Thursday, January 19, 2012

The Big Picture

Parts of ER nursing are still really difficult for me to deal with. Twice today, I had to clean up the pieces after patients were given some very bleak diagnoses. Sweet people. People who thought they were coming to the hospital for minor emergencies who found out otherwise. Turns out, this cough looks like pneumonia that's probably secondary to AIDS. Yeah, this headache is a brain tumor. Trying to hide the fact that I'm crying when saying goodbye after someone looks me in the eye and tells me I'm a great nurse just because I wiped their tears away and brought them a sandwich.
But in combination with other things, it's almost intolerable. The enraged patients who are upset because they waited so long to be told nothing is wrong. The one that swore and screamed and threatened to sue because the million dollar work up was all negative (side note, she knew her body). The ones using their immaculate, cancer free brains to think of what to say to get more Dilaudid, yelling obscenities at us at the top of their healthy, well oxygenated lungs on the way out the door to go home to their families that they will spend several more pain free decades with.
The juxtaposition kills me, but the truth is that most all of us, myself included, are walking around on and breathing with tons of precious gifts that we never acknowledge. I've been bummed out about my ten year old car breaking lately. This morning I'm just thanking God for my pain free body and my kick ass cardiopulmonary system. Not everyone got one today.


  1. I am a firm believer that the real challenge and test of character in nursing is after taking care 50 high maintenance ER patients... that you can still have empathy... compassion... and grace when you get the honor of taking care of someone who's life just changed forever.

    From the looks of it... you passed.

  2. Your grace and humility inspire me more than I could ever write in a silly comment here. Thank you for what you do.

  3. Thank you for all you do. I wish someone like you was the one to tell me I have what I have. I, also went to the er with yet another kidney infection, now almost 2 years later I am dealing with CRF. Thank you for being so kind and caring. There are still some patients that appreciate what you do from the bottom of our hearts.

  4. Ditto! My daughter still remembers the kindness of the nurses who cared for her when she was in the ER w/meningitis (and as a scared mom, who is also a nurse but a very scared nurse/mom that day--all turned out fine)...what you do DOES matter, to so many people, many at such a terrible time in their lives.

    Counting my blessings!

  5. My husband died of pancreatic cancer over 2 years ago; the first (and throughout, the worst) symptom was constipation and low motility. I still think about it EVERY TIME I take a dump, how lucky I am to be able to just sit down and do it! How lucky we are!!

  6. It is SO difficult to deal with the whiny, entitled idiots in this world - I'm struggling with it myself. Thankfully, catching flies with honey rather than vinegar really does pay off usually. And you can respect yourself in the end because they can't say you were an ass. However, most importantly, you hold onto that sweet little self so it can be used on and most appreciated by the patients that truly need it.

    Just today, had an old man with a DNR and a whole mess-a cancer get admitted for weakness towards the end of a VERY hectic awful shift. He and his son were the nicest people. And 5 minutes after I dropped him off on the medical floor and left, he died. All I'm hoping to get out of that right now is that he died with his loved one there, and a nice clean comfy bed, and that he wasn't saddened by his care in the ED!

  7. Sometimes seeing others around us helps us to stop and look at how good we really have it. That and how in the blink of an eye everything can change.

  8. There's no crying in baseball, newbie. ;-)

  9. Great post. One of the hardest parts of life in medicine can be dealing with the people who don't appreciate what they have amongst the people who have had everything taken away from them. Life is cosmically unfair at times.

  10. I know I am coming late to the party, but this post meant a lot to me.

    I was lucky enough to have my maternal grandparents live with us as long as I can remember. My grandmother was a polio survivor who had crippling arthritis and assorted other health problems and my grandfather was injured in WWII, which led to rheumatic fever which necessitated a mitral valve replacement in his 50's ... he had a massive stroke after that and never regained the use of the right side of his body. (But that itself was a miracle - the doctors said he would never be more than a vegetable.)

    But my grandparents traveled the world! They used to take me and my 2 younger siblings on RV trips across the US and Canada every summer - they were the adult supervision we needed and we were the army of arms and legs they needed. They packed up their special electronic carts and got out of the house every day. My grandfather could fold a fitted bed sheet Martha Stewart perfect using only his left arm and teeth. I learned from the moment my memories started: where there is a will, there is a way and be grateful for everything you have, because many have less.

    Through my 20's I had a visceral reaction anytime someone would get all defeatist or act like a small problem is the end of the world. Especially when my grandparents were both at the end of their lives and suffering terribly but still taking it all in stride. The number of times I wanted to punch people's teeth down their throats for complaining about stupid crap ... I pat myself on the back for getting through my 20's without a body count.

    A few years ago, my marriage ended - my ex was suffering from mental illness he refused to treat with anything that wasn't booze. Comments from people I knew about "stupid husbands" who forget to put down the toilet seat would make me want to scream in their faces "oh yeah?!?! Mine forgets to use the entire f'ing bathroom sometimes! Try that one on and see how you like it!!!" "Oh, your husband complained when you told him he has to go to dinner at your mom's next week? Mine threw a table at me." I would hear complaints about such comparatively small things and it hurt my heart - I would have given anything to trade "problems."

    And then I got some perspective and it has really saved my sanity. I met people who would have traded my problems for theirs in a heartbeat. Every day I can put both feet on the floor, draw breath and rise up to start another day I am doing a hell of a lot better than a lot of people.

    I learned to feel grateful that my friends and family had no idea what it was like to live through the end of my marriage - it was lonely, but because I love them I am glad that they have no idea how good they have it - I wouldn't want any of them to know firsthand how bad it got for me which was a hell of a lot better than a lot of people have to deal with. And I speak up sometimes - when someone is tweaking over something dumb and being especially obnoxious about it, I like to point it out "If having to ____ is the thing that is upsetting you the most right now, get down on your knees and thank whatever deity you pray to for your charmed life!!!"

    It's better for me like this. I spend less time contemplating violence toward whiny people and more time reflecting on how truly charmed my life is. Yeah - I have a lot of bills to pay ... but i also have a job, a bank account, eyes to read the statements and fingers to fill out the check ...