I Double Dawg Dare You, Do It!

HyperRNRachel · Dec 22, 2005

As a student (I hope this still counts) I had a patient who was dying from cervical cancer. She was only 40, had been married for 20 years, had two children in college, and was a popular member of her church. She had been diagnosed with cervical cancer in July and it was now October. My instructor wanted me to do an assessment and gather information about her past sexual experiences in order to determine if she had multiple sexual partners that could have contributed to her cancer. I did not do it. In fact, I did not ask her anything about her past. I told my patient she was my only patient for the day and I was there to help her in any way, shape, or form that she needed me too. Since her family was also very attentive to her needs I also allowed them to be with her while I got them juice, coffee, or snacks. I did have opportunities to speak with the patient, but I allowed her to discuss her family, we shared humorous stories, and we all got a good laugh at my clumsiness and awkwardness as a student nurse. She died about 3 weeks later.

I didn’t do anything that any other nurse would have done. But that day I forgot about pleasing my instructor (which she took points off an assignment that I did on cervical cancer because I cried) and I forgot about gathering information for my correlation sheet (also points off), none of that mattered.

I think about her family and I am proud of how I handled the entire experience. I did not gain any valuable data about risk factors associated with cervical cancer(although I did find out she did not get annual pap smears and only went to the MD after feeling pressure for several months) but I learned an incredible lesson.

O.K. Bipley thanks for sharing your story...it made me cry and after thinking about my patient I am now in a full fledge bawl.

Ladies and gentlemen remember to tell the women in your life to get annual pap smears. Cervical cancer is easily detected and has a high cure rate (something like 99% curable) when detected early.

General E. Speaking, RN, RN · Dec 22, 2005

I try not to get too attached to my patient's but every now and then one sneaks up and captures your heart. The one I remember was a 40's something man with terminal pancreatic cancer. He had a loving wife and preteen daughter. He was in our hospital for about a week. The diagnosis was fairly new. He was such a kind dear man. Any extra time I had, I would spend in his room. His appetite was very poor. I would swipe popsicles from the pedi unit because they had riddles printed on the stick. You had to eat the popsicle to find out the answer. We traded riddles and jokes throughout his stay. We talked about his fears about dying and how his family would cope. He pre-arranged everything regarding his funeral and wishes so his wife wouldn't be burdened. When it was time for him to go home to die (with Hospice) I wanted to wheel him down to the car myself. I am crying as I type this. I asked my charge nurse what should I say to him? This is probably going to be the last time I see him. She gave me the best anwser possible. I only use it on very special patient's. I said, "It has been an honor to take care of you." Simple but from my heart. I guess, I really didn't do anything extraordinary with this patient but the memory of him keeps me grounded somehow. It reminds me on those bad days when I am caring for an obnoxious patient or dealing with impossible-to-please family member that he is the reason I became a nurse.

Thanks,

Kris

tvccrn, ASN, RN · Dec 22, 2005

A little background before I get to the story. Living in Wisconsin is much differrent from the area of Texas I came from. Here the ambulance crews are voluntary except for the helicopter/ambulance transport crew for the hospital. At any time of the day there are dedicated people whose jobs allow them to leave work and go on an ambulance run. These people risk the interruption of family get-togethers, holidays, and special occasions for no money whatsoever. They are the first responders to people's worst mightmares time after time, never thinking it would happen to them.

I was on orientation in the PICU and hadn't had a lot of trauma patients. I was due to come off orientation soon and was feeling unprepared for traumas. In our unit the ratio was 1 to 1 except for the less critical, about to move out to the floor patients. So when you got a call for a pedi-trauma you went to the ER and was in on the care from the very beginning.

One night we get a trauma code and my preceptor and I head down to the ER. In comes a teenaged male who lost control of his car and hit a tree.

His mother was a first responder on the local EMS and took the call. By the time she got to the scene, there were others there and they prevented her from seeing the worst of it.

No seatbelt, long extraction time, the whole works. Upon arrival to our ER, it was fairly evident that there was no hope. They talked with the family. Turns out he probably did have his seatbelt on, however just the week before they experienced a malfunction where it would unbuckle for no obvious reason. The older daughter had it happen to her one day.

The CT showed obvious herniation and there was posturing. When the doctor's spoke with the family, Mom asked that we try to do what we could. So, we took the patient up to the unit and settled him in. Once the initial assessments and paperwork was done, Mom wanted to be close to him and we made room for her at the bedside. Then my preceptor did something I never would have thought of, she made room in this very crowded bed for a grieving mother to lay and hold her dying son. This mother climbed into the bed and didn't leave for the entire night. Our assessments and vent checks were done around her.

In the morning, she got out of the bed and went out to be with the rest of the family. Later that day they withdrew care. The family was understandably upset, but the decision was made in a very rational and calm manner. You see Mom knew that her son was gone when he came in, she just needed that last night to let go.

mandana · Dec 22, 2005

:crying2:

Keep 'em coming. I so need to hear these stories.

You guys are all wonderful!

Amanda

KatieBell · Dec 22, 2005

Last year I worked in Sudan (yes, that very big country in Africa.) We had a situation where a mother was very ill with Tuberculosis and her son was also ill with TB and Malnutrition. We initially attempted to have the mother feed the child at the TB center, but she was really too ill, and lacked the understanding of how to feed the child properly. So, we seperated the mother and child- taking Grandmother and the child to the Feeding Center and leaving Mom at the TB center.

Child had a pretty hard time of it. About one week later, the TB nurse and MD were doing a TB visit, and saw the child. TB nurses decided the child was not salvagable and wanted to return the child to the mother where he could die with her. I flat out refused. We had a huge blow out arguement, and I finally remember saying, "Well there is always hope, until there is none" He stayed, and took forever to gain weight. I was called every night out to the center due to his fevers/convulsions. When I left the assignment, he was still in the ICU. His mother soon started to look much better as a result of her TB treatment. I passed through Paris in July and learned that the patient was almost ready to be discharged cured of TB and "cured" of Malnutrition. My colleague who told me this information was also generous enough to tell me he had witnessed the arguement and felt that I had saved this child's life. With all the death that surrounded me there, this was a huge gift.

Now, I've never actually told anyone this, so I feel totally strange.

boulergirl, CNA · Dec 22, 2005

We had a resident who was clearly artistic in nature, and she reminded me of my mom, who was an art major in college. One night I happened to bring up my mom's hobby in conversation (she rubber stamps and makes greeting cards) and this resident asked me if Mom could make her a birthday card for her grandchild. Because it was a one-time request, Mom made it for free. When my resident saw the card, she was amazed. She told me it was beautiful and much better than she imagined it would be.

A short time later, she moved, and I just learned that she is in a wheelchair now. It makes me feel better to know that I was able to make a difference in her life when I had the chance.

weetziebat · Dec 22, 2005

I'd just started working in a LTC facility in a tiny little town. There was a man there who I had taken care of when he had been a patient in the local hospital. He was a really nice guy, who'd had a hard life, and we enjoyed chatting.

The next weekend I was in charge. The staff at this facility had all been there a long time, and had formed a clique, and made it clear there was no place in it for me - so while I was in charge, and they would do what I directed, there was no feeling of togetherness at all.

This gentleman came to me, saying his entire family was having a get-together, with relatives coming from all over the state, and he'd love to go. Family would be there that he hadn't seen in many years and he was afraid he would die never seeing them again. Staff had told him they were sorry but there were no arrangements made in advance (policy) and besides, there was no way for him to even get to his family's home. So end of that.

I really felt for this man and didn't see the difficulties in arranging this. Called the o/c administrator, but no answer. So, I took it upon myself to make the decision. Told him he could go, and I would give him a ride to his family's home in town, as long as they could get him back to the facility that night. He called and they were thrilled, and said someone would get him back that night. He also promised me he wouldn't drink alcohol (had a bad liver from that stuff).

No one else believed him or thought he should be allowed to leave the facility. Nothing was arranged and suppose he drank afterall?

Anyway, the next weekend I worked he was waiting for me near the front door. He'd had a fantastic time. All his family was there and he'd spent hours talking to a brother he hadn't seen in many years. They talked about the old times and had a wonderful visit. And he'd kept his promise and hadn't touched any alcohol. Late that night, his brother drove him back to the facility and then drove to his home in another part of the state. The next day, word had come that his brother had had a massive MI and died in his sleep.

The gentleman was so thankful that I'd allowed him to go. He'd gotten to spend the day with his brother, who was now dead. He himself died not long after this. And I was so glad I'd taken the chance and broke the rules and allowed him to have this final visit with his family.

Nikki69 · Dec 22, 2005

I had a resident named Annabelle who came to my LTC home last year. She had been an active part of her daughters life until she suddenly had a stroke. She then was very still, didn't talk, and couldn't eat or drink. She would follow you with her eyes, and if I asked her a question, I told her to blink once for yes, twice for no, and that's how we communicated. Her daughter came in every day, but was unsure how to talk to her mother. And even more unsure that her mother knew what she was saying. I would spend all of my free time in that room, moistening Annabelle's mouth, lotioning her skin, washing her hair, just trying to pamper her. Annabelle went 21 days without food or drink, and the day she died, her daughter and I were both with her. I was stroking her head, and her daughter was saying mommy, I love you, mommy, I love you. After she took her last breath, I held Annabelle's daughter, and we cried together for a few minutes before I reported to the nurse. A couple days later I had a great big bouquet of wild flowers in a very nice flower pot sent to me at work. It was a great feeling.

I also have a resident, Bertha, who is 97 years old, who has been chewing tobacco since she was 4 years old. All she takes for meds is a daily vitamin. Since she is old, and crippled up, she has a hard time getting her spit in the right places. It gets all over the floor and her clothes. Some of the other residents complain about it when she wanders out of her room, and our housekeeping department complains when they actually have something to clean up, so our social worker said we have to limit Bertha's chew to certain times, and certain amounts. The tobacco has to be kept in the nurses cart, and is only to be given in in the med cups when she can have it. Well, I don't think so. This woman has lived 97 years, has chewed for 93 of them, and I make sure I come to work prepared with a package of chew in my scrub pocket for my little lady.

Bipley · Dec 23, 2005

I am so thrilled I started this thread. I absolutely love every story here.

Com'on people, we ALL have a story. Spill it!

jaimemds · Dec 23, 2005

I had an elderly woman in a skilled LTC unit. She had MRSA and was on Respiratory isolation. This was Christmas time. She has to spend all day every day in her room. She was sad and depressed. She would sit in her room writing Christmas cards, all the while hooked up IV's. She was very lonely. After a few shifts working with her, I fell in love. She was sooo sweet and loving. I felt so bad that she could not see the xmas trees or lights. Her family rarely came to see her because of the isolation. One day, i took it upon myself to speak with one of the maintainance men. Together we hung lights in the shape of a xmas tree on the outside of her window. We also decorated another small tree that was within her vision. When she saw those lights for the first time, she broke down cryng. She told me that noone had ever done something so thoughtful for her in her life. I think of this anytime I have a pt. that is lonely and try to do something special just for them.

MMARN, BSN, RN · Dec 23, 2005

In nursing we all do things that we look back on and we are proud of. Even though we do it we don't always acknowledge it. So I double dawg dare you, just HOW have you made a difference in a single person.
Let's face it, it is always easy to point to another and show what they have done, now I challenge you to show what YOU have done. Think long and hard about this. It could be a smile at the right time, holding someone's hand at the right time, breaking rules such as taking your mask off in OR to show your smile to a pt too fearful to undergo surgery before they are put under.
I think those of us in nursing need to respect what we have done vs. what we were unable to do. So.. what is yours?
I have a favorite. It was H. I referred to him earlier in a different thread.
H was 90+ years old and a hermit. He looked like what Jesus Christ would look like at 90+ years old... long beard, long hair, the works.
I used to try to get him to come out of him room and join in fun with other LTC pts. He refused. So I would go to his room and talk. Verrry little talking with Herbie. There, I wrote his name. He deserves nothing less.
My all time favorite thing to do was to get my old folks to tell me what life was like when they were my age. Considering I was about 25 and Herbie was about 92, we had a lot to discuss.
I would ask him questions. Example, during the holidays I would ask what a Christmas tree looked like when he was my age. He would explain that his family didn't have money. They would use food (popcorn, fruits, etc.) to decorate their tree. It was amazingly hard to get Herbie to talk, but when he did he was very interesting.
In our main building we would have a variety of trees during Christmas. I tried to cover everyone's beliefs and traditions.
One year I paid especially close attention to what Herbie explained his trees. Herbie was kind of cold, standoffish, not really wanting to elaborate on anything. It was clear he was merely annoyed at amusing me with his stories. Well, I did pay attention and I listened to exactly what he told me.
One of our trees was exactly as I pictured Herbies trees from when he was younger. Fruit and popcorn for decorations, candles for lights. Paper people cut out in place of tinsel. A hand-drawn angel to top the tree. (That was beyond my skills, had an artist patient do that one for me.)
I finally had the tree decorated JUST as I understood Herbie to describe it. It was about 10PM. I went to Herbie's room. I woke him from a deep sleep. I apologized, yet begged him to come with me. Most annoyed he did as I requested. I took him to the main building where everyone else was asleep and we had the room to ourselves. I had an employee whose ONLY job that night was to watch that ONE tree. It had live candles lighting it. ALL that employee had to do that night was to watch the candles so the tree didn't catch on fire. (Needless to say, I had a LOT of offers for that job that night!)
Hand in hand, Herbie and I walked into the main dining area where we had several trees, including HIS tree.
We sat down and he looked at that tree in awe. He just stared at that tree, I quickly realized I did a good job. It was as he described. I could easily tell just by watching Herbie.
We sat there for the longest time just watching the tree. Without moving his eyes from the tree he put his hand on mine and said, "Thank you, child."
That still makes me feel good to this day. In nursing we all get caught up in the pressures of the job. But we all do good things for people too. It might be simple or it might be elaborate. Or... it might be inbetween.
I think during a time of stress (our very jobs!) we need to focus on what we do quite well.
So, what IS it you do well? What have you done or what do you want to do to impove how you feel about your patients, or more important, how you feel about yourselves?
Com'on... I risked telling my story. The least you can do is to not leave me hanging. What have you done or what do you want to do?
Mods... I *need* this thread for reasons I'd prefer not to go into detail. Please don't move it. I need to hear from my fellow medical peers.

Bipley,

That was something that I will remember. I hope I become just as dedicated to my patients as you obviously are. I shed a tear!!!:)