Posted on 05/05/2007 1:42:23 PM PDT by 60Gunner
God has a way of bringing patients into my life who serve to remind me of what this nursing stuff is all about. Through these encounters, He restores my sense of the holy purpose of nursing. Without this sense of altruism, nursing becomes nothing more than an application of mere science and aesthetics; The patient is reduced to nothing more than a problem to be fixed- the "kidney stone in room 3"- rather than a human being in need of care.
Dealing with malingerers and drug-seekers on a daily basis tends to make me more cynical and suspicious than I can comfortably admit. After dealing with at least one malingerer per shift for nearly a week, I have to admit that I can get pretty jaded.
Sometimes a patient will come in for emotional distress. There may be no underlying pathology. But an emotional or spiritual emergency is still an emergency. The person's life is a shambles and he or she has run out of ideas and hope. If ignored, it can be devastating. (The reader need only refer to my recent post about a coworker's suicide to see my point).
Some may suggest that a counselor or a church would be a more appropriate place to take one's personal demons. My answer to such a statement is simply that while counselors and churches are not open 24/7, Emergency Departments are. And when there is nowhere left for a distraught, frightened or hopeless person to go, the ER is the perfect place to come for help. Why shouldn't they come here?
I had a patient a couple of weeks ago who came through triage complaining of "loneliness" (her stated chief complaint). She was three months pregnant, and her boyfriend had left her. She had come with him from the East Coast, and she had no way to get back home. She had been living day-to-day and roof-to-roof for nearly a month and had run out of friends, money, shelter, and strength. She was tearfully apologetic about taking up my time as I assessed her in the treatment room. She never asked for any medication. She never asked for so much as a blanket, although it was chilly and her arms were covered in goosebumps. I gave the woman three blankets fresh out of the warmer.
It is amazing how therapeutic a fresh warm blanket can be, and how strongly it can communicate compassion. It says, "You're safe here." The woman visibly relaxed and smiled with a sigh as I wrapped one around her shoulders and covered her body and upper legs with the second, and wrapped the third around her lower legs and feet.
We ran some basic tests on the woman just to make sure she and the baby were okay, and everything checked out fine. I assessed fetal heart tones and pointed out the fast, loud wow-wow-wow-wow of the baby's heartbeat under the doppler head. The woman brightened when she heard the sound of her baby's heart rocking steady in her belly.
A nurse's responsibility is not for a heart, a lung, a brain, or a lacerated toe, but for the whole patient. Certainly, the woman and her baby were physically fine, and there was nothing medically to be done for her. But emotionally, the woman was a train wreck. She was a harmless, stranded, frightened and lonely human being whose toolbox was completely devoid of coping skills. She was isolated from her family, cut off from a way home, and cold. And she was pregnant. She didn't want drugs; she just wanted to feel safe and that she was cared for- or more to the point, cared about.
Some might criticise the woman for abusing an already-overstretched Emergency Department. I must confess that I fought hard to suppress an involuntary rolling of my eyes as I read the patient's chief complaint. But as her story unfolded, God softened my heart. He reminds me about how important to Him human beings are. And by the time I finished listening to the woman's story, I had a good idea of what God expected me to do for her.
I approached the MD, who was sitting at his computer and sat down. He paused from his dictation and turned to me.
"You have that look," he said suspiciously. "Who is it?"
"The pregnant woman in 12," I said. "I know you haven't examined her yet, but she isn't physically ill."
"Why is she here?"
"Her heart is broken," I answered. The MD raised an eyebrow and I held up a hand. "She isn't asking for meds, she isn't in pain, and the baby is fine. But she's in a heckuva jam, she's scared, and she needs some help. I'd like to get Social Work involved."
"If you think she needs it, go for it. I'll go in and examine her so we can get things going."
I entered an order in the computer for a Social Work consult. I then called the SW to see how soon she could come.
"What's going on?" the SW asked. I laid out the problem and she said, "I'll be right there."
ER Social workers amaze me. These people can conjure up support resources seemingly from thin air. IN my ER, we nurses love our SWs and view them with something close to awe. This particular SW was a real veteran and one of my favorites. She came to the desk and chatted with the MD and me about what we felt should be done. The MD and I agreed that getting the woman back home would be a great goal if possible, and that finding shelter for her in the meantime would be icing on the cake.
The SW sighed. "You don't ask for much, do you?" She stood up, grabbed her papers, and went into the woman's room. She was in there for nearly an hour, and at one point I clearly heard the woman sobbing. At last, the SW stepped out. I noticed her left shoulder was wet. She sat down next heavily next to me at the nurse's station and said, "She is a wreck."
"Yep. What did you find out?"
"Well she doesn't fit the mold, for starters. She's smart and very articulate. She has a degree in economics. She came out here because her boyfriend got a job at the Geek Palace. They were going to buy a house together and she was going to try to get on at the University. Then she got pregnant. He didn't want the baby, and she wouldn't get an abortion, so he threw her out. She couldn't find a job and ran out of money and friends. She hasn't called her family for help because she was afraid they would be angry with her. But she gave me her parents' phone number and gave me her consent to give her folks the whole story. I'm going to go call them before it's too late over there. I'll be in my office if you need me."
Twenty minutes later, the SW came back and sat down. I looked at her expectantly. She sat down and folded her hands in her lap.
"Well, we can get her home and put her up in the meantime," she said at last.
"I never doubted you for a moment. What did her folks say?"
"They had no idea. They said she sent letters and called almost every day until about a month ago. Then she just vanished. They were worried about her and I had to convince them that their daughter was not dead. They want to talk to her, but I told them that I had to let the patient know first. I'll go in and give her the news. When I give you the high sign, call this number-" she handed me the paper- "and then transfer them to the phone in her room."
The SW went into the room with another warm blanket and closed the door. A minute later the SW opened the door, stuck her head out, nodded, and closed the door again. I called the parents, introduced myself, and then transferred the call. Within seconds the woman was sobbing again. Shortly thereafter, the SW stepped out.
"How's it going?"
"Just fine," the SW answered with a smile. Her parents have old friends here, and they gave me the number. They live about thirty miles north. I called them from the room, and they're on their way to pick up our patient as I speak. Her parents are going to arrange for a flight home in the next day or so."
"Wonderful! How is our patient?"
"Remorseful, but relieved. She'll have some things to work out for herself, but she'll be home in a few days and her parents are just happy that she's alive and healthy."
I informed the MD that things were squared away for our patient and gave him the plan. He smiled and printed out discharge instructions for pregnancy-related nutrition. The patient was already dressed when I entered the room; I gave the patient her instructions and informed her that she could wait in the lobby until her parents' friends showed up.
As we stepped into the hall, I offered my hand and said, "All sorts of good luck to you, ma'am."
She shook my hand and said, "Thank you. I'm glad I came here."
"Me too."
I still prefer this kind of forum, though. Books don't engage in dialogue.
Brand new monitor and it’s already blurry.... a beautiful story, well-told. God bless you folks.
'Truly, I say to you, as you did it to one of the least of these my brothers, you did it to me.' (Matt. 25:40)
Nice job, Gunner.
Thank you so very much for sharing your testimony, dear 60Gunner! And thank you so much for the ping, dear bd476!
How very,very, true. Here in Alaska where nearly every (EMS) patient has a degree of hypothermia, I learned a long time ago that one of the best interventions is to take the blankets from the gurney, apply a quick spritz of H20 and into the patients microwave.
Keep up the great stories!
You are very welcome, Alamo-Girl. It was something too beautiful not to share. :)
My sister was an ER nurse and we were out to dinner one night and she got a call from a Dr.. It seems a woman accidentally ran over her toddler and was inconsolable although the child was only slightly injured and the nurses on duty were being very short with her. He wanted my sister to come in because he knew that she would be able to show the woman some compassion. I’m glad to know that there are people like you out there because I have a lot of loved ones who might need you or someone like you someday.
When one is at the end of their rope, the simplest things are the most important. You could not have helped this woman more is you were to perform surgery. Compassion is what saved her and her child’s lives.
Thank you for bringing the Lord’s hand to this earth, where it is so desperately needed.
Wow! Typing this reply through blurry eyes, for some reason (!) Awesome job, I heartily applaud you, hospital ER social workers and everybody who takes care of us at what can be the worst time in our lives!
Moments like those are what makes me think of nursing of more than a profession - but a vocation too.
And social workers are wonderful, I use them all the time and they do work magic sometimes for our patients in discharge planning. You remind me again to thank them when they work so hard on one of our 'requests'....
You helped to remind me again to be kinder,less hurried and really listen - be the person who can make the difference! God Bless you! :)
God bless you and all the nurses. I don’t think people have an inkling of how hard of a job it is.
Great story sir but I hope you are blurring a few facts....not because I want you to lie...but because HIPPAA has been know to bite a few of us in the back-side...even the smallest bits of private info put into the wrong hands can get us into a lot of trouble!
Thank you. Very inspiring.
Thanks for your concern. To answer, I am very careful about identifiers. I don’t specify date, I don’t specify age, I wait at least a couple of weeks before writing, and while the situation remains the same in essence, even what the reader knows about the patient is modified a bit while the reality of the situation is preserved.
By the way happy nurses day!! Thanks for all you do!!
I wonder how many other places she could have chosen to go for help would have started with the abortion recommendation.
Thanks 60Gunner, another great story. We need more folks like you. If I ever end up in the ER I hope it’s yours.
I see some real heart breaking things in the ICU where I work....often I can’t even tell my family about what I see.
However I did tell my daughters of a cautionary tale of a 30 something female who had come in on a third time around drug overdose complicated by injection induced blood sepsis who had had a number of children being cared for by family members or the state. Third time around on the vent was quite enough for the haggard family who were otherwise decent and kind folks who had thrown up their hands with the wayward girl. Rather than go thru the whole months of revery routine again, they had had enough and requested life support be terminated, especially as her condition was less than a 1 per cent chance of return...
My girls eyes were wide open at the descriptions of the destruction the girl had reaped on her self, her turning tricks to survive, her lesbianism, and the drugs injected with dirty needles, the 2 weeks spent with no one visiting her except her “friend” who visited once, who dropped off a cheap Chinese made
stuffed animal, and of the last night i had her when I was in the room and visibly saw the change in her color and the acceleration of heart rate into the 150’s and felt in my soul she was slipping away...gases were bad and her k level rose above 6.
We bought her some time that night by bicarb, d50 and insulin and I was not there that next day when her familiy
came in after not having seen her in months, saw her condition and decided, “no not again...” and had her taken off support.
The room was empty when I came in the next night save for one momento....the pathetic stuffed animal I saw staring mutely out of the trash can...with that I brought my tale to the end with a warning to my kids not to go that way, that I might decide that their plug should be pulled!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.