My version of Palliative care
I am working on my 2nd year of practice in this nursing profession. But yesterday got me questioned my emotional strength. I realized I have yet learned to control my emotions. I don’t know but I suddenly felt stupid or too human that I cant get to help my patient whining from pain. He’s suffering from colorectal cancer with round the clock doses of Fentanyl. I was introducing a water soluble contrast via NGT and he felt cramps afterwards. No not cramps but pain. Untolerable pain. A no-joke kind of pain. I mean one of the things you’ll learn from being in this practice is to validate those pain scores a patient is giving you. I’ve encountered patients giving me a score of 10 saying it to me with a huge grin on their face. I’ve been handling this patient for 2 or 3 weeks now. And I’ve never seen him in this terrible state. It somehow disappoints me that my interventions didn’t help him to be well but sadly it looks like it deteriorates his condition. What was going on in my head that time? Should I comfort him by saying good stuff? like “that’s fine, it will be gone in a few”. Should I validate by asking his pain score? Or would he yell or bring a fist to my face should I have done that? How about deep breathing exercises? Should I refer to the doctor right away? Nope, that’s a very wrong answer in the boards. So what now? I palpate his stomach which is distended as it has been. I have a stethoscope around my neck so I checked for breath sounds and a ‘lil help of my fingers to check his pulse rate. But c’mon. I need an intervention. But the truth is I was hurt then. I can’t think through. I wanna cry with him too. I want to tell him that God has greater plans and bigger reasons for everything. I want to take him with me and drive him out of town and enjoy the simple pleasures of life, living the moment and just breath carelessly. But I can’t. Pain is subjective. It is an unpleasant sensation. What makes it worse is that death is inevitable. What if death is more potent than a fentanyl drip circulating in your bloodstream? What if?