Friday, March 28, 2008

One Of Those Patients...

Have you ever had one of those patients that you just couldn't help falling in love with?

Some Patients Capture Your Heart More Than Others

Perhaps it is the tragedy of their diagnosis...so young, so grim a prognosis. Or perhaps it is how their disease is manifesting itself by resulting in more and more hospital admissions, more and more tests, procedures and surgeries and more and more pain each time. Or perhaps it is their attitude throughout it all...they never lose their sense of humor. They always make the staff laugh and you find yourself genuinely feeling that taking care of them is a labor of love, not a chore.

Even Though They Are A "Total Care"...

They are what we nurses consider to be a "total care patient" due to the amount of care they require (weak, non-ambulatory, high risk for skin breakdown). But although they are one of the highest acuity patients on the floor, somehow you don't see it that way.

They are the kind of patient that you catch yourself thinking about often on your days off and they are the first patient you inquire about when you return to work. Their pain and suffering is inconceivable yet they are not ready to give up, not ready for hospice.

They've got diversions for bowel (colostomy) and bladder (ileoconduit) and fistulas (radiology drains). The amount of IV and oral pain medication they're on would normally kill a horse but it leaves them with just barely adequate pain control. You are not surprised to see that their latest PCA order includes quadruple strength Dilaudid with a strong basal rate. They are literally prescribed such massive amounts of pain pills (Oxycontin, Methadone, Neurontin) that they they can no longer keep up with them, sometimes having to refuse doses. Yet they remember you by name and give a big smile when you greet them in the morning.

It Makes No Sense

I recently took care of one of my favorite patients. It had been a heartbreaking day. I think for the first time, the full gravity of her condition was very evident to the patient, myself and my nurse assistant. There weren't as many jokes that day. None of us talked about the reality of her situation but it seems things have truly taken a turn for the worse.

Later that night, a noise woke me up out of a deep sleep. I immediately started thinking about her and the tears started flowing. So sad. Makes no sense. Why her? Why anyone? Poor, poor lady. God bless her. I became overwhelmingly grateful for that present moment and thanked (my) God for all the blessings in my life. It took a while to get back to sleep.

Compassion Is A Gift

The experts talk about compassion fatigue and burnout but you see it differently. You see it as having been given the gift of TRUE compassion for another human being, while at the same time having been given extremely stressful circumstances in which to experience it. Not enough resources, not enough certified staff, too many orders to process and too many stat tasks all combining and colliding at the same time with your love for humanity and your true desire to help and heal others. This is why nursing stress is so unique.

Nurses are gifted but they must fortify themselves emotionally, spiritually, physically and nutritionally. It is simply imperative that nurses take care of themselves because there will always be special patients counting on them!

Question: What is it about some patients that makes them so special? Post your answer as a "Comment" below.

Take Care of Yourself Nurses!
Theresa Waller, RN
714 293 5398

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