Some patients will impact our careers in profound ways. Some will make a complete and closing circle in our careers, watching their struggle beginning to end. These patients shape us as providers.
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You were one of my very first patient assignments I had fresh out of nursing school about two years ago. You taught me that behind the assignment was a person. With you I learned my first lessons in humility and compassion. As a stressed out new graduate on a postoperative unit it was hard at times to view patients beyond the assignment, beyond the task, beyond the pathology.
You were a scared and anxious patient. At first I perceived it as stubborn and noncompliant with the medical treatment.
I learned that listening closely, staying in the room even 30 seconds longer, and holding someone's hand can make all the difference.
I remember how you insisted I give you a warning before flushing your PICC line because the taste of saline made you so nauseated! I remember how you used to eat a cherry sour with every flush. Drawing blood and flushing the line and giving you an IV push medication was always an ordeal. It annoyed me at the time but I began to realize that this wasn't about my feelings but about your comfort.
Each time you came back to our unit you came back sicker and sicker. Your demands became less and less frequent ... and funny enough I missed your quirky demands that once used to annoy me.
I knew these were signs you were getting sicker. Your hair began to thin, your generalized color was pale, your weight had dropped drastically. Your once loud and diva-like voice was lost in the midst of this illness.
Months went by... I had not seen you anymore because I had moved on to the ICU.
Until one day you became my patient again.
The page came in from the executive nursing officer.
"52 year old female respiratory distress history of PE to room 22" No name was provided so naturally I did not know this was you.
And as we rolled you into the room and on to the ICU bed I recognized your face. Except this time it seemed so lifeless. So skeletal. Could this really be you?
Then it happened, you began to code. You coded immediately after transferring you from bed to bed. I still remember the feeling of the compressions against your tiny frail body. You were but 5ft 2 inches in height. Frail and skeletal. No fat whatsoever on your body. No muscle either. Wasted away by disease. It felt grotesque, as any compressions usually do. I remember catching a glimpse of the people of whom I used to once work with outside the hall. My former coworkers, the floor nurses that brought you down to me.
The look on their faces, as they witnessed the team of nurses and doctors try to revive you, I still recall. The nurse who brought you to me? She happens to be my best friend. She questions herself as to whether she could've done something to catch the impending doom. But we knew that death was coming.
History of two pulmonary emboli. History of multiple DVT's. Hepatobiliary pathology. History of clotting disorders. Malignant cancer riddling your body.
The doc finally called time of death. I was strangely relieved. Relieved that your suffering was over. Unfortunately your family did not know your exact desires regarding death and dying. They admitted this and preferred we do full interventions, "just in case". Which is an understandable and natural reaction from a psychological standpoint.
That evening my friend called me. She kept wondering what she could have done. I assured her she did all she could. She called a rapid. She called the doctors. She made her voice heard. However most importantly she stayed by her side the entire time.
