Improving Your Practice, Uncategorized

The Epiphany that Changed Everything.

“Any fool can know, the point is to understand” Albert Einstein
We have all had a patient that shifted our perception.  One that somehow made us see past ourselves, our bias, our exhaustion and really see them.  Sometimes that change is imperceptible and alters your view ever so slightly, and sometimes it’s very profound and you never look at anybody the same way again.  I had the benefit of having the latter occur to me quite early in my career. Working in a hospital, you get used to seeing episodes.  Little snippets of a patient and who they are, often at their worst. Those snapshots make it difficult to see them as anything other than that.  Sometimes you feel like you’re binge watching episode after episode, and it gets very easy to simply check out. If you’re not careful, you’ll forget that they are more than their illness. That is where we lose our effectiveness as true caregivers.

I had a patient in my second job who I took care of nearly every shift for almost eight months. He was an exhausting patient, but we had developed our own rhythm and dance of care. I knew when he was starting to get sicker, and when he felt better simply by looking at him. I knew he liked his bath at 4 am and not a minute sooner, how he liked his pillows, and where to place his call blower/yankour (he was a new incomplete quad).  I was on a first name basis with his mother who lived a state away, and called every night without fail at 9:10 pm just to make sure he was okay.  I though we knew each other. I was wrong, and it hit me one night like a ton of bricks (coincidentally at the perfect time).

Anyone who has cared for the same patient over an extended period of time understands how rote and routine things can become.  You can almost stop looking at them like a person, and see them only as a list of tasks to complete to ensure their care.  I know how harsh this sounds, but it had become my reality. That is, until his family, in an attempt to fend off his deepening depression, sent us an envelope of photos. They asked us to place them around his room and above his bed so he could remember his life before.  There were pictures of him working on his home, throwing a ball with his son, rock climbing and laughing with his friends.  There was joy and adventure. Most of all there was love. A love of life and of living, something that I hadn’t had the opportunity to see as he lay slowly deteriorating in my ICU bed.  Those photos bridged a gap I didn’t even know had developed in me, and taught me something I carry with me to this day.

What it taught me, is to remember that our patients weren’t always like this.  Whether they are now battling sepsis, waiting for a heart, or leaving this earth. They have had a whole life that we will never see. I had grown to not see his life that he was forced to let go of, but only the things I did to care for him. For the first time I truly understood what he had lost. The moments he would never get back, nor possibly ever have again. The son he had never met or held, because he had been born during his hospitalization and we didn’t let babies in the ICU. I started to see the whole picture, and it was devastating.  That understanding has changed my practice so much in the years since.

I used to have a goal to just get my patients out of the unit, or out of the hospital.  That’s not enough. Now, I need to know what I can do to help return them to their life. The vibrant life that’s filled with people I’ll never meet and places I’ll never go.  I must aid their return to what they value, not just get them through. I must also revere those who will never leave my care, and fully honor the impact they had in their world.

This person helped to grow me up as a nurse, and as a person. It taught me not to rely solely on the episode I”m seeing right now, because that’s not the whole story.  My well of compassion was deepened, and my capacity for empathy continues to be redefined. They taught me to consider their life before, and to guide my care accordingly.  Ultimately, if we aren’t considering their life, what are we doing it all for?


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