Friday, October 24, 2008

Nurse Follies: Remembering Who They Are

When you are in nursing school, you get assigned one or two patients for your clinicals. You usually go the day before to the site, collect the information, go home, and spend the next 8 hours typing up all kinds of crap: pathologies, drug information. It was endless and any nursing student, current and former, will attest to the madness of staying up all night doing paperwork, getting maybe 4 hours of sleep that night, and getting up at before the buttcrack of dawn to go to clinicals. If your paperwork wasn't finished, you not only were chastised by the nursing instructor, you were given a bad grade, maybe sent home for the day AND you were on the instructor's shit list for the duration of your nursing school career.

Anyway, with all the effort you put into your paperwork, you really got the know the patient. You got to know their history, and you spent a considerable amount of time with them throughout the day. You got to know their families. Because you are a young, idealistic nursing student, you still could see the patient for the person they were.

Sadly, as most any nurse will tell you, even a few years in the trenches, you lose that. Instead of seeing Mr. Smith as an avid sportsman, three kids, loves Doritos, who happened to have cancer, you just saw Mr. Smith: pancreatic cancer. With the way things are with crappy staffing, and all the other bullshit that takes nurses away from the bedside, like mountains of charting on what their poop looks like, you don't see people. You see patients and their diagnosis, and they happen to have family members at the bedside. It doesn't make us bad nurses. We still have sympathy for the lady who dies and leaves loved ones behind, but still it's something viewed on the periphery.

I got report on one of my patients. A gentleman who had been found non-responsive. For the time being, docs called it a stroke. I jotted my notes down in my report: review of systems, prognosis, tests, tasks, and oh yeah, his family stayed with him all the time.

I went into the room and the wife was sitting at the bedside. She smiled at me as I introduced myself and did my assessment. I took off my stethoscope and was making conversation with the wife. The patient, who could not speak, just looked around the room, looked at me, looked at his wife. I don't know if he understood what was going on.

I asked the wife just how this all began. She told me about the routine they usually did on Fridays, going out on a boat ride together. He had complained of a headache, but no one thought it too odd. They came home and puttered around the house, then she said something that completely caught me off guard.

"We made love," she stated before going on with her story about how she took a shower and when she came out, she found him unconscious.

It wasn't the fact that she so openly told me about having sex with her husband that gave me a moment's pause, but it was the manner in which she said it. Unashamed. She was sharing a very intimate detail to me, and it wasn't even relevant to what was going on with her husband at that time.

After she brought me up to speed, I looked at her husband, I suddenly didn't see my patient as just Mr. Bob: hemorrhagic stroke. I saw a man who was a father and a husband who took his wife boating on Fridays, and sometimes made love to her in the afternoon. The diagnosis was secondary. In spite of my cynical nature, I found myself really hoping he would eventually get better so he could go home and make love to his wife again.

1 comment:

bobbie said...

Great story ~ TFS!