respected, but I never realized that kind of caring could be so profound in a nurse-patient relationship. I may or may not see those nurses ever again, but walked away with a new understanding of the weight my role as a nurse carries. I always knew I had the ability to extend kindness, compassion, and care to those I cared for, but now I understand the magnitude of influence my presence can have on the patient experience.
I nurse because I love to care for others. I love the ER because it is new, fast-paced, and ever changing. That being said, our best trauma is often someone's worst day. No one plans to go to the ER, and often those days are life-changing for many. This experience gave me a new perspective in my own practice. I hope each and every patient I care for walks away with the same feeling of caring I felt from those who cared for me in one of the hardest, most life-changing moments of my life.
To those of you who are nurses, thank you for what you do. Even on the toughest days, don't forget or underestimate the power of your touch and the impact of your compassion.
Sunday, April 29, 2018
Pray with Me
"Here," she motioned to me with tears in her eyes and her arm outstretched over her dear friend's cold body. "Will you pray with me?" She pleaded, tears in her eyes.
"Of course," I replied quietly. I took her hand and we prayed the Our Father prayer as the whole room stopped what they were doing out of respect for the family and the young patient we had been unsuccessful in resuscitating.
We finished praying and the room took a pause of silence to acknowledge the life that had passed before us.
Who was this soul and why was today his time? What was his story? How did he end up in the condition he was in? Was this his fault? Was there anything that could have been done differently on our end? What about his end? Was this the culmination of a lifetime of choices or simply God's will that today was his day? What about his friends? His girlfriend? Why do they have to suffer too? What made this guy different than me? What made him the same?...My mind spun
I have seen many lives pass in the ER and there is always some level of dissociation. I'm not sure if it is a natural coping mechanism or a subconscious way of protecting myself from the hurt that comes with watching death and trying to be present to those who are suffering. Maybe it's denial, or maybe it's the fact that death has not personally been apart of my reality for quite some time. And the last time it was, it was slow and expected, not sudden and traumatic. The fact is, my brain often finds reason to not connect with the person dying for a plethora of reasons. He was older than me, or she had a significant medical history, or his lifestyle put him here, or she was high risk...always some barrier as to why that wouldn't be me or my loved one.
Reflecting on this case made me recognize my quick reflex to guard my fear of becoming that patient, or, heaven forbid one of my family members being such a case. The family and friends on this day broke my guard and shattered it in to a million pieces when they entered the room. The first thing the friend said was "We need a priest for last rites. He's Catholic and that is important to him".
Guard down and personal barrier shattered.
This struck at my core. I too am Catholic, and if I were him that is something that would be important to me. Immediately, I felt spiritually connected to this patient and the family and I assured her I understood what she was talking about. Unfortunately time was limited and no priest available, so I offered to pray over him with her as he passed, in hopes that God would hear our prayer and embrace him.
As different as we were, I let myself feel connected with these people through prayer and a shared belief that God was present in the room at that moment and that He heard us. There was a vulnerability and humanness to the situation, but also surprisingly a healing and peace that accompanied the grief.
He will always remain on my heart, as I felt honored to be invited in to his last moments with his loved ones. As the nurse it is not often that families ask you to pray or invite you in to their grieving space. It is a beautiful gift. Sad, yes, and emotionally draining to an extent. Thankfully not a daily occurrence, but one that offers hope in the midst of sadness and one of those moments that reminds me why I do what I do.
"Of course," I replied quietly. I took her hand and we prayed the Our Father prayer as the whole room stopped what they were doing out of respect for the family and the young patient we had been unsuccessful in resuscitating.
We finished praying and the room took a pause of silence to acknowledge the life that had passed before us.
Who was this soul and why was today his time? What was his story? How did he end up in the condition he was in? Was this his fault? Was there anything that could have been done differently on our end? What about his end? Was this the culmination of a lifetime of choices or simply God's will that today was his day? What about his friends? His girlfriend? Why do they have to suffer too? What made this guy different than me? What made him the same?...My mind spun
I have seen many lives pass in the ER and there is always some level of dissociation. I'm not sure if it is a natural coping mechanism or a subconscious way of protecting myself from the hurt that comes with watching death and trying to be present to those who are suffering. Maybe it's denial, or maybe it's the fact that death has not personally been apart of my reality for quite some time. And the last time it was, it was slow and expected, not sudden and traumatic. The fact is, my brain often finds reason to not connect with the person dying for a plethora of reasons. He was older than me, or she had a significant medical history, or his lifestyle put him here, or she was high risk...always some barrier as to why that wouldn't be me or my loved one.
Reflecting on this case made me recognize my quick reflex to guard my fear of becoming that patient, or, heaven forbid one of my family members being such a case. The family and friends on this day broke my guard and shattered it in to a million pieces when they entered the room. The first thing the friend said was "We need a priest for last rites. He's Catholic and that is important to him".
Guard down and personal barrier shattered.
This struck at my core. I too am Catholic, and if I were him that is something that would be important to me. Immediately, I felt spiritually connected to this patient and the family and I assured her I understood what she was talking about. Unfortunately time was limited and no priest available, so I offered to pray over him with her as he passed, in hopes that God would hear our prayer and embrace him.
As different as we were, I let myself feel connected with these people through prayer and a shared belief that God was present in the room at that moment and that He heard us. There was a vulnerability and humanness to the situation, but also surprisingly a healing and peace that accompanied the grief.
He will always remain on my heart, as I felt honored to be invited in to his last moments with his loved ones. As the nurse it is not often that families ask you to pray or invite you in to their grieving space. It is a beautiful gift. Sad, yes, and emotionally draining to an extent. Thankfully not a daily occurrence, but one that offers hope in the midst of sadness and one of those moments that reminds me why I do what I do.
Friday, April 13, 2018
Fierce Love
I often have heard nurses say how the case wasn't real until the family members entered the room. This simply meaning that a personal or emotional connection wasn't associated with the patient in cardiac arrest on the table until the family member's cries were heard or tears witnessed at the same time, or sometimes after the fact. I have experienced this as well.
We see trauma frequently in the ER and are used to kneeling at the side of a spouse and holding their hand while they weep. In these cases, we know that words typically do not suffice and presence is the best form of communication we have to offer in that moment. None of those cases are easy, but none of them present quite the same either. As humans we all have different ways of grieving and coping with life's challenges.
The love of a parent for their child is immense and one of the hardest grieving instances to witness in an acute emergent situation. Whether that child is an infant or fifty years old, no parent should have to watch their child die, it's just not right.
This man was his son's biggest fan. They had both been down a rough road, but his son was his world. He was an adult, but far too young to be on death's doorstep, and this father watched his son's heart rate drop and then stop. He watched the initiation of CPR through intubation and took his place at the foot of the bed. Your average family member would step out or sit quietly and watch. This man's response was unique as he cheered his son on throughout the process.
You're going to come through this. You've got this son. Hang in there.
Talk about heartbreaking. Dad was more than engaged. He was a member of the team. He asked questions about prognosis, length of compressions, tests being run, and drugs administered. He maintained a spirit of hope and his rooting for his son worked in conjunction with the team's desire to resuscitate the young life on the table. I talked dad through the process, potential diagnosis, the medical workup, and what to expect over the next few days. What at first felt like an awkward time to be answering technical medical questions, that is what dad needed. All he had control over was knowledge and hope, and he held on to both tightly.
After my shift that evening I found this same dad behind me at the coffee cart and he insisted on paying for my morning muffin. I gave him a hug and he looked me in the eye and said Thank you for what you do.
Wow. Those are the moments in this profession that remind me why I do what I do. That man was a brave soul who took his fear and transformed it in to hope as he faced something no father should have to. His spirit was unlike anything I had witnessed, and his face and name will remain with me as one that I won't forget. I know he was hurting deep down and had a long road ahead of him, but he demonstrated a love for his son that was fierce, deep, and dedicated. A beautiful example of the love of a parent for his child.
Thank you, my friend, for reminding me of the beauty of loving fiercely in this life.
We see trauma frequently in the ER and are used to kneeling at the side of a spouse and holding their hand while they weep. In these cases, we know that words typically do not suffice and presence is the best form of communication we have to offer in that moment. None of those cases are easy, but none of them present quite the same either. As humans we all have different ways of grieving and coping with life's challenges.
The love of a parent for their child is immense and one of the hardest grieving instances to witness in an acute emergent situation. Whether that child is an infant or fifty years old, no parent should have to watch their child die, it's just not right.
This man was his son's biggest fan. They had both been down a rough road, but his son was his world. He was an adult, but far too young to be on death's doorstep, and this father watched his son's heart rate drop and then stop. He watched the initiation of CPR through intubation and took his place at the foot of the bed. Your average family member would step out or sit quietly and watch. This man's response was unique as he cheered his son on throughout the process.
You're going to come through this. You've got this son. Hang in there.
Talk about heartbreaking. Dad was more than engaged. He was a member of the team. He asked questions about prognosis, length of compressions, tests being run, and drugs administered. He maintained a spirit of hope and his rooting for his son worked in conjunction with the team's desire to resuscitate the young life on the table. I talked dad through the process, potential diagnosis, the medical workup, and what to expect over the next few days. What at first felt like an awkward time to be answering technical medical questions, that is what dad needed. All he had control over was knowledge and hope, and he held on to both tightly.
After my shift that evening I found this same dad behind me at the coffee cart and he insisted on paying for my morning muffin. I gave him a hug and he looked me in the eye and said Thank you for what you do.
Wow. Those are the moments in this profession that remind me why I do what I do. That man was a brave soul who took his fear and transformed it in to hope as he faced something no father should have to. His spirit was unlike anything I had witnessed, and his face and name will remain with me as one that I won't forget. I know he was hurting deep down and had a long road ahead of him, but he demonstrated a love for his son that was fierce, deep, and dedicated. A beautiful example of the love of a parent for his child.
Thank you, my friend, for reminding me of the beauty of loving fiercely in this life.
Thursday, April 5, 2018
What is Caring?
I hear a lot of talk about caring in my weekly work. I entered in to nursing initially because it is a profession of caring and service and I love that I have the ability to positively impact others in my daily work.
But what does it mean to care?
Thinking about this, I think caring comes from two different perspectives: that of the "carer" and that of the person being cared for. I can care for you with every ounce of my being and heart with all the best intentions in the world, but if my style of caring does not meet your needs, my efforts may be perceived as futile. It reminds me of the book The Five Love Languages by Gary Chapman. Chapman discusses how you may love someone with all your heart, but if you do not show them love in a way that speaks to them, their cup will feel empty. For example, if giving gifts is how I love to show affection to others, but my spouse's love language is quality time, all the gifts in the world will not make him feel loved unless it is the gift of my presence.
I am not implying that a nurse must love every patient who walks through the door, but think the two concepts parallel. For one patient, they feel cared for if you are in their room every fifteen minutes to chat. For another, they feel cared for because you managed their pain level. A third patient feels cared for because you gave him a gatorade, sandwich, warm blanket, and the quiet to sleep for a few hours.
Caring is relative. It is finding where your strengths as a caregiver can meet the needs of the one you are caring for and finding the finesse to deliver that care with sincere intention. There is a reason nursing refers to caring as an art.
A few weeks ago a single mom came in with severe back pain. She was uncomfortable and it hurt to twist and move. This was only exacerbated by the fact that she had a six month old baby who would not stop crying. Holding the baby hurt her and baby could sense her tense, uncomfortable state which only made her cry harder. Baby's tears turned in to mom's tears and the baby could be heard throughout the department. With no support system she had no one to help her with the child.
I have never been a baby person. I helped raise my two youngest brothers and was around kids my whole life, but never had baby fever or was the one who had to hold someone's newborn. I am due to have a sweet baby boy of my own in less than two months and couldn't imagine being in this woman's shoes. The night was slow and I popped in to round and ask her how our staff was making her feel cared for as a person. Tears welled in her eyes and I thought to myself How could I make her feel cared for as a person? She was obviously uncomfortable and needed pain meds, but what she really needed was to focus on herself, which she couldn't do with an inconsolable child.
May as well get some practice I thought to myself, and offered to hold baby and walk around the department to give her some peace. The relief and appreciation in this woman's eyes touched my heart as baby stopped crying. She was a beautiful, sweet baby girl and we strolled the ER hallways for some time until I could nestle her into her carrier in a peaceful sleep.
For this woman, caring was someone telling her it was okay to take a break and ask for help. Caring for her was rocking her baby to sleep, a task too painful for her at the time. While it felt a little weird to hold a stranger's baby for an hour, it was a beautiful experience for me to step out of my comfort zone and recognize the importance of not just asking about care, but finding a special way and time to extend that care to another.
Caring is a growing art. It is individualized, unique, and something that grows with each person throughout their profession. At the end of the day when I know someone I met left feeling well cared for (and you can't please them all), that makes for a good day.
But what does it mean to care?
Thinking about this, I think caring comes from two different perspectives: that of the "carer" and that of the person being cared for. I can care for you with every ounce of my being and heart with all the best intentions in the world, but if my style of caring does not meet your needs, my efforts may be perceived as futile. It reminds me of the book The Five Love Languages by Gary Chapman. Chapman discusses how you may love someone with all your heart, but if you do not show them love in a way that speaks to them, their cup will feel empty. For example, if giving gifts is how I love to show affection to others, but my spouse's love language is quality time, all the gifts in the world will not make him feel loved unless it is the gift of my presence.
I am not implying that a nurse must love every patient who walks through the door, but think the two concepts parallel. For one patient, they feel cared for if you are in their room every fifteen minutes to chat. For another, they feel cared for because you managed their pain level. A third patient feels cared for because you gave him a gatorade, sandwich, warm blanket, and the quiet to sleep for a few hours.
Caring is relative. It is finding where your strengths as a caregiver can meet the needs of the one you are caring for and finding the finesse to deliver that care with sincere intention. There is a reason nursing refers to caring as an art.
A few weeks ago a single mom came in with severe back pain. She was uncomfortable and it hurt to twist and move. This was only exacerbated by the fact that she had a six month old baby who would not stop crying. Holding the baby hurt her and baby could sense her tense, uncomfortable state which only made her cry harder. Baby's tears turned in to mom's tears and the baby could be heard throughout the department. With no support system she had no one to help her with the child.
I have never been a baby person. I helped raise my two youngest brothers and was around kids my whole life, but never had baby fever or was the one who had to hold someone's newborn. I am due to have a sweet baby boy of my own in less than two months and couldn't imagine being in this woman's shoes. The night was slow and I popped in to round and ask her how our staff was making her feel cared for as a person. Tears welled in her eyes and I thought to myself How could I make her feel cared for as a person? She was obviously uncomfortable and needed pain meds, but what she really needed was to focus on herself, which she couldn't do with an inconsolable child.
May as well get some practice I thought to myself, and offered to hold baby and walk around the department to give her some peace. The relief and appreciation in this woman's eyes touched my heart as baby stopped crying. She was a beautiful, sweet baby girl and we strolled the ER hallways for some time until I could nestle her into her carrier in a peaceful sleep.
For this woman, caring was someone telling her it was okay to take a break and ask for help. Caring for her was rocking her baby to sleep, a task too painful for her at the time. While it felt a little weird to hold a stranger's baby for an hour, it was a beautiful experience for me to step out of my comfort zone and recognize the importance of not just asking about care, but finding a special way and time to extend that care to another.
Caring is a growing art. It is individualized, unique, and something that grows with each person throughout their profession. At the end of the day when I know someone I met left feeling well cared for (and you can't please them all), that makes for a good day.
Sunday, March 4, 2018
Like a TV show
Most people have a disillusioned view of the reality of nursing in a hospital if they have not spent a significant amount of time in the hospital setting. I hear patients comment on how their psychotic neighbor (of whom they know nothing about except whatever he or she is yelling from their room) is either very entertaining or utterly terrifying. It's like they feel like they are in an episode of Grey's Anatomy or Scrubs. I don't blame them, as I too knew nothing of work in the hospital until I entered the nursing field, and quickly learned that the Hollywood portrayal of my job was far different than the startling reality I encounter each day.
And then you experience those days that truly make you feel like you lived a television episode simply because the reality of a case or the weight of an event or situation feels like it shouldn't be happening to the people who are involved. The day where a patient pulls up to the front of the ER already in cardiac arrest and you watch a coworker jump on the stretcher and perform CPR as the patient is wheeled down the hallway to a room followed by a heard of nurses ready to jump in and aid in the resuscitation.
And slowly behind the crowd of people comes a distraught spouse, in too much shock to cry, trying to put the pieces together as she watches CPR in progress and her husband intubated. I sat off to the side with her and explained what was going on as the tears trickled down her tired face. He had been sick, that's all. Sick like every other person in Denver who had come through our doors with the flu or other virus this season. Yet this man's reality was that his sickness was too much for his body. His need for oxygen prompted his wife to take him to the doctor, but the demands on his body were too much. She had no idea that she would set out from her home that evening to get him help and that when she pulled into her driveway later that evening her reality would be completely changed.
I held her and hugged her as they called time of death, because there really were no words except I'm so sorry for your loss. The strength of this woman was remarkable as she said her goodbyes and asked me where she could pay on her way out. She was in complete shock. I told her payment could come later and allowed her to leave information as I walked her out to her car, which she insisted upon driving home.
She thanked me and the team for all the efforts and great care provided, and my heart broke. She was grateful knowing we did all we could, and yet all I wanted to do was apologize, wishing we could have changed her reality, but knowing we did everything we could for her and her family.
These are the realities people face on a daily basis and these are the cases we struggle to process at the end of a shift. Why him? Why her? What if they had arrived sooner? Would there have been a chance? We are trained to do CPR and run a code for a patient in cardiac arrest. We are trained to push meds and to walk a family member through the steps of the death process. We are trained to see things the average person does not see.
But we are not always told it will hurt. We are not always warned that when family steps in to the room it changes the dynamic of how you feel about the patient and their humanity. We forget the pain that comes with death until we hear the cries of a loved one. We do not always realize that there are faces and names that are ingrained on our hearts after certain cases because we cannot shake the memory. And we are not always taught to talk about the hard stuff, but these are the times that need the most processing. This is the side you don't see in the movies, the aftermath of trauma that hits hard after you've gone home.
Cry, vent, talk it out, whatever you need to do. It's okay to feel for others and it's important to acknowledge your feelings. We can only truly care for others when we take the time to regularly care for our own mental, physical, and spiritual well-being. Only then can we be present to the mourning spouse or the tragic case and not carry each patient's pain home every night.
And then you experience those days that truly make you feel like you lived a television episode simply because the reality of a case or the weight of an event or situation feels like it shouldn't be happening to the people who are involved. The day where a patient pulls up to the front of the ER already in cardiac arrest and you watch a coworker jump on the stretcher and perform CPR as the patient is wheeled down the hallway to a room followed by a heard of nurses ready to jump in and aid in the resuscitation.
And slowly behind the crowd of people comes a distraught spouse, in too much shock to cry, trying to put the pieces together as she watches CPR in progress and her husband intubated. I sat off to the side with her and explained what was going on as the tears trickled down her tired face. He had been sick, that's all. Sick like every other person in Denver who had come through our doors with the flu or other virus this season. Yet this man's reality was that his sickness was too much for his body. His need for oxygen prompted his wife to take him to the doctor, but the demands on his body were too much. She had no idea that she would set out from her home that evening to get him help and that when she pulled into her driveway later that evening her reality would be completely changed.
I held her and hugged her as they called time of death, because there really were no words except I'm so sorry for your loss. The strength of this woman was remarkable as she said her goodbyes and asked me where she could pay on her way out. She was in complete shock. I told her payment could come later and allowed her to leave information as I walked her out to her car, which she insisted upon driving home.
She thanked me and the team for all the efforts and great care provided, and my heart broke. She was grateful knowing we did all we could, and yet all I wanted to do was apologize, wishing we could have changed her reality, but knowing we did everything we could for her and her family.
These are the realities people face on a daily basis and these are the cases we struggle to process at the end of a shift. Why him? Why her? What if they had arrived sooner? Would there have been a chance? We are trained to do CPR and run a code for a patient in cardiac arrest. We are trained to push meds and to walk a family member through the steps of the death process. We are trained to see things the average person does not see.
But we are not always told it will hurt. We are not always warned that when family steps in to the room it changes the dynamic of how you feel about the patient and their humanity. We forget the pain that comes with death until we hear the cries of a loved one. We do not always realize that there are faces and names that are ingrained on our hearts after certain cases because we cannot shake the memory. And we are not always taught to talk about the hard stuff, but these are the times that need the most processing. This is the side you don't see in the movies, the aftermath of trauma that hits hard after you've gone home.
Cry, vent, talk it out, whatever you need to do. It's okay to feel for others and it's important to acknowledge your feelings. We can only truly care for others when we take the time to regularly care for our own mental, physical, and spiritual well-being. Only then can we be present to the mourning spouse or the tragic case and not carry each patient's pain home every night.
Sunday, February 25, 2018
The Little Things...
I crawled in to bed one morning after a long string of nights and hugged my husband. "You're not allowed to die" I often tell him when I come home from working in the ER, and he always gives me this strange look and says "I'm not going to die, stop saying things like that". But those life-changing scenarios and stories are what I witness all night long. What makes my life not in the percentage of spouses who have a heart attack or get in to a tragic accident while coming home from work?
In one night there was a woman who frantically called 911 after realizing her husband was having a stroke with severe deficits in the middle of the night. Another woman got the call that her husband was flown to another state in critical condition after a terrible accident, and a third woman writhed in pain in the hospital bed while her husband paced the ER trying to figure out how he could take away her pain, too tired and nervous to head back to their new assisted living home alone. All three heartbreaking, and people just like you or me.
This particular night I was trying to be mindful of the fact that the ER is not people's place of choice at 0200 on any given early morning, which is easy to forget when you feel like you live there working nights. I communicated with the wife en route to her husband who had endured serious trauma. I was the first person she spoke to, the one to tell her he was still alive but critical, the one voice she heard between home and the hospital. As I gave her the facts my heart broke for her in her state of shock, simply wanting to know the extent of injury and what she was walking in to...I couldn't imagine being on the other end of that phone line, and it struck me that I was in a position to calm her immediate fear, that her husband was not dead, yet still had to deliver that he was critical. Not your average job duty...
Rounding around later that evening I encountered the flustered husband of the woman who had fallen and sustained a severe break. He came out to ask for pain medication three times in three minutes as the team worked to help make his wife comfortable. He paced the halls, appearing anxious as she was wheeled to and from radiology for multiple scans. Recognizing his frustration I brought him some coffee and went and sat with him to give him some company. His poor wife was shaking with anxiety and pain as the nurse pushed the IV medication. She looked miserable, as did he with no control and no way to help ease her pain.
This man and I chatted for some time. He explained how he couldn't get a hold of his children and they had just moved in to a new facility where he did not feel comfortable heading back alone. It was late, he was tired, frustrated, and completely out of control. I offered to look up his son's phone number and helped him leave some messages. It was no surprise there was no answer at the early hours of the morning that it was, and I assured him they would call back when they woke up for work in a few short hours. I saw a cup of coffee, some phone numbers, and a simple conversation turn his demeanor. This sweet man just needed someone to talk to, to acknowledge his fears, and to know his wife was going to be okay.
This gave a whole new meaning to my leadership rounding question of "What has staff done to make you feel cared for as a person?" It's not a matter of asking someone if they need something, but looking them in the eye, caring, and your actions asking "Are you okay? I care about you and want to know if you need anything." I was drawn to put myself in this man's shoes thinking how I would feel on the other side, and he reminded me the importance of taking time to truly listen and be present and intentional in my words and actions. Sometimes it's the little things like looking up a phone number or a cup of coffee that can help someone regain control and feel human again. It's a privilege to have the time to sit and listen, and I will remember that gentleman, and remember to make the most of the time when I have it, knowing it can make all the difference.
In one night there was a woman who frantically called 911 after realizing her husband was having a stroke with severe deficits in the middle of the night. Another woman got the call that her husband was flown to another state in critical condition after a terrible accident, and a third woman writhed in pain in the hospital bed while her husband paced the ER trying to figure out how he could take away her pain, too tired and nervous to head back to their new assisted living home alone. All three heartbreaking, and people just like you or me.
This particular night I was trying to be mindful of the fact that the ER is not people's place of choice at 0200 on any given early morning, which is easy to forget when you feel like you live there working nights. I communicated with the wife en route to her husband who had endured serious trauma. I was the first person she spoke to, the one to tell her he was still alive but critical, the one voice she heard between home and the hospital. As I gave her the facts my heart broke for her in her state of shock, simply wanting to know the extent of injury and what she was walking in to...I couldn't imagine being on the other end of that phone line, and it struck me that I was in a position to calm her immediate fear, that her husband was not dead, yet still had to deliver that he was critical. Not your average job duty...
Rounding around later that evening I encountered the flustered husband of the woman who had fallen and sustained a severe break. He came out to ask for pain medication three times in three minutes as the team worked to help make his wife comfortable. He paced the halls, appearing anxious as she was wheeled to and from radiology for multiple scans. Recognizing his frustration I brought him some coffee and went and sat with him to give him some company. His poor wife was shaking with anxiety and pain as the nurse pushed the IV medication. She looked miserable, as did he with no control and no way to help ease her pain.
This man and I chatted for some time. He explained how he couldn't get a hold of his children and they had just moved in to a new facility where he did not feel comfortable heading back alone. It was late, he was tired, frustrated, and completely out of control. I offered to look up his son's phone number and helped him leave some messages. It was no surprise there was no answer at the early hours of the morning that it was, and I assured him they would call back when they woke up for work in a few short hours. I saw a cup of coffee, some phone numbers, and a simple conversation turn his demeanor. This sweet man just needed someone to talk to, to acknowledge his fears, and to know his wife was going to be okay.
This gave a whole new meaning to my leadership rounding question of "What has staff done to make you feel cared for as a person?" It's not a matter of asking someone if they need something, but looking them in the eye, caring, and your actions asking "Are you okay? I care about you and want to know if you need anything." I was drawn to put myself in this man's shoes thinking how I would feel on the other side, and he reminded me the importance of taking time to truly listen and be present and intentional in my words and actions. Sometimes it's the little things like looking up a phone number or a cup of coffee that can help someone regain control and feel human again. It's a privilege to have the time to sit and listen, and I will remember that gentleman, and remember to make the most of the time when I have it, knowing it can make all the difference.
Subscribe to:
Posts (Atom)