The patient had just returned from testing downstairs when we came rolling into the room hot and heavy. As I pushed the huge ICU bed around the corner my coworkers met me at the patient’s room. When I was in the elevator and had seen the heart rate on the monitor suddenly shoot up and the oxygen saturation quickly go down I knew we were in for trouble, and while trying to arouse my lethargic patient I had pulled out my cell and contacted my respiratory therapist and charge nurse.
Then I went into the mode. The mode of saving my patient.
He was gonna code; I just knew it, and though we worked quickly and efficiently as a team to prevent it, he still deteriorated.
Upon our arrival back to the bedside my eyes had met those of his daughter. I had nodded, perhaps spoken something or other, but had quickly placed my attention back on the monitor. Non-rebreather on at 100%, but still his oxygen saturation fell. We called for the intubation meds, and I glimpsed a panicked family member from the corner of my eye. Even as I started chest compressions I saw a coworker take her outside the glass door, one arm guiding her along while the other patted her back.
I’m usually the one who takes the initiative to try and calm family, explain the ordered chaos, and try to emotionally ground them in such a crisis situation. It’s what I like to do, but that day I could not. My focus was on my patient, and that’s where I was needed.
Sometimes it’s hard to show support and compassion when your mind is fixated on fixing the situation. It’s difficult to explain what’s going on when you’re still trying to figure it out yourself. When your focus is on making things right it may appear wrong, and the grim expression on your face may make you appear indifferent, removed, perhaps even heartless.
When a situation becomes extremely serious your nurse may do one of two things, or maybe even both. They will either become extremely serious and stern-faced or they will crack jokes. Often times I sing. I don’t hum the melody of Gershwin musicals because I don’t care that my patient is dying, but rather to steady my nerves.
I don’t keep a blank expression because I don’t care about your mother, but rather as a means of emotionally separating myself for a moment when memories of my own momma try and creep into the situation. A certain level of professional detachment is necessary at those moments, for when I see you breakdown into tears in the hall it reminds me of myself the day my own mother died. Then I may sing a few lines from The King and I under my breath.
When a team of healthcare professionals is working fervently in fluid motion to resuscitate your loved one they may appear detached, disinterested, or even heartless, but this couldn’t be further from the truth. Your nurse isn’t heartless. Your nurse is sustaining self. They are preserving a certain amount of emotional detachment so as to make their life saving interventions possible.
You see, nurses are faced with a very difficult task. We are expected to empathize and emotionally support those under our care, but then to maintain the integrity of our own psyche we must also keep enough of a distance so that we don’t collapse under the stress and strain of so much death and dying that consistently surrounds us.
We must maintain a level of connection and relationship with those we serve so as not to become callous and lacking in compassion, yet not so connected that we crumble if something bad should happen. It’s not an easy balance to keep, trust me.
I always wish to keep you abreast of the situation, and my desire is to keep the atmosphere light and cheery, but sometimes circumstances will sweep me up into their flurry of busy efficiency. In those moments I might appear aloof.
I always strive to be professional, but understand if I joke to lighten the heavy mood it’s so as to keep my own sanity. If I sing when chaos surrounds me it’s to keep my own head clear. If I appear that I am frowning it’s only because I’m deeply focusing on the task at hand, and if I appear heartless, well, that’s just not the case.
Michelle Canten says
So true….! I’m a hummer of various songs during stressful times working. Like you it helps clear my head and keep me focused on the task at hand! You always find the most beautiful words and stories to express things as nurses we only wish our patients and their families understood… for that we all thank you ?
brieann.rn@gmail.com says
Thank you!
Christi says
So true! In life saving mode…I’m in a bubble with the patient, I don’t see or hear anything else.
monica says
I am not a nurse, but a home Healthcare aid. The spouse of the man I keep collapsed last week, and now I understand the “emotionalessness” demeanor all too well…because I felt it on my face as I called 911 and there daughter, pulled off his O2 finger meter and stuck it on her, and grabbed hid blood pressure cuff. It was like my brain was in hyperdrive, and I was acting automatically, but I barely heard him crying out and certainly had no time to calm him until the EMTs arrived. Thankfully, she survived and is doing well but I will never judge a nurse’s fcousin again after that