A Patient Made Me Cry Today

My skin is really thick. I've seen a lot of things between being a nurse and a paramedic. I've seen abuse, neglect and death before. Today, IĀ got a patient from the emergency room with a massive infarct. The report I got never could have prepared me well for this patient. He truly broke my heart. Nurses Relations Article

When he arrived to the floor, I couldn't honestly tell if he was breathing. His gaze was fully deviated, he was contracted to one side, and had incredibly shallow, labored mouth breathing. I pulled him from the stretcher to the bed, got down to his eye level, held his hand and said "I'm allison, I'm going to be your nurse today." he pulled his hand away from me, completely frightened, and yelped out. I asked him a series of questions, but he had no answers. Just a wide eyed, terrified, deviated stare.

He was 88 years old and he looked like he was a survivor from auschwitz. He was so emaciated, he may have weighed 80 pounds soaking wet.... Upon assessment, I could actually see his guidewires from his pacemaker bulging through his skin. His skin turgor was so poor and he was so dehydrated that we were unable to place a peripheral line... And after two sticks from me, I gave up. He had been hurt enough.

His body was covered head to toe in bruises, in various stages of healing. They looked like palm prints and hand prints. His skin was totally ecchymotic and he had so many skin tears it took 12 pages of wound photos to document them all. His skin peeled back like the skin on a banana just by touching it... And on his back and his shoulders, a purple hand print that was probably very fresh.

I turned him over to assess his back. He yelped out again. His orifice was excoriated and bleeding and was probably the size of an apricot or small plum... It appeared that something was forced in it. He shook in fear and moaned loudly as the cna and I gave him a good bath, combed his matted hair, put him in a clean gown and applied lotion to soothe his dry skin.

I called the abuse hotline. I never intended to point a finger of blame... But someone had forgotten to treat this man like a human being. Social services came and did their own assessment and took lots of photos. He continued to moan, louder and louder. He pulled away every time we touched him as if we were going to hurt him. What happened apparently was he was at a nursing home until his medicare ran out... But made too much for medicaid, so he had been paying a "caregiver" to see to his needs at home. I didn't see this caregiver.. And I'm glad I didn't.. Because I may have said something very bad.

Lab called.... His troponin was 17. His infarct had spread to over 4 leads. His bp was dropping and his urine output was 0. I chased the doctor down to the icu to get a hospice referral and a dnr. I was not about to have to call a code on this man. The least I could have done was to get him a comfortable death. Paperwork was signed and hospice came to see the patient and agreed to take him at the end of my shift this evening.

I documented and documented. I turned him every hour, swabbed his mouth, made sure his skin was clean and dry, and went and sat for just a minute by the bed, to make sure he knew that if I he wanted to go, I would be there to sit with him. I didn't want him to die alone, not like that.

The paramedics came to pick him up and bring him to the hospice home. I signed his papers and helped them place him on the stretcher. He just kept moaning, and letting out these yelping noises. I walked them to the elevator and grabbed his hand and said "they are going to take you to the hospice house, so you can be cared for and comforted. It's ok to let go now." his eyes didn't move, but I knew he knew I was there.... Because tears started rolling down his cheeks.

And without saying a word for 12 hours, my patient made me cry.

May god bless him. I hope his ending is peaceful and that he is moved on to a much better place than was ever provided to him here. Today, I remembered why I became a nurse.

Specializes in ER/Trauma.

*sniff* Blurry vision... I need to go see an eye doc, I guess.

Allison,

Your story was very touching.

The circumstances saddened me - human cruelty is often as banal as it is vicious. Most of us cannot fathom that someone would do such a thing to someone else but reality is often all too stark naked and raw.

But what you and your colleagues did for this individual is exemplary. He may have never recognized you... he may have never even known who/what/where/when he was. But that didn't stop you or your mates. You waded in, busy as you were, to make him a little more comfortable. You chased down docs and other support personnel, to ensure that this patient would suffer no more... and would at least be made more comfortable.

No doubt you've heard in nursing school about how "nurses are patient advocates". Well, if I were teaching a class, I'd use your story as a good example. You stepped up to the plate and did all you could to care for this sick patient.

flightnurse2b said:
somebody loved his man once. i hope he sees them again when his journey is over.

Ya know what?

As much as I cuss and moan about the drug seekers/frequent fliers and all the other assorted hassle I deal with every shift, a part of me can't help but think "this is some poor woman's progeny. This is some Father's child" .

That same part of me makes me think of 'em every time I deal with a very unpleasant patient. That somewhere out there is probably a Mother or a Father wondering/suffering/grieving over what their child has become.

Your story reminded me - painfully - of an incident I experienced last Saturday with a very sick patient.

I hope your patient is comfortable and freed from his torments.

I thank you for sharing your experience.

It couldn't have been easy to do.

If you ever need a patient ear to vent/cuss/rage/spill-beans/younameit - just send me a PM... m'kay?

- Roy

PS:

flightnurse2b said:
his skin turgor was so poor and he was so dehydrated that we were unable to place a peripheral line... and after two sticks from me, i gave up. he had been hurt enough.

ER/ED didn't start a line (and didn't tell you he has no access)?? I'm most astonished! :eek:

1 Votes
Specializes in Acute Care Cardiac, Education, Prof Practice.

What struck me most was not the immense torture this man was obviously put through, but by the pure blessing he and you received by being there for each other. He taught you something about yourself and you gave him a few hours of safety that he expressed meant a lot to him by his tears as he left. He may not have said anything, but he very intensely knew you were safe and kind.

Please remember that when you think of him and be very content with all you gave him in a short period of time.

1 Votes

You were that poor man's angel that day....May he be at peace.

1 Votes
Specializes in Cath Lab, OR, CPHN/SN, ER.

Ok, you've made me cry, and it takes a lot to do that. I probably would have cried during his assessment. Make God let him god in peace and may the person (people) who let that poor man get to that state get what they deserve. :(

If you ever cry at work, blame it on the hormones. :) Works if you yell at someone too.

1 Votes
Specializes in Assisted living.

Wow...it's horrible how some people are treated:( You sound like a wonderful nurse. Your patient was lucky to have you.

1 Votes
Specializes in Cardiac/Step-Down, MedSurg, LTC.

I got misty as well on this issue, and I rarely do that. Thank goodness that this pt. had a nurse like you. It's obvious that he felt some form of love that day, which he hadn't had in awhile.

I don't even know what else to say, I'm just touched by your kindness and caring, and deep down - love. Thanks for sharing.

1 Votes

It breaks my heart to see someone abused like that. In my opinion the piece of flesh (I won't give them credit as being a human being) that abused this poor man needs to pay. I'm not an advocate for cruel and unusual punishment except in cases like this. I admire the way you handled the situation. I'm sure those few hours meant more to him than you will ever know. Good job.

1 Votes
Specializes in Cardiac.

Allison, what's going on where you work! You had him AND 7 other patients? And you were still able to give Q1 hour care (turns, mouth care, time, comfort) along with great care to all your other patients....

You are a fantastic nurse!

Specializes in Peds, Neuro, Psych,Home Health, Telemetr.
my skin is really thick. i've seen alot of things between being a nurse and a paramedic. i've seen abuse, neglect and death before. today, i got a patient from the emergency room with a massive infarct. the report i got never could have prepared me well for this patient. he truly broke my heart.

when he arrived to the floor, i couldn't honestly tell if he was breathing. his gaze was fully deviated, he was contracted to one side, and had incredibly shallow, laborered mouth breathing. i pulled him from the stretcher to the bed, got down to his eye level, held his hand and said "i'm allison, i'm going to be your nurse today." he pulled his hand away from me, completely frightened, and yelped out. i asked him a series of questions, but he had no answers. just a wide eyed, terrified, deviated stare.

he was 88 years old and he looked like he was a survivor from auschwitz. he was so emaciated, he may have weighed 80 pounds soaking wet.... upon assessment, i could actually see his guidewires from his pacemaker bulging through his skin. his skin turgor was so poor and he was so dehydrated that we were unable to place a peripheral line... and after two sticks from me, i gave up. he had been hurt enough.

his body was covered head to toe in bruises, in various stages of healing. they looked like palm prints and hand prints. his skin was totally ecchymotic and he had so many skin tears it took 12 pages of wound photos to document them all. his skin peeled back like the skin on a banana just by touching it... and on his back and his shoulders, a purple hand print that was probably very fresh.

i turned him over to assess his back. he yelped out again. his orifice was excoriated and bleeding and was probably the size of an apricot or small plum... it appeared that something was forced in it. he shook in fear and moaned loudly as the CNA and i gave him a good bath, combed his matted hair, put him in a clean gown and applied lotion to soothe his dry skin.

i called the abuse hotline. i never intended to point a finger of blame... but someone had forgotten to treat this man like a human being. social services came and did their own assessment and took lots of photos. he continued to moan, louder and louder. he pulled away everytime we touched him as if we were going to hurt him. what happened apparently was he was at a nursing home until his medicare ran out... but made too much for medicaid, so he had been paying a "caregiver" to see to his needs at home. i didnt see this caregiver.. and i'm glad i didn't.. because i may have said something very bad.

lab called.... his troponin was 17. his infarct had spread to over 4 leads. his BP was dropping and his urine output was 0. i chased the doctor down to the ICU to get a hospice referral and a DNR. i was not about to have to call a code on this man. the least i could have done was to get him a comfortable death. paperwork was signed and hospice came to see the patient and agreed to take him at the end of my shift this evening.

i documented and documented. i turned him every hour, swabbed his mouth, made sure his skin was clean and dry, and went and sat for just a minute by the bed, to make sure he knew that if i he wanted to go, i would be there to sit with him. i didn't want him to die alone, not like that.

the paramedics came to pick him up and bring him to the hospice home. i signed his papers and helped them place him on the stretcher. he just kept moaning, and letting out these yelping noises. i walked them to the elevator and grabbed his hand and said "they are going to take you to the hospice house, so you can be cared for and comforted. it's ok to let go now." his eyes didn't move, but i knew he knew i was there.... because tears started rolling down his cheeks.

and without saying a word for 12 hours, my patient made me cry.

may god bless him. i hope his ending is peaceful and that he is moved on to a much better place than was ever provided to him here. today i remembered why i became a nurse.

This ripped me aprt i sit here now with tears running down my cheeks, i guess even when we think we are hard as stone, someone will always remind us of why we do what we do!

I for one am so glad you where his nurse!!!!!!:redbeathe

Also i am in hopes of the caregiver being reported !!!

Thanks for sharing from your heart. I am a second year ADN student who returned to school after a first career in the business world and raising a family. I have seen many cases of burn out or nurses who just don't seem to care anymore. At times I feel idealistic in my desire to really care for patients as you did this this man. I am aware that the real world is vastly different than textbooks and what you learn in school. However, I am encouraged to know there are nurses out there like you. I choose to believe there are many more and will consider it an honor to join your ranks one day soon.

Your compassion drove you to document this mans pain and suffering. Perhaps not only did you help him but I'm sure whoever did this has done it before. Now social services and law enforcement will be able to deal with those who commited such horrific abuse. You've probably helped to break a cycle of abuse.

Your grace and love is a testimony for all of us.

PS. I think it's wonderful that your heart broke and you wept. If we cannot know heartbreak we cannot know joy. Your mother obviously raised you right!

(((allie)))...you gave him a wonderful gift today...

the gift of yourself, of your heart, of your love.

and, even if he's not cognizant of it, the gift of hope.

because of this, he will undoubtedly be tenderly and lovingly cared for, right to the very end.

i can't think of anything more extraordinary.

thank you, sweetheart...

just for being you.:redpinkhe

leslie

My thoughts are the same as Leslie's. Thank you. ((((((Allison))))))

Dan