Why am I doing this, anyway?

[PedsDrNurseTheo, ADN, BSN, MSN, DNP, RN, EMT-P, NP]

"Good luck, dude, you're gonna love this one," the charge nurse told me as he handed out the patient assignments for the day. "You win the lottery this morning - dude needs a guy cause he's really inappropriate with the female staff. Really." Oh, wonderful, I thought to myself. A frontal type TBI patient who is also a quad - this ought to be fun. As I took report from the off going nurse, and she told me that the kid's mother was also going to be around - a LOT - I started seriously questioning my choice of career. And as I heard the continuous fecal refrain from the room, I knew I should have studied computer science instead.

"@#$!, @#$!, @#$!, @#$!!" "You're a dumb@#$." "@#$! off." He couldn't vocalize, but he spoke loud and clear. It took me about half the shift to realize that his anger was neither triggered by nor directed towards me - though I was the nearest available object with ears. It took a little less time than that for me to recognize that he could not control the repetitive speech - it was like a nervous tic. The more stressed he got, the worse it became.

So I stopped responding to him with dismissal or anger - I took my feelings out of the equation - and listened to him. What I began to hear was a spirit in agony - and a person who not only had been robbed of all power in his own mind; his caregivers had robbed him of all power as well. We were not listening to him, we were not giving him any say in his own treatment, and we certainly were not willing to entertain the idea that behind the repetition of the curse words there might just be a devastated, emotionally shattered, kid - who was terrified.

I spent a week working with this young man - and I learned a lot about myself in the process. I learned that I needed to discard my ingrained thought processes with him, and do some real thinking outside the box. I learned that sometimes life changes occur quickly, and dramatically, in the tinkling of shattered glass and the groaning of twisted steel - and sometimes much more slowly, in the gradual transition from total dependence to having a voice in one's care, from bedfast to chair trips downstairs and outside - from constant infusions of sedatives and antipsychotics to vent weaning and Passy-Muir valve.

On the day he finally could fully vocalize, I put the Passy-Muir cap on his trache tube and braced myself for the now familiar refrain. Instead, I heard "Thank. You. Thanks." I knew then that computer science would never bring that kind of lump to my throat, or ever feel that fulfilling.

This is where I belong.

[ellakate]

Thanks for sharing this story. I need it today.

[tebyrd0020]

This is beautiful. So beautiful.

[Chapis]

you're a beatiful human being and a great nurse. you took the time to understand your pt and helped him in his needs. bravo!!!

[Going4myRN]

As a nursing student I learned more from this story then from many of the lectures I have heard in the past year! Lesson learned, never to be forgotten. Thank you. I'll enter each room looking for the person behind the diagoses.

[Recuerdo]

You have shown us the stuff of which heroes are made.

Carry on!

[VivaLasViejas, ASN, RN]

Fantastic story..........thanks for reminding me of why I became a nurse!

[Julz034]

Brought tears to my eyes. If only everyone could be this way....

[BullyLoveRN]

Oh my goodness, I am not a crier (in public at least... I am at work on break) and your story just made my eyes well up with tears. I work in pediatrics (currently in LTC, but have done Acute Care as well) and get kids with severe cognitive/neuro devestation, sometimes it's a new thing (trauma or ABI), sometimes it's from an illness (CP). One thing I always do with every patient I have is talk TO THEM! I don't care how old they are (an infant or 15 year old), I don't care how A&O they are, or how cognitively delayed or developmentally delayed they are, I talk to them. I greet them when I walk in the room, I tell them what I am doing, I sing to them (not always a good thing), I tell jokes and give them a hard time (in a fun-loving way), and I soothe them when they show discomfort (even if it's only shown through HR or RR). I always try to put myself in their shoes and wonder how frustrating in would be not to be able to tell other people what I am feeling, want, need, etc!

We must remember, that even though our patient's may not be able to talk to us or communicate at all to us, doesn't necessarily mean they can't understand US!

[Brian, ASN, RN]

Great story, thanks for sharing it!

[holiday2525]

That kid was lucky to have a nurse like you. I hope I remember to also be as compassionate and as caring. You are a blessing to your pts.:heartbeat:yeah:

[C2CNurse]

one of the many challenges nurses face. with a rewarding outcome, not just for the nurse, but most importantly, for the patient. we are only human, yet we must attempt becoming a superhero for those face with devastation. empathy, patience, and understanding. just a few of the qualities we must embrace.

a terrible incident, but wonderful account of your experience, tdflmedicrn. and certainly one heck of a reminder of what our focus must be at all times, every time.