Wednesday, January 12, 2011

Reassurance

I love working in the ER. I really do. The chaos, loud noises, knowledge base required and crazy scenarios are what I most enjoy. Sometimes, though, I feel like I don't quite get the opportunity to interact with patients on a basic level. Sure, I can give them pain meds and talk while I'm assessing their mangled leg and reassure family members before we do a conscious sedation to reset that mangled leg...but in all the craziness it just isn't possible to give as much time to each patient as I would like to.

So the other night, when it was shockingly slow - only four patients in the ED for more than an hour - my attention wandered to the patient belonging to another nurse. I had overheard the staff talking earlier; apparently this patient was related to one of the more prominent administrative peeps in the hospital, and they just didn't know how else to help her. This patient also had severe, advanced early-onset Alzheimer's. The patient was waiting for a social work consult in the morning - but even though she had been reminded of that many times, the patient had no idea she was waiting for that social work consult. She also happened to have been PC'ed by the doc, so security was sitting with her.

Since it was the wee hours of the night, and dementia robs people of the ability to critically think or analyze a situation logically or even remember what situation they are thinking about in the first place, she was starting to get very anxious. She started pacing back and forth, going from bed to chair to doorway and back. Security kept getting gruff with her, telling her to sit down and stay on the bed.

Now this lady had been in the ER for 8 hours already...I'd be pacing too. She kept getting more anxious, and security kept getting shorter with her. Her primary nurse happens to be someone I like personally but detest as a nurse - she is lazy, preoccupied, and would rather go take a smoke break than talk to her patients. The primary had also been complaining about this dementia patient, since her agitation was preventing a long and relaxed lunch break. So when the lady wandered to the doorway for the umpteenth time, I walked up to her.

"I have to get out of here! It's so late, and my husband just died and I don't know what to do..." She rambled and paced, so I offered to take her for a walk.

And we did.

We circled the pod hallway at least ten times. How else to comfort someone whose husband has actually been dead for a decade, yet who is experiencing the grief as if it were new? After a dozen laps, I asked if she wanted to do another. "No, I think I want to go lay down," she said.

And she did.

She went to sleep for the next three hours, until change of shift. She woke up when dayshift staff came out, and so I went back up to her to let her know about the social worker coming in soon. She climbed out of bed and gave me a hug, and started crying. "Thank you, and please tell my husband that I'll be home soon," she said. "And also, you smell very nice."

I am glad for this slow night, for the chance to be able to be there for someone. I didn't need nursing school to do what I did. It required no critical thinking, no med knowledge, and no IV skills. I didn't titrate a drip, or do an EKG, or keep an eye on the cardiac monitor. But I think it made a difference to that lady, just having someone who was there for her, to hold her hand. And that felt real great. I felt more like a nurse in that short time than I have in the past few weeks. Even though, in six hours, she will forget I ever existed.

And let's be real...it's always nice to be told you smell good.

8 comments:

Filia Dei said...

Good job girl. Nursing is hard work. I'm glad you got an opportunity to feel the fact that you really do make a difference in people's lives.

Lais said...

And that is what make you such a great nurse... your compassion. I admire you and so happy to see that there are nurses like you around. As a nurse myself and with history of working with dementia/alzheimers pts, I always took the chance to just be with each pt and just talk to them. And yes, they will forget about who you are but I know deep down inside they appreciate that time you give them. :)

AtYourCervix said...

So very nice that you were able to have a genuine feel good moment, when you normally have the "get em in, get em out" crazy patient assignments. I live for the moments where I can actually feel like I made a difference, even just for a short period of time, in my patient's life.

Zazzy Episodes said...

I like stories like these that make me want to keep going through my nursing endeavors. Keep up the good work.

Nick and Kaley said...

you do have a heart tin man!

Me said...

I'm the DON of a 120 bed SNF, and we see this all the time. I probably could amend that to "most of the time" quite frankly. You really did a wonderful think for that patient, although I don't know if she came from a SNF.

Nurses and CNAs in my SNF are amazing at what they do. Redirection of behaviors and anxiety is one of our core skills. This is one area where CNAs shine, and have a lot to teach nurses. They re-direct males and females with anxiety into "office jobs" (which they held prior to retirement). They sort, group, file, do simple math--on collections of paperwork that activities has made up. It's amazing how calm they become, and the satisfaction and pride the exhibit when they return their "job" to the Unit Manager. I could go on and on, but just wanted to say again, what you did for the lady you posted about was a wonderful thing.

Pissed Off Patient said...

Lovely story.

Thank you for doing that.

M

Gabe said...

Talking, connecting to patients, educating them, all things we were taught in nursing school. Too bad there is little opportunity to do these things in reality. Which is exactly the reason I will be eventually leaving the crazy hectic world of ER nursing.