For some reason, it was the beard I couldn’t stop noticing.
It was uneven, scraggly at the ends; Bobbing as he talked incessantly. I braced myself and tried my best to follow his logic.
He was, after all, my patient’s son.
45 minutes later, I somehow made my exit and sighed relief. 6:48pm the clock read and I quickly tried to catch up my charting.
Families don’t know. They don’t realize. Arriving at 12 noon and then haunting my steps until 7pm… that doesn’t make miracles. I am, and always will be, the exact same nurse I always am. Badgering me constantly will do nothing but make me lose sleep.
The son talked incessantly as I worked. Always with a pseudo polite front of , “I don’t mean to bother you…” and then a 40 minute dissertation on why I wasn’t either doing my job correctly or that the doctors were not treating his mom correctly.
Mostly because I knew the husband of the patient was withholding information.
He hadn’t told his kids the severity of the brain injury.
He hadn’t described in detail the kidney failure, liver failure and reason for ventilator support.
He hadn’t told them yet that the reason the doctors suspected that she had cardiac arrested was because she had a pericardial effusion caused by cancer. Stage 4. Adenocarcinoma.
He hadn’t really communicated this at all. And so I looked like the jack ass. The incompetent fool.
So, I stood by my patient’s bedside and listened to the son passive aggressively tear apart the medical team and my care. I listened to him decide that he should bring his own neuro consult in. I listened to him.
He didn’t listen to me. Even when I gently tried to explain what I saw and what he should have seen.
A berated body that was so badly broken and laying in the bed.
A breathing tube replaced the feisty voice her family swore she had. The feet they swore she crammed into stilettos were necrotic and blistered from IV pressors.
A central line dangled from her neck shuttling blood pressure medicines to keep her pressure up even though they all swore she had high blood pressure.
A dialysis catheter connected her to the continuous machine that allowed her kidneys to vacation and her blood to filter.
A tube fed her, a tube shuttled feces and another hurried any urine away from her body. We were controlling everything her body did. A tube was in her left lung to keep her lung from collapsing again and another in her pericardium to drain away any fluid that compressed it.
I tried to gently explain the severity of the condition but he interrupted repeatedly.
Some, I have realized in my career, don’t care about what a nurse knows and only what they think they know.
It made me frustrated. And yet, I smiled politely as he dissed my profession. It made me furious, and yet I took a breath and continued to care for the patient.
She deserved to be cared for with everything I had to offer. And, after 8 years- I can offer a lot.
So I spent my time turning, nurturing and catering… not to her family. Who in my opinion, while being hopeful, were also being cruel and ignorant to her suffering. But I nurtured her. I made sure her mouth was clean and moisturized. I made sure she was turned and cleaned as often as I could. I medicated her for pain and paid attention to subtle signs of her suffering.
I spent time agonizing over her wounds and applying lotion and ointment to each area of hurt.
My heart was fully invested in her care, for two days I worked to correct each wrong she suffered.
So when the son attacked and berated on the eve of the second day… I did not cope as well as I should have.
I walked out of there, gave report, and ensured he was calm and appeased.
However, I went home and got frustrated.
I went to bed and didn’t sleep.
I did everything I could think of to do for this patient and more…
And, yet I left feeling inadequate and didn’t know why. Every concern I had, I addressed with the doctor. I did not slight her care at all. To the best of my ability, she had excellent nursing care under me. Yet, I was left with an unease, anxiety and inexplicably- terror.
A feeling that I was not good enough at my job. Was it because the overbearing night nurse who was degrading me during shift change made me feel like I wasn’t caring enough?
Was it the patient’s son, whose uneven beard and spacey questions haunt my subconscious?
Is it the swollen body and scleral edema of my dying patient that poke a hole in my reverie and make me feel sad?
Why this one… Why not the others who come and go in my life? Why not the last 10-20 patients who have never left our unit alive? Why is there this one patient who makes me feel so completely incompetent?
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gracieabrams
turnnoffyourmind
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