Thoughts from the bedside after a long night shift

My mother has bad feet. This is because she rarely gets off them. And so I sit - to chart, to tie my children's shoes, to visit with a patient. I've learned that sitting - the actual sitting part is key - with a patient is often the most therapeutic intervention I can offer in a 12 hour shift. When I enter the room, and I see a damp cheek, or glistening eyes; sense the reticence in the air as the person in that bed tries to hold themselves together while you measure vital signs and trade small talk. I'm not a fan of small talk, and measurements tell me much less about that person's health sometimes than a good chat can. I pull up the hard hospital chair, pull it close, and often reach for my patient's hand.


Last night, a stoic Scandinavian spent 10 minutes talking about the weather, her grandchildren, and her favorite card game before her eyes moistened and we got down to business talking about her looming cancer work-up. We cried together, her apologizing for taking my time with her worries, and I lamenting that I could do nothing more for her than accompany her in this pain. In that moment was a bit of the "silver lining" to my own cancer battle: I can say to that patient, "I have been in this space you're in. I know how difficult it is to want answers and find none. I know what it is like the first time you stare your death in the face." It really sucks that one of the main reasons I can figure for my own suffering is that it allows me to deeply empathize with patients going through similar trials! I wish I could say this to a few students I helped through hard times during nursing school - someday you will be glad you went through this, if only for a brief moment. It redeems some of that pain you've gone through when you can ease the pain of someone else because of it.


Back at the station, I was charting furiously and listening just as intently. I hear it all the time - this patient really should take better care of themselves. That patient should never have let it get that bad. Why is this patient so filthy? Why is that patient so addicted? The truth is, caregivers are as human as their patients, and cleanliness and good manners will get you gold stars in the hospital halls, too. If you haven't suffered much, it's hard to imagine not being able to wash your own feet, shave your own legs, not to mention those poor souls who can no longer clean themselves after toileting. Yet very few of those patients are dirty because they want to be. Whether they are hampered by more visible impairments like limited mobility, weakness, and disease, or the invisible tethers of mental illness, chronic pain and fatigue, they did not obstinately refuse to bathe. No homeless person set out to be so. I've never met an uninsured patient on state benefits and food stamps who planned that out while they were in high school. Why do we have expectations of others, even when they're ill?


Nurses, caregivers of all kinds, pull up a chair, take time to know the person you are caring for this shift. Not the diagnosis, lab values you are watching for, or med that hasn't come up from pharmacy. There is a person lying there suffering - vibrant once, with passions and fears, all kinds of adventures to tell you of, things they regret they may be pondering right this minute. Those moments spent just talking have become the most treasured of my career.


And if you ever have to go the hospital, take your grandma's advice and ALWAYS put on a clean pair of underwear!