Patients who have changed my life
Early in my career as a Burn Nurse I met a patient who along with his family impressed me beyond words.
My pt was an independent contractor who accidentally touched a high tension wire and the enormous amount of electricity coursed through his arm,through his chest and torso to exit out of his leg by blowing a large amount of tissue out of his thigh. In the course of his hospitalization he was faced with the sad realization that the high voltage had damaged his arm beyond repair and without adequate blood flow,he had to have it amputated to save his life. He was shaken to his core but he faced the surgery with remarkable equanimity and had the amputation knowing that he would have to learn how do things very differently from now on. He plunged gamely into his physical therapy even while still healing from very deep and painful burns. His family was there with him daily.
About this time another problem was manifesting itself in the worst way. His leg injury,although not immediately thought to be as badly damaged as his arm began to look worse and worse. Although there was a distal pulse,the area of injury was very severe and left his distal leg an "island" of surviving tissue although not for long. The area of damage demarcated at above his knee and although his foot was untouched by the electricity it would have to be removed or he would die of sepsis which was rapidly gaining on him anyway. This strong man,the head of his household who rarely even took a day off from work was now looking at a life of disability. To be taken care of rather than taking care of everyone else and although his family was there en mass with their support this strong man began to break down with the thought of his long recovery and resultant changed life.
I was taking care of him the night shift just prior to his surgery and he was inconsolable. "How can I take care of my family?" he wondered. "I'll just be a burden" he said quietly. I did my best to talk to him that night. I told day shift of his despair.When I came back that night he had had his surgery and was still intubated to be weaned in the morning because his body and soul were having difficulty coping with the insult of the large surgery.
When I assessed him he was tearful,he denied needing anything but I gave him pain medicine commensurate with his injury and previous analgesia doses. He dozed periodically waking up suddenly and he tried to hide his tearful,sad expression from me as I was so concerned.
His wrist was restrained because he had made an effort to extubate himself previously despite being told he would need to get a little stronger before he could be extubated. He indicated that he wanted the tube out despite it's possible fatal outcome.
He gestured to me numerous times to take out the tube so he could die and it broke my heart to see this formerly healthy and happy man brought suddenly to this depth of sadness. I told him gently over and over "Ed,I cannot take the tube out now". I assured him that his family was going to love him as much as ever. The words sounded lame. His sorrow and agitation increased and I was very afraid for him.
I did something that I didn't usually do,I called his family in the early morning to tell them of his distress. I was taking a risk. He was intubated and most families hardly know what to say while present with the patient much less over the phone. I didn't want to scare them either but his wife was so gracious and thankful,she just asked me to hold the phone to his ear and although I wasn't trying to eavesdrop I could hear her strongly affirming her love for him and telling him that they would learn to manage whatever handicap he would have because his being alive was all that mattered. In a lull of the conversation I would put the phone to my ear to tell her that her husband was indeed hearing her and responding positively,knodding his head,briefly smiling through tears. I hung the phone up after she talked to him thinking that that was very impressive of her to be able to talk over the phone that way to someone who was intubated.(they lived quite a distance from the hospital). "Ed" was doing better now too,starting to relax more and breathing easier.
Another call rang through,it was his daughter who definitely had her mothers grace and wisdom about her,she talked lovingly to her Dad over the phone and the effect on him was very obvious now. He was no longer tearful or motioning to me regarding the ETtube. He was genuinely relaxing and thanking me profusely for calling his family via notepad.
I'm already thinking what a fabulous family this patient has when yet another call came through(this was in the wee hours) from another relative in another state who my patient had grown up with who delivered another talk to my patient although he was unable to respond in any way. His eyes were closed now and he listened with a half smile on his face and I breathed a deep sigh myself feeling like the worst was over.
I hung up the phone for him and was rather horrified that he took my hand again in what was now a familier gesture that he had been making previously for me to take the tube out. Instead he took my hand and kissed the back of it. Oh I was history,I started crying,I thanked him for being so sweet and told him what a fabulous family he had then I had to duck into the bathroom for a longer more dedicated cry.
Here I was thinking there in our "big,bad burn center" we were the only ones doing what this patient needed to get better and his family comes through and shows me it's not all in our hands by any stretch of the imagination. I was very humbled. I was trying to treat with modern medicine what can be helped only by the soul. I also felt a larger presence at work here.
This patient and his family showed me that I was just part of a large team of players needed to get his wonderful big bear of a man well. He did get well and leave the hospital.I still remember him although that was nearly 30 years ago. He and his family are definitely changed how I was as a nurse definitely for the better.
Joined: Apr '08; Posts: 316; Likes: 559
Care Taking parents full time; from US
Specialty: 30 year(s) of experience in CVICU,Burns,Trauma,BMT,Infection controlAug 18, '08BelleKat, I am in tears. I'm not a burn nurse- don't know if I could ever do it, but your interaction with and adcovacy for your patient is inspiring. He truly needed to hear that his family was totally behind him, and you took that risk. I'm glad it worked out. How did he do?Aug 18, '08Hi Oncnursemsn,thanks for the comment,his wounds healed and he went home. I don't know much beyond that,on night shift we didn't tend to hear much about them after they went home. Day shift did since the pts came to clinic during the day and all.
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