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nilknarf RN

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  1. nilknarf

    The Gift I Didn't Want to Give

    If Carrie Lawson had tried to invoke a feeling of serenity by the way she'd designed her home, she'd succeeded. The walls were a painted light green, and the curtains a complimentary olive. The furniture looked plush and comfortable. The lighting and soft music added to the overall charm of the room. But Carrie had never planned for the latest addition to the room: a stark, steel-railed hospital bed. On that bed was her husband, Jeffrey. On the day I met him, Jeffrey put that room to its ultimate test: congested, jaundiced and moaning incoherently; Jeffrey was a stark contrast to the room's serenity. Jeffrey was one of my first hospice patients. I'd spent the previous two weeks working with a nurse who had 30 years' hospice experience. I'd tried to absorb all the knowledge she'd given. I thought I was ready for the "Jeffreys" I'd have to care for. My introduction and opening explanations to Carrie fell flat. Her responses to me were quiet and clipped. I felt her hostility before I'd had a chance to warrant it. My questions drew eye rolls before she gave me brief, clipped answers. Her eyes kept drifting to Jeffrey; then they'd stare off into the distance. All my training hadn't prepared me for stiff, rejecting posture and her unwelcoming ears. As the visit ended, I asked if she had any questions. She asked why one of his symptoms seemed to be increasing so quickly. Relieved that she seemed to want clinical knowledge, I gave her a brief review of Jeffrey's disease and its anticipated course of progress. My words were met with silence. But, then, her anger came. "I want a different nurse," she spat. "You act like he's a page in a textbook and like you're looking at a scorecard for his future." Her words hit me hard. I'd wanted so much to be a comfort to her. My heart filled with remorse and fear: what if this was how I'd be greeted by all my future patients? But I swallowed my pride and finished the visit as quickly as possible - and later, asked my supervisor to send a different nurse for Jeffrey. That was hard, because what if the supervisor wrote me off as a bad risk for this job? She didn't. Instead, she reminded me one of the ways people try to regain control is by expressing anger. She pointed to my account of Carrie's flattened responses to my questions. She asked me to imagine how it might feel to Carrie - who had, obviously, worked so hard to instill a sense of serenity into her life. She asked me how that person might feel; to have to cope with uncertainty and chaos, in the form of her husband's illness and impending death. She asked me to try to understand that Carrie might be very angry at this intrusion into the serenity she'd planned, for her life. I began to understand: since Carrie would likely find it difficult to be angry at her husband, she had to find a target for that anger. She had found one: me. "In a way, you gave Carrie a gift," my supervisor told me. "You gave her someone to be angry with." Seeing the sense of this didn't make it easy to accept Carrie's angry rejection - but it did make sense. In time, I would meet many other "Carrie's" - and those words have always stayed with me. I remind myself that sometimes, one of the gifts I can give someone is the gift of someone to be angry with. It's not a gift I want to give, but it may be the one that someone most needs.