I cared for 2 patients - both of home were in their early seventies. That was about the only thing that had in common. Going down the list almost every other assessment and observation differed. One patient was malnourished, the other slightly overweight. One patient had a complex medical history prior to admission, the other did not. Female, Male. Depressed, Optimistic. Few visitors/support system, a room decked in flowers, cards, phone calls, and an attentive wife. You get the idea.
Clearly, the second patient was easier to be around. When I walked into the room, his face lit up, he would greet me by name, and put out his hand. I was thanked repeatedly for every task I performed. We chatted like old friends...about the Peace Corp, folk dancing, nursing school, faith in God. We laughed about an episode of urinary incontinence. And yet, in the midst of all that, I knew I was not necessarily needed. If I hadn't been there, someone else would have. Whether it be his wife, one of many friends who called in to send their get well wishes, or a staff member [as they all adored him], when I left his room today after saying my goodbyes, I left with a light heart, knowing that his faith, his optimism, and extensive support system would pull him through.
On the other hand, saying goodbye to my other patient was not as painless. Without going into too many details, this woman has led a hard life. Due to a number of psychiatric issues and a debilitating swallowing disorder, this woman looked like a small child curled up in her bed. There is not an ounce of fat tissue on her body. She does not receive anything by mouth and is hooked up to a feeding machine that goes into her jejunum. She is notorious on the floor for overuse of her call light, and before I had even chosen this patient at the beginning of the week, I had already heard about her. Most of her requests were for more of her anti-psychotic medications...but really any care need was fair game. She was often anxious and in distress, and I witnessed her tell a number of people to just leave. She was intent about particulars: no lights on in the room, ice water with no ice, stack of washcloths within reach, come as quickly as possible when the call light flashes, but do whatever you can to avoid entering otherwise, don't ask a lot of questions. And I totally get why almost every care giver on the floor was griping about her. I heard everything from "I'm so sorry that you have THAT patient" to "I think it should be a rule that no one has to take care of her for two days in a row." Let's just say I had to do A LOT of biting my tongue. Granted, I recognize being a student nurse and being a staff nurse or PCT or doctor is not exactly the same. However, I do not believe that is an excuse to speak or act this way about a human being.
Now, I admit there were moments in caring for her when it was not easy. Today, I was accused of stealing her keys. A few times she expressed wanting to be alone. And so many times I just didn't know what to say to her. But my heart just ached for this woman. Here she is all alone in this hospital room, anxious as hell, all she can think about are her medications, feels like everyone hates her and that no one is listening, and frankly, does not have much going on in her life to be hopeful about. She is a mother and grandmother, but I just sensed that she hasn't felt like a useful and productive human being in a long time. At one point, she looked at me as I was holding her hand and said in a very distraught and scared voice "I will never be normal." My heart just broke into pieces.
I saw myself in that woman. I realized that as much as our life circumstances differ, humanity jointly desires significance and reassurance. The neat thing about just patiently listening and promptly answering her call lights is that she really seemed to be calmed by my presence. She learned my name quickly and would watch for me as I passed in the hall and would call out. And although this was exactly the reason so many were at the end of their rope with her, I found myself delighted to see the light come on. Granted, it did make it difficult if I was in the middle of something and in some regards took away from the time I spent doing other tasks, but that light symbolized an invitation to love. I didn't care if she begged me for more medication or asked for an endless amount of cloths or was upset about something I had nothing to do with. In every moment, I just looked into her eyes and did my best to convey that I cared. Even if it took me a few times to understand what she was saying. Even if in that moment she abruptly decided she wanted me to leave. It was worth it. Today she called out saying she needed to be changed and that she wanted "Alyssa" to do it. And it just made me smile. I didn't try and preach too much to her about how everything was going to be okay or how she should be more cooperative with treatment or any of that. But today before I left, I took her frail hand and held it in mine and said, "You are going to have to hold on a bit longer. You are beautiful. And I care about you. I love you. And God loves you." She just looked at me for awhile and gently nodded. She squeaked out a "thank you" and that proceeded to say "thank you for helping me." I gave her a little squeeze and told her how nice it was for me to meet her. As I stood up to walk out of the door, she looked at me with a slight hint of a smile and said "Drive safe."
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