A patient made me cry today

  1. my skin is really thick. i've seen alot of things between being a nurse and a paramedic. i've seen abuse, neglect and death before. today, i got a patient from the emergency room with a massive infarct. the report i got never could have prepared me well for this patient. he truly broke my heart.

    when he arrived to the floor, i couldn't honestly tell if he was breathing. his gaze was fully deviated, he was contracted to one side, and had incredibly shallow, laborered mouth breathing. i pulled him from the stretcher to the bed, got down to his eye level, held his hand and said "i'm allison, i'm going to be your nurse today." he pulled his hand away from me, completely frightened, and yelped out. i asked him a series of questions, but he had no answers. just a wide eyed, terrified, deviated stare.

    he was 88 years old and he looked like he was a survivor from auschwitz. he was so emaciated, he may have weighed 80 pounds soaking wet.... upon assessment, i could actually see his guidewires from his pacemaker bulging through his skin. his skin turgor was so poor and he was so dehydrated that we were unable to place a peripheral line... and after two sticks from me, i gave up. he had been hurt enough.

    his body was covered head to toe in bruises, in various stages of healing. they looked like palm prints and hand prints. his skin was totally ecchymotic and he had so many skin tears it took 12 pages of wound photos to document them all. his skin peeled back like the skin on a banana just by touching it... and on his back and his shoulders, a purple hand print that was probably very fresh.

    i turned him over to assess his back. he yelped out again. his anus was excoriated and bleeding and was probably the size of an apricot or small plum... it appeared that something was forced in it. he shook in fear and moaned loudly as the CNA and i gave him a good bath, combed his matted hair, put him in a clean gown and applied lotion to soothe his dry skin.

    i called the abuse hotline. i never intended to point a finger of blame... but someone had forgotten to treat this man like a human being. social services came and did their own assessment and took lots of photos. he continued to moan, louder and louder. he pulled away everytime we touched him as if we were going to hurt him. what happened apparently was he was at a nursing home until his medicare ran out... but made too much for medicaid, so he had been paying a "caregiver" to see to his needs at home. i didnt see this caregiver.. and i'm glad i didn't.. because i may have said something very bad.

    lab called.... his troponin was 17. his infarct had spread to over 4 leads. his BP was dropping and his urine output was 0. i chased the doctor down to the ICU to get a hospice referral and a DNR. i was not about to have to call a code on this man. the least i could have done was to get him a comfortable death. paperwork was signed and hospice came to see the patient and agreed to take him at the end of my shift this evening.

    i documented and documented. i turned him every hour, swabbed his mouth, made sure his skin was clean and dry, and went and sat for just a minute by the bed, to make sure he knew that if i he wanted to go, i would be there to sit with him. i didn't want him to die alone, not like that.

    the paramedics came to pick him up and bring him to the hospice home. i signed his papers and helped them place him on the stretcher. he just kept moaning, and letting out these yelping noises. i walked them to the elevator and grabbed his hand and said "they are going to take you to the hospice house, so you can be cared for and comforted. it's ok to let go now." his eyes didn't move, but i knew he knew i was there.... because tears started rolling down his cheeks.

    and without saying a word for 12 hours, my patient made me cry.
    may god bless him. i hope his ending is peaceful and that he is moved on to a much better place than was ever provided to him here. today i remembered why i became a nurse.
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    About flightnurse2b

    Joined: Jul '07; Posts: 2,287; Likes: 4,696
    Paramedic/LPN; from US
    Specialty: EMS, ER, GI, PCU/Telemetry

    127 Comments

  3. by   ElvishDNP
    Oh honey......you did all the right things for this man. What a horrible life he must have had until you and he met. Thank you on his behalf. You are a wonderful nurse.

    I truly hope he passes in peace, as he so much deserves it.
  4. by   EarthChild1130
    I am so glad that man knew your kindness today...and I am certain that whoever did that to him will get what they deserve, one way or another. Karma has a funny way of doing that. (((Hugs))) to you.
  5. by   NotReady4PrimeTime
    I have to second that, Elvish. Flightnurse2B, you made that poor man's last hours/days better and you treated him as we all should treat those placed in our care. Your description of your day brought tears to my eyes; today you did a great thing... you reminded us why we do what we do. Thank you.
  6. by   NewRN2008
    thank you for being a fellow CARING, LOVING, wonderful nurse. it makes me proud to know that there are others that 'stand by my side' and have a heart in this crazy crazy world.

    and GREAT job!! really!
    -H-RN
  7. by   PostOpPrincess
    I hardly cry anymore, but you just made me do just that. Thanks for sharing and reminding me what it's really expected of me beyond being a nurse, and that's to remember that a human being deserves the dignity he or she was meant to have.

    Thank you.
  8. by   leslie :-D
    (((allie)))...you gave him a wonderful gift today...
    the gift of yourself, of your heart, of your love.
    and, even if he's not cognizant of it, the gift of hope.
    because of this, he will undoubtedly be tenderly and lovingly cared for, right to the very end.
    i can't think of anything more extraordinary.

    thank you, sweetheart...
    just for being you.:redpinkhe

    leslie
  9. by   SweetLemon
    Wow, what an incredibly heart wrenching day you had and it sounds like you made it through with such grace too. Your story truly brings tears to my eyes and makes me wonder what kind of people exsist in this world that could do that kind of harm to another human being. I really hope they find whoever that &^*#$ is and place them in jail (not that they don't deserve much worse in my opinion). You sound like an incredible nurse and I am so glad he was placed in your caring hands for what sounds like the last hours-days of his life. redpinkhe:redpinkhe
  10. by   tnbutterfly
    I am sitting here wiping my eyes and shaking my head. How can anyone be so cruel. I am so glad you were there for this poor soul. You will never know the positive impact you had on him. He will hopefully remember your compassionate care.

    The King will reply, "I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me."
    Matt 25:40
  11. by   KateRN1
    {((((((((((Allison))))))))}
  12. by   catshowlady
    Flightnurse2B, you brought tears to my eyes too. Thank you for being there for him and making sure he spends his last hours in peace. :icon_hug:
  13. by   flightnurse2b
    i have been crying on and off since i got home (and i don't think i can blame this one on my hormones). i really am just kind of haunted by it right now. i just feel awful. i am not much of the type to take work home with me... but my god that poor man, i can't even imagine what kind of horror he had lived through.

    thanks for all the encouragement, i needed to let it out. i tried so hard to hold it back at work, because i had 7 other patients, and i kept pawning of my red eyes on my allergies.... but i honestly am really shaken over this patient.

    i was just on the phone talking to my mom whose been a nurse for almost 30 years... and she said that it makes you remember, that when you have those patients who get on your last nerve, who just want the extra minutes of your time, etc... you could be the last person to ever care for them and love them.... something that i think i from time to time forget, because i'm so busy with charting and medications and this and that and the other thing.....

    somebody loved his man once. i hope he sees them again when his journey is over.

    i need to go to bed.
  14. by   NotReady4PrimeTime
    Allison, your mom sounds like a very wise lady. (Guess where you got your "stuff" from!) Another lesson for all of us.

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