Who was your last "bad" patient? Mine was ThreeTimes an Hour.
At least,that was the average timing of my patient ringing the call bell that night. Often times he rang more (rarely less), leading to a night remembered as one of the longest shifts of my nursing career. All thanks to a pesky prostate and an elderly gentleman who required assistance to stand.
Its funny to look back and think about how much time I spent in that room, helping this man onto thin, frail legs as he attempted to hold on to the plastic urinal with equally frail hands (always with my hand underneath it - never trust shaking fingers to hold a urinal, as I have learned the hard way!). As soon as he produced more liquid gold, I would help him back into bed, ensure his pillow was fluffed and the call button was in reach, and then run out of the room to check on my other patients, get tasks done, and chart as much as possible before the inevitable ring of the call bell returned, marking another twenty minutes as passing.
By the time morning rolled around, I was exhausted. The addition of the straight forward task of helping Three Times an Hour to my other workload meant I was one tired lady. When the next shift finally came in, they saw the haggard look in my eyes and assumed the worst - was this a "bad" patient?
We have all been there. You walk in at the start of a shift, and see the look in your colleagues' eyes. "Is this a bad patient?" we wonder (or perhaps say brazenly aloud). Is this one who demands much but needs very little - Rude and Condescending, perhaps? Bed-Ridden While On Lactulose, maybe? Needs a Linen Change As Soon as the Bed is Clean (also known as the Back Slayer, the Blanket Hog, or the Leaky Rowboat)? The list goes on for what constitutes, in a broad term, a "bad patient".
For myself, however, I have learned much and can appreciate much from these less than savory folks, these who are eagerly dumped onto the next shift as quickly as possible. Don't get me wrong - I get exhausted and frustrated as well, telling myself vehemently that "this isn't what I went to school for!". This particular night was no different - I found myself cursing under my breath each time the call bell went off, each time I found myself already running behind on a myriad of tasks ("why do old guys have to pee standing up? Why?!"). Every twenty minutes, I was expected at the bedside, not to help perform life-saving care or even contribute to the overall diagnostic standing of this man, but to help him with something he genuinely needed assistance with. But isn't this the heart of nursing, all jokes aside?
No, we are not merely bedpan cleaners, butt-wipers, or order-followers - we are much more than that. But at times, in these more humbling moments of humanity, I would see in myself what is terrifying to comprehend - my own vulnerability. I see the future: I am not sick, my parents are not sick, my siblings are not sick, we are not weak or fragile - but we will be. Even more frightening? The knowledge that such frailty is not limited to the old; physical demise cannot be compartmentalized to worry about later.
And that, I believe, is what makes nurses so special. We see in others, on a regular basis, that which the rest of society gets to conveniently forget about - that is, at least, until they or a loved one are the ones clasping the bedrails with trembling hands. We act as caregivers and healers, but also asa barrier - the very sick can present an ugly truth to those who retain their health. They are, in the very seconds we are cleaning them up, helping them stand, or turning them over, facing the very thing humans like to forget about- demons that we as nurses can stand between, and, for the moment, at least,form a wall of caring that can make even the smaller things feel like uplifting victories.
Often, when I drive by hospitals, I look up at the windows and wonder what illness lies behind them, what battles are being waged, but more often than not, I also think about who is performing the exhaustive, thankless work of the Three Timesan Hour patient, my brother or sister aiding in the quest to maintain dignity. I wonder, as I steal a glance up at what must be windows to inpatient units of all kinds, if others do the same - do other caregivers feel moments of solidarity with the souls working that day? Do others feel the pain and fatigue of their cohorts, valiantly working inside?
It can be hard to explain to others why nursing is so special, how we not only make a difference for others, but how those we care for can give to us more than weever expect. It can be frustrating to be reduced to a doctor's handmaiden or a glorified pill-pusher. People wrinkle their noses at our stories,and tell us they don't know how we do it. I am grateful for the chance to do it. It isn those moments of looking into someone's eyes as they are frightened, alone, depressed, or embarrassed that I find my work the most humbling. While it may be easy to say,as a new nurse, that you never want a shift like that, you never want to givethe immobile patient a Kayexalate enema or have the patient who needs so many little things that they amount to an enormous mountain, I believe they are necessary for building stronger nurses - if we allow it, those patients can teach us more than we ever imagined. I don't remember my other patients from that night - their acuity, their needs,their care escapes me - but I remember very strongly this man and the care I provided him.
Although he was my most recent, Three Times an Hour won't be my last "bad" patient. Next time, in the midst of perspiring profusely onto my scrubs as I perform whatever draining task awaits, my hope is that I remember how I feel when I am outside looking up at the hospital, oddly thankful for the opportunity to humble myself and be called a nurse, holding the beasts at bay.
