As nurses, there are some times that we all have to take care of patients who, due to circumstance, due to mental anguish, due to mental illness, or a combination of all of these things are desperately seeking ways to end their life. On the same shift, or in the same week, or in the same day we also are often taking patients who facing a terminal condition, are desperately seeking to live. How do we go from one extreme to the next and still feel intact?
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Suicide can be described as a permenant solution to a temporary problem. The most frustrating thing when taking care of a patient who is suicidal is safety, and if there is a plan, what is it? Patient's who are actively seeking to die have thought about this and planned this act with great care. Suicide by and large can also be described as the most selfish act that someone can complete. By and large, counselors and social work are large components of the plan of care of the suicidal patient. Sitters that not only watchfully sit and observe, but often need to start the process of de-escalation. The thing to try and remember is that the problem or issue that a person who is suicidal is overwhelming to THEM in that moment.
A number of nurses are bound by human nature. We are only human after all. It is most difficult when a person is suicidal over the break-up of a boyfriend, when your other patient is dying of pancreatic cancer and wishing for a miracle. At that point, we can often think "theraputic communication?!?!?! REALLY?????"
I am here to say, yes, really. Most patients who decide to end their life do not do so with a faint heart. Literally, they feel there is no other option, their life as they know it is unbearable, and they are no longer of "use" to anyone, including themselves.
Terminal conditions, on the other end of the spectrum, often strike when someone is vital, strong and in the prime of their lives. Most endure many treatments, most all of them painful, in a bid to prolong things in order to, well, get their lives in order. To complete a bucket list. To see their kids grow up. Because people need them. Because they have needs. And wants. And desires. And it is heartbreaking to see a decline and for a patient to lose control.
At that point theraputic communication can seem fruitless, and difficult. It is almost like trying to convince someone that it is OK, and that they need to try and let go. And in the next breath to say to the other patient that it is OK, but they need to hold on.
As a nurse, it is painful to be at both ends of the spectrum. A nurse can be as professional as they come, and still go home and try and file everything in their minds in a way that makes sense. That helps them to be in the present. That they can look to the rest of their day with a sense of purpose. To be determined that they can and will leave the problems of the world at work.
Sometimes that means looking to a power greater than yourself. Sometimes that means sitting in your backyard and letting the breeze blow through your hair. Sometimes that means the car ride home is singing to the oldies on the radio. Sometimes it is a good book, a better movie, or snuggle time with your loved ones--human or animal.
Nursing is really about human suffering. Of the mind, body and spirit. But to be mindful of your own body, mind and spirit can give you a greater sense of yourself, and greater good in what you do for a living.
Take time to smell the roses. Take time to just listen. Take time to breathe. And in your everyday life, take time to tell people that they are important to you. And most importantly tell yourself that you are important to you.
