In the past ten years of nursing, I never cried for a patient. It's not that I am cold or unfeeling. I do often get comments from patients how "nice" or "gentle" I am. While I do care greatly, I just don't get overcome with emotions at work. But a few nights ago, I ran away to our hospital chapel (during my break) and sat there, crying. I did not go there to pray -- I am not religious -- but I just needed some solitude.
So what happened?
The last couple weeks have been strangely emotional -- a dying patient, a frustrated patient, saddened family, etc. etc... the usual of course, just with more intensity.
The last straw came from an unexpected patient. I had the patient often in the past -- I work in hem/onc/BMT unit where many patients stay for a long time. I knew his medical history well but not the person, as he is rather aloof, often irritable. And I am certainly not the type who's good at conversations. So it was very surprising when he suddenly seemed quite talkative one night and I ended up listening to him for almost half an hour. He talked about his religion, his little kids, his personal circumstances and how hard it was for him to deal with his diagnosis. He even talked about his feelings toward his own mortality... heavy stuff... I ended the shift feeling quite good, thinking I lent him a good listening ear.
The next night, he had a visitor who stayed the night, and initially seemed in good mood. It all happened when I went in later to give his meds. Everything was just as usual. I rattled off the meds I was about to give, scanning the packets. Then, I heard a sniffle. I stopped and looked at him. He had his eyes covered, but the sniffle and quiet shaking was unmistakable. My mind went totally blank then, standing there frozen. I glanced at his companion, hoping she would intervene somehow. But she only stayed quiet, looking pensive.
Oh how I wanted to be anywhere but there, standing next to the crying man, completely at a loss as to what to do or what to say!
My hand reached out to touch his shoulder even before I figured out what to say, because anything was better than just standing there stupidly. A few seconds later I stammered, "Anything I can do?"
Ugh, stupid! What could I possibly do?
"Just need a minute?" A vigorous nod.
"I'll leave your medicine on the table, okay?"
I was about to sneak out, but he got up then, and took his meds. He asked for his pain med later and that was that.
I have certainly witnessed more dramatic tragedies before. And I am still puzzled why this particular patient, whom I don't even know very well, should disturb me so. There was just something so disturbing about watching a man, with a big and imposing stature, but now helplessly lying in a bed, crying.
It is possible I felt more connection to him because he opened up more in the previous night, but still, I don't think I cried because I felt bad for him. I feel many things, but I don't do "feeling bad" for my patients. I think I am frustrated and angry, extremely frustrated, because I really have no idea how to lessen their pain -- their emotional pain.
Here's my problem. I am not good at socializing to begin with. I completely suck at "reading" people. While I can be "nice" in most situations, I have no idea how to react when people who are normally reserved suddenly show vulnerability. Do they want me to stay and console them? Do they want me to leave them alone? What should I say? Should I touch them or should I stay away?
It has been exactly a year since working in oncology, and I have never been this frustrated with my inability. I've been studying furiously -- studying the books is about the only thing I can do confidently -- but my true problem is something that no book can teach me.
So I ask your wisdom. What do you do, what do you say, in that awkward moment when your patient suddenly cries?
