People do what they need to do at any given moment and it is up to us to be advocates for them. I know there are those who will say 'save those feelings for when you are in the nurses' station, or in the staff room'. I would challenge that. I would say, suspend those feelings entirely until it becomes a part of you. Stop them in their tracks.
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I have just graduated from an RN program. A month before my grad, my dad needed emergency brain surgery for an injury he sustained at work. Due to a series of complications, what should have been a relatively easy surgery turned into him being put into a medically induced coma. It has been over a month now, and he is slowly coming back to us, after weeks on end of non-responsiveness.
All the while, there have been great nurses, and there have been not-so-great nurses. I have learned such valuable things from both kinds. Sure, they are all terrifically 'efficient'. That means nothing to me, actually. We have had amazing care and consideration from a handful of them. Sadly, more often, we have also had thoughtless and hurtful things said to us, in front of us, and within earshot of us, unbeknownst to them. There have been things said in the presence of my father who was in a deep coma that I am sure he heard, because now that he is somewhat lucid, he nods 'yes' when I ask him certain things to see if he remembers anything from when he was 'out'. My father has been treated as a 'throw-away' patient in the ICU because he is 72 and has a brain injury. A few of his nurses never even bothered to get the back-story and did not know that he worked for a month with a chronic subdural bleed after his original concussion, that he is ridiculously healthy and active and strong in real life. That he beat terminal cancer 24 years ago when told he had 3 months to live and is tough as nails and has an incredible will to live. That he was put into a coma by his neurologist, he didn't go into a coma because of his injury. They treated him (and us) like he was a hopeless case, a vegetable. We were actually told by one nurse that his treatment was a waste of time when his neurologist ordered an EEG. Why? How hard is it to just do an EEG without sharing your opinion on whether or not you think it is necessary?
The biggest thing I have learned is that it is not up to us to cast judgment on a family's choices for their loved ones. It is not up to us to share our opinion or use diagnostic or prognostic language. Our job is to support patients and their families wherever they are at, nothing more than that. The grief, the reality, the anguish and doom, and gloom will take care of itself, trust me. We don't need to add to it. I know nursing is hard physically and emotionally. I know nurses get 'burn-out' and are privy to emotionally intense situations that might 'numb' us, or cause us to jump to conclusions in other situations. But acknowledging this is not good enough. It's not ok, regardless of the reasons.
I will never again judge anyone for not signing a DNR. I will never again judge anyone for any decision they make at any time. People do what they need to do at any given moment and it is up to us to be advocates for them. I know there are those who will say 'save those feelings for when you are in the nurses' station, or in the staff room'. I would challenge that. I would say, suspend those feelings entirely until it becomes a part of you. Stop them in their tracks. Do not attach judgment. Just be the support that the family needs.
I went to my graduation this past week and cried as I crossed the stage because my dad should have been there to see me. I also felt guilty for being there because I was not sure he was getting the care he needed while I was 4h away. I did not trust his nurses to care for him without me there advocating. It occurred to me again and again that this should never be the case. Nurses should ALWAYS be our advocates. I have not felt that yet during this experience. I have told the nurse-manager of the ICU this. I shudder to think of the patients whose families do not know enough to advocate for their loved ones.
And my dad? He is slowly making a recovery, is awake and is starting to move his body, his arms, and legs. His eyes open, and when his trach was plugged he spoke his first words to my mother in over a month- she told him she couldn't wait to get him home to his own bed. His response? 'What are we waiting for?' followed by a chuckle. He moves his arms and legs and tries to sit up. I asked him if he was doing this because he was uncomfortable. He said no. Through a series of yes and no questions (he can nod 'yes' and 'no'), we deduced that he is, in fact, doing his 'exercises'. He wants to get out of his bed, and he will. He affirms he is bored and wants to catch up on 'Mad Men'. He does math problems in his mind to stimulate his brain (my dad is a genius and can solve ridiculously complicated calculus problems in his head for 'fun'). The floor is abuzz with the news of my dad's awakening. He is surprising everyone.
All of this from a man who we were told would not survive, and his life was not worth the effort we were making.
As nurses, this is not up to us to decide, and it most certainly should not have an impact on the care we provide.
