As a new nurse, I am always running, my brain whirring, trying to anticipate the next step. In the beginning, I had plenty of time to learn my patients and know them fairly well (at least well for a brief ER interaction) but now as I grow more adept with my few patients, I have been taking on more patients, and more. It’s hard to know them as well now, often, just staying on top of their medical case is the best I can manage. Sometimes I yearn to spend more time with just a few patients…respond to all their “real” needs as well as the self-professed “real” needs, instead of triaging their professed needs myself. (For example, bleeding wound=real need. Fix it: clean, gauze, tape, presto-donezo. While, “I’m starving, I haven’t eaten in 18 hours, get me some food now,” is not a real need…I am sorry but it’s not, when the guy in the next bed is bleeding.) I want to respond to all needs equally, which is simply impossible in the ER. I have to make snap decisions, which clearly doesn’t please everyone. The flip side of wishing that I only had a few patients, is that obviously there are some patients that you would much prefer never even crossed the threshold… Luckily, there haven’t been many of those.
Sometimes it’s impossible to miss a special moment though. Yesterday, I had an elderly patient with a laundry list of geriatric problems — Alzheimer’s, Parkinson’s, new onset seizures, the works. Oh yeah, and probable pneumonia on admission. The wife (who looked much better, I might add, and at least 10 well-preserved years younger) claimed that her husband, on a better day (pre-pneumonia, I imagine) walked around the house a little bit, and even spoke occasionally. Pretty incredible to believe from what I saw lying on the stretcher. Nonverbal, limbs contracted inwards, shivering and weakened by illness, he was a full workup waiting to happen. He was in my care all day, while being screened into the ICU and then waiting for a bed to become available. While we drew labs, waited for results, started broad-spectrum antibiotics and gentle fluids, and periodically changed his sweat-soaked sheets, I watched the wife interact with her feeble and febrile husband. He never spoke, but she spoke to him and seemed very certain of what he needed at any given moment. She, dressed in a smart red suit with perfectly arranged hair, sat at his bedside for hours upon hours. And this is no private room either. The ER is full of incessant beeps, whistles and alarms, combined with a cacophony of human-emitted noise – complaints, moans, the works. It can’t be pleasant for a patient or a family member (not that I particularly care for it, either). Yet, she calmly and gracefully sat by his side and thanked us for all the care we provided, not once blaming us for the slow pace of diagnosis and admission to the ICU. At regular intervals when I checked on him, she would be stroking his forehead whispering gently to him, or rearranging his pillows and blankets, or spoon-feeding him miniature bites of applesauce. It nearly brought tears to my eyes, such tender and private interactions that I witnessed as my patient’s nurse. These are the moments that I live for and that I strive to reproduce as a nurse for my patients that have no one at bedside. If this patient had been all alone, I might not have known a single thing about him other than the details of his illness. But with his wife at bedside, I learned that he had someone who loved him dearly, and he probably loved just as tremendously in return. Learning these little tidbits reminds me that my patient is also a person, with a story all his own beyond the hospital stretcher. On a busy day, there isn’t often time to find out the stories of every individual, but it’s important to remember that they all have one.