Being a nurse isn’t easy. Aside from the physical stresses of the job, there also lies an emotional component that makes it extremely difficult and taxing on the caretaker’s ability to perform. When faced day in and day out with so much disease, poor outcome, negativity, and ultimately death it becomes necessary for the nurse to place a protective barrier between the patient and herself. It’s not that they wish to develop a hardened heart; you couldn’t do the job without compassion. It’s simply that a professional wall of sorts must be erected to prevent full exposure to the nurse’s tender spirit. If she didn’t do this she would burn out quickly after multiple episodes of collapsing in the hall floor like a useless piece of sobbing jello.
I have done this. In my professional life I have an invisible shield that protects my heart. It’s like it is semipermeable, allowing empathy to affect my care, and allowing compassionate kindness to connect with patients as real individuals, but it also always whispers in my ear the hard truth. You are the strong nurse. They are the sick patient and struggling family. They need you at your best!
When faced with performing quickly, skillfully, and without mistake to execute lifesaving intervention in a critical care setting it’s pretty much necessary to keep a small divide of emotional connection from patients and family. To prevent a nurse’s eventual, emotional collapse it’s imperative.
It’s required, kind of like licensure renewal, so imagine my surprise when I let him become more than just a patient.
I noticed right away the lines on his face. They ran deeper than many I had seen, and his white, full head of hair crowned his murky, blue eyes. I knew before I even looked at his chart that he was a very old man, and it seemed like we saw more and more of his demographic as medicine progressed. But more than I noticed how the deep wrinkles on his face defined his age was how they seemed to transform when he laughed into the most perfect joy I had ever seen on a human countenance. His eyes crinkled, the murky blue cataracts seemed to disappear, and all I saw was a happy man content no matter his circumstance. I fell in love with him immediately.
It happens I suppose. There are certain patients you connect with on a personal level more than others, but this seemed different. I listened to the stories of how he and his perfect little wife met, and I found myself honestly enthralled to hear more. I wasn’t biding my time until I could slip out the door, and it hit me then that I had stopped really enjoying listening to my patient’s personal stories some time ago. I had been missing out, and as I laughed heartily, a real chuckle and not just a forced guffaw to be polite, I wondered if I had done the right thing.
I was of two minds as I reminisced with my new friends, and I found myself guarded and slightly frightened that I was enjoying their company so much. I quickly excused myself to go and chart, and as I sat at my computer I understood my complex feelings. I hated that I didn’t do this sort of thing more as it was really wonderful, but I also knew why I didn’t.
My eyes looked at the monitor screen of my advanced age patient, I scanned the new orders for upcoming interventions, and I was afraid. I feared for him, something I tried not to do, but I couldn’t help myself. Over a period of two days I had allowed him to become more than just a patient to me. I had let down my normally ever-present guard, and I had developed a true affection for him. I mean, I love all my patients, even the difficult ones, but I really cared for this old man. And I realized as I sat at my desk that I was overly worried that he would die the next day. Medicine is a wonderful thing, but years of experience had shown me that once you reach a certain age the risks inherent with us fiddling around in your insides increased exponentially.
I spent the remainder of my shift trying to push my fears away, and even though I wished to remain polite and kind, but safely distant, I just couldn’t. He was sad I wouldn’t return to be his nurse the following day, and with tears in his eyes he said, “I really need you to come hold my hand before I go to surgery tomorrow.”
Before I left I hugged him tight, and I said, “I love you.” I probably would have whispered it any other time, but he was as hard of hearing as the day was long, so instead I screamed my unique farewell.
And I left. I clocked out, and I tried to leave him behind like I left them all behind. I had to! Do you know how many times I return and the bed is empty or occupied by someone new, not because of getting better, but because they got worse? There’s no where to go above and beyond critical care except the OR or the morgue, and I left work at work for that very reason. It protected me. It sounds cold I suppose if you’ve never been there, but sometimes calculated indifference is the best thing you can offer for the longevity of your vocation.
But I couldn’t leave him behind, and I couldn’t forget about him and his darling little Missus I had wanted to bring home. I went to bed with prayers for them on my lips, and I awoke with a strong desire to know how he was doing. I tried to push it away all morning long, using my time to care for my children, but he persisted at the back of my mind.
I suddenly knew why I was delaying the inquiry. I was worried he would be gone. I was worried my fears would be realized, and I knew that in my attempts to separate myself I had not gone and just held his bony, pale hand like he had asked. I would feel guilt, grief, and I just wasn’t ready for that.
I pushed it away as long as I could, but by lunch time I found myself calling work and asking for my replacement in his care. Please be okay, I whispered to myself as the on-hold music played, and I realized my left hand was clenched.
I don’t think words can express how I felt to hear he had pulled through just fine, and as I thanked the other nurse profusely I finally let my fisted hand relax. I started to chastise myself for my worry, and I was still surprised I had let it get to this. I had allowed him to become more than just a patient to me, but I realized then that it was okay. I was glad in fact.
Whether he had made it or not, whether he lived through the week, or made it ten more years, and even if he died that day, I knew I wouldn’t regret our interaction. It had reminded me why I do what I do, and even though it was emotionally stressful much of the time, it was because of the person behind the hospital gown that I existed as a nurse.
The person who was the patient, they were why God had placed me in the field to begin with. It was still necessary to separate myself to some degree for my own sanity, but there was also nothing wrong with falling in love with an elderly couple who had broken my normally solid shell.
The field was full of disease, but it was also full of healing. It was full of bad outcomes, but I also had the opportunity to see some really amazing miracles. It was riddled with negatively, but the positive situations were what really shined the brightest. It was true, there was a lot of death, but there was also life. There were stories of falling in love, gut-busting laughter, and wonderful relationships that reminded us why we became nurses in the first place.