relation; connection, esp. harmonious or sympathetic relation: a teacher trying to establish close rapport with students.
from dictionary.reference.com.
i had a patient who was gonna die. in a sense, all of my patients are going to die, but with a terminal illness, sometimes you know someone is going to die sooner rather than later. the patient was in a bad way. young (40's) and terminal. they had a form of cancer that had spread throughout the body, and the only treatment was one that would be really, really bad for certain organs. said organs belonging to my patient were not working, and had not been working for some time.
i had an instructor in nursing skool tell me that all medicines were poison. i still think of them that way. i mean, look at all the commercials for meds on TV. the majority of the time, they have time to state the name of the drug, what it might help with, then the remainder of the time left, they pay those used car sales guys to go thru, like, 50 bazillion side effects.
'depressed? try abilify! side effects may include, increasedriskofsuicidedepressionanxietydecreasedlibidosexualfunctioningdeathorworse.
so my patient had this cancer, and these crappy organs, and had apparently been using home/herbal remedies to try and fix said organs. the ROCK; the patient had cancer. a treatable cancer, but the treatment wrecks havoc on certain organs which THE HARD PLACE were in failure, necessitating a transplant. the patient really needed an organ transplant, but with the cancer, there was no way.
you get the picture? terminal.
so, i'm work a buncha days in a row, then i have a buncha days off. so i had there patient for a long time at night, while during the days, there were different nurses that came and went. most of the day nurses would report to me that the patient was in a sooper funk, and either depressed or in denial or inappropriately processing, if at all, the fact that DEATH was in the room.
however, the patient was totally 'with it.' for me.
why?
well, for one thing, i didn't talk to the patient about dying. didn't mention it. instead, i talked about stuff like college and pro football, favorite books i read/was reading. i spoke about my family. i asked about my patient's family. and really got to know about my patient and the life that was BEFORE.
where dayshift got one-word answers or no answers at all, i got life stories. i didn't walk into the room with a sympathetic look on my face and encourage my patient to 'just let it all out,' or 'give a good cry.' i refused to look in the corner of the room where DEATH was sitting, reading his copy of People magazine.
lest you think i'm some sort of genius or something for my approach, let me tell you why i did what i did. i am not good with emotions. i'm not a fan of how my emotions make me feel. plus, the mechanism that enables most humans to cry broke on me a long time ago and i never took it back in to get it fixed. when i cry, it sounds like hell and looks worse. snot, redness, weird noises and the works. NOT. PRETTY.
so i do not allow my self to get emotional. not for my self or for my patients. i don't want to cry, and i don't want my patients to cry either. that is not to say that i don't feel for my patients, i feel very deeply for them, just not while i'm at work. i save that feeling crap for my days off the occasional bottle of Blue Moon.
so DEATH is in the room. sitting at the bedside, in his dark rotting robes, playing 'angry birds' on his ipad, like everybody else. he's probably pissed that i'm ignoring him, or maybe not. i figure he's seen everything at this point. point is, i ignore him. and for twelve hours that is my shift, my patient can ignore him too. because i am babbling about Malcolm Gladwell and Brett Fav-ruh, and the Miracle at Qwest field. and my wife'd boob-feeding and how max drives me crazy.
and it is just what my patient needed. (disclaimer; i do offer to hold my patients hands, if needed and appropriate. i do practice appropriate therapeutic touch. and i touch my patients without gloves. at least a couple times per shift.)
5 comments:
You sound like a great nurse and it sound just like what that patient needed. Sometimes the patient just wants to feel "NORMAL" again....enough of the death stuff...obviously he was getting enough of that already....and in his reaction...that clearly shows that sometimes NORMAL LIFE is what a dying person needs.
I think that is why it is a good thing to die at home, where things are a little more normal and you are experiencing life (as much as you can) or at least are in the middle of it, as opposed to watching everyone else do it....
Death is already on the doorstep. If you are going to linger a little and "stuff" is dealt with...enjoy life - what's left, anyway, as much as possible....
So true Nurse J. I would guess that most patients have no desire to talk about their impending death. Why would ANYONE??? Talking about their life before is much more interesting, and less depressing. I'm not sure why some people feel that patients must accept their impending death (verbally) and embrace it (also, verbally) and that they feel a responsibility to get patients to do so. Denial is a very powerful antidepressant. Dying people should be allowed to talk about what they want to talk about.
cartoon characters-thanks. OMDG-i like that, 'denial is a very powerful antidepressant.' sounds like it should be the title of a book or something.
That's great! I love it. I have been accused of being "cold, uncaring and unemotional" because I do not cry with or about my patients. I truly do care. I just don't think it is productive for me to cry and get all crazy about things. I like what you said about your crying parts being broken.
Seriously, Just because someone does not take the same road as you, it does not mean that they are lost...
You let your patient "live" his best life at the time. Thats what nursing is all about. Its not about us or how we think a patient should be acting. Thank you so much for remembering that.
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