My First Patient
I met Mrs. Z. late in my first year as a student nurse in 1969. I was “in training” at a large children’s hospital and Mrs. Z., originally from Eastern Europe, was my first patient on my Adult rotation at the nearby general hospital.
On that Monday morning I walked onto Public Medicine, proud of myself as always in my white bib and apron over a blue under-dress, with starched collar and cuffs, distinctive hospital cap, white nylons and white Cuban-heeled shoes. After a brief orientation to the unit we were assigned our patients. Mrs. Z was 71, with carcinoma of the lungs; she had had a lobectomy but the cancer had returned along with a nasty bronchial infection.
When I went in to do her a.m. care, she was smoking. With no oxygen present in her 4-bed room, this was commonly allowed in those days, but I was horrified to see her doing it given her diagnosis. I did health teaching about smoking and cancer (read: lecture) but Mrs. Z. continued to puff defiantly, ignoring me.
Our next encounter was her a.m. med pass, and these she refused. Another lecture about the need for taking prescribed medications, and the war was on. I was not able to sign off my meds as “given”!
This continued all day, with Mrs. Z. refusing every med and treatment, smoking all the while. I was used to pediatric patients doing as they were told, and this Adult Patient was not listening to reason.
The next day, I finally went to the head nurse with my indignation. To my surprise, she said quietly, “Don’t push her too much.”
I backed off with my lectures, but for the rest of the week continued to offer Mrs. Z. her medications, and could at least look disapprovingly at her ashtray full of butts. When I brought her meal trays in, she would yell at me, “ You go way! You make nervous me—you go!”
On the Friday she was discharged, and as was the custom, I wheeled her to the lobby to await her son’s arrival. It was a raw February day and the lobby was full of puddles of melting snow and folks awaiting pick-up. Suddenly Mrs. Z.’ s usually grim face lit up and she waved at a car under the portico. I prepared to wheel her forward to the exit door.
Suddenly she opened her purse, took out a handful of change and flung it on the floor, yelling at me, “ This is you TIP! You get it!” She got up out of her wheelchair, made for the door and let herself out into the waiting arms of her son.
I had to get down on my knees and crawl in the slush among the legs of the public, picking up so that no one would slip on them in the wet, a total of 17 pennies. As people stared down at me, watching my humiliation, my seething anger slowly transformed into a new awareness. My immaculate apron dirty and soaked, my cap askew, my knees black, and my pride crushed, I awkwardly got to my feet with those wet pennies in my hand and a tip more precious and lasting than money.
I failed you, Mrs. Z., but you gave me a gift that lasted over my forty years of nursing.
Anne, BN RN CPMHN(C)
PsychiatryLast edit by Joe V on Jan 10, '15
Sep 4, '08What a revelation... I can imagine that Mrs. Z's essence sticks with you as clear today- as it was back then. I personally cherrish the numerous hard lessons that have shapped my career as a Nurse, as well as a member of the human race. thanks for sharing- Priceless.Sep 4, '08Thanks for taking time to comment on my story. Of many lessons learned in nursing school and in decades of practice, it was maybe the most important one for me---the nurse is an instrument who facilitates healing, or as Henderson said, if healing is not possible, asists the individual to a peaceful death. I was and would have remained insufferable...had not Mrs. Z. had the spunk to take me down a peg.Sep 4, '08Well said!
(I truly believe that Henderson hit the nail on the head).
Limestone, your writing skill is fantastic- the pristine description of your nursing immediately took ME back to MY student nursing days when I was so incredibly proud of wearing that blue dress, white apron, white nursing stockings and shoes, and the esteemed nursing cap... Thanks!
(side bar): I look back and chuckle now, but somehow the tradition of it all indeed meant so much. I felt that we were being literally groomed not only for a career, but to a certain code of honor, thru that nursing uniform.(I often wonder if the nursing generation of today has that same sense of tradition, by way of free-formed " ")...? oh well, that's another story, for another day.Sep 12, '08Quote from oldskool61I'm currently in nursing school and will be graduating next August... I am so upset that there isn't going to be a cap at the end of all of it! I may have to buy one for myself! LOLWell said!
(I truly believe that Henderson hit the nail on the head).
Limestone, your writing skill is fantastic- the pristine description of your nursing uniform immediately took ME back to MY student nursing days when I was so incredibly proud of wearing that blue dress, white apron, white nursing stockings and shoes, and the esteemed nursing cap... Thanks!
(side bar): I look back and chuckle now, but somehow the tradition of it all indeed meant so much. I felt that we were being literally groomed not only for a career, but to a certain code of honor, thru that nursing uniform.(I often wonder if the nursing generation of today has that same sense of tradition, by way of free-formed "scrubs"...? oh well, that's another story, for another day.Sep 17, '08I graduated in 1990 and we only had to wear our caps for the ceremony, however, I was, and still am proud of the tradition of earning that "cap".
Although I never wore it professionally it is with my other treasures and I can see it whenever I want. Please try to see "scrubs" from a different light. I am short and chubby. Fitted clothes such as the nursing uniform never fit me right and wer hard to work in. I did much better in srubs.Sep 17, '08Boy, can I relate... We must always remember that it's what we posess in our hearts and minds that make us fantastic, comitted nurses- not just by what we choose to wear! scrubs indeed have their rightful place as being greatly functional for those of us that are blessed with unique anatomy, as opposed to dresses and skirts of yester-year. I often wonder just how challenged my grandmother and beloved Mom (also nurses) must have felt in dresses and stockings, while being physical in their duties...!
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