My First Patient

littleRNthatcould

I grew up in a family of medical professionals. Three aunts and my mother were nurses, two uncles and cousins paramedics/firefighters, my own father and grandfather Army medics. Routine dinner conversation at family gatherings were enough to send the most hardened stomachs screaming away from the table. While I regarded the stories of my father, grandfather and uncles as heroic and noble, the stories from my mother and aunts left me wondering, "Is this what it means to be a nurse: Cleaning up after various bodily excretions, bowing and scraping before doctors?"

No thank you.

But that year something changed. My father who had been a source of strength, my rock throughout all my years on this earth, was diagnosed with colon cancer. At the time I had been living out of state. When I came home, the sight of the man that had once been my father was enough to knock me to the floor. His solid frame was withered, bony prominences now showed where muscle mass had been. His bright blue eyes dulled and dazed from disease and medications meant to keep him comfortable. The smell in the room was overwhelming. It was the smell of death. I was so terrified that I excused myself from the room and slid down the wall in front of the nurses station at the VA hospital.

A nurse at the station, a beautiful middle aged woman came and knelt beside me. I looked at her with tears in my eyes and my voice choked with sobs. I asked her, "How can you stand to do this? Everyday, to see people in so much pain and misery?" She looked at me and smiled and said, "Because you can't, I will. It's as simple as that."

Over the next several weeks in the hospital, I became a sponge. I learned to listen to the nurses, watch them care for my father, I also watched him, loathing the fact that he couldn't care for himself. I began asking questions about the disease, learning as much as I could about everything: medications, diet recommendations, activities to get him up and out of the hospital room. One morning when the Oncologist rounded, I hit him with a barrage of questions: "What about this? Can we try this? What do you think about this" He smiled politely and answered all of my questions, explaining what could and could not be done. I later heard him at the nurses desk jokingly asking if they had put me up to it because I sounded just like them. It was the push I needed. THIS was what nurses did. Not bow and scrape or merely clean fluids. They use skill, compassion and knowledge to find answers, fix what they can and truly care for patients. That day, I stopped being a bystander watching my father succumb to this disease. That day, I became a nurse. Perhaps not in knowledge and skill, but in spirit all the same.

I began slowly, helping to feed him when he was too weak, applying cool cloths to his forehead when the fevers came. When he felt well enough, I helped him out of bed and to ambulate around the room. I began recording his oral intake and urinary output and informing/ questioning the nurses on what was right and what was wrong. Most importantly, I was there. If he woke in the night, confused and scared from the illness that plagued him, I was there. A calm reassuring voice, helping him to remember where he was, and that he was safe.

On the day he had major abdominal surgery to remove the very large tumor from his colon, I sat down with his nurse again and discussed discharge planning. She informed me that he would likely return from surgery with a very large incision that would require very involved dressing changes and a brand new colostomy. She told me that his VA benefits would cover a home health visit, but only once a day. These dressings would require changing twice, maybe 3 times a day. I asked her fearfully how we were going to manage this? My parents were divorced, my aunts were far away. Who would care for him? She looked at me and smiled that smile that was just as beautiful and comforting as before and said, "You will and I'm going to teach you."

Our first day home, it was time. I knew that I couldn't let dad see any fear or repulsion in my face as I unbuttoned his pajama top to expose his abdomen. Peeking out from the side of his Montgomery Straps was his new colostomy and bag. I looked at it for all the signs the nurses had taught me. It was pink, moist, normal for what it was. I said, "looks good." Dad grimaced, barely raising his head off the bed looking down at his belly asking, "What's it look like?" I could've answered with all the new techinical terms that I had picked up from the nurses. But instead I remembered the times they had joked with him to elevate his spirits and that even in times of his greatest pain, he couldn't resist the urge to laugh at their sillyness. "It kinda looks like a giant fishing worm." I answered. His laughter broke the ice. I was able to perform and finish the sterile packing on his secondary intention incision all while telling him that the neighbors would most likely shun him due his inauspicious lack of a belly button. My technique was perfect, my sterile field intact, but bigger than that I had made my dad comfortable enough to endure it.

Three years later I would stand on a podium and accept my degree from nursing school. The place that I never wanted to be, the thing I never wanted to become had become the one thing that I wanted to do with all my heart. I looked out into the crowd to see my family members so long in the profession waving excitedly and in the middle sat my first patient, my father, with tears of pride in his eyes as I began my commencement speech entitled, "Because you can't, I will".

It has been 13 years since that day in the hospital, 10 since my day at the podium and on August 10th, 6 years since my first patient passed from this life to the next. And I am forever changed.

My First Patient

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