Learning from Those I’d Least Expect to Teach Me Something

I had a patient, let’s call her Jane, who I was totally dreading admitting when I read her notes in the computer. She was in acute respiratory failure, refusing to do the treatments prescribed by the ED physician, and had a history of heroin use. I looked at these notes and dreaded the picture of the patient I had already drawn in my head before receiving report or meeting her. When she got to the floor I went in and started her admission paperwork and quickly realized what a phenomenal human being I was working with. She could barely breath, couldn’t talk because she didn’t have enough breath to form a sentence, and she was terrified. But let me tell you a little about one of the many patients who have taught me about the incredible capacity of people.

Not having enough oxygen will make anyone anxious, it’s just the physiologic response (I suppose it might be part of why humans still exist?) and her oxygen levels were at 86% when I got her. COPD, or chronic obstructive pulmonary disease, changes the way your body gets its’ drive to breathe. The “normal” way is that when your body has too much CO2, it will kick your respiratory drive up to expel CO2 and balance things out. In someone with COPD, their respiratory drive has more to do with the amount of oxygen in their system, so giving them too much oxygen can actually decrease their drive to breathe. Jane was aware of this and was terrified we were going to raise her oxygen levels too high and hurt her. She looked at me and begged to know what her oxygen percentage was, she was trying to tell me how important it was that we not get it too high. This moment truly broke me out of whatever bias I had carried into that room. I stepped away from my computer and went and sat at her bedside, I took her hand and looked her in the eyes and told her that I was going to take good care of her while I was her nurse. It’s hard to convince someone who can’t breathe to calm down, but a few moments of sitting and holding her hand, we worked through some of it together.

Jane had so many reasons to be anxious including being very ill, an opiate habit, and her husband died suddenly within the past month. I sat at her bedside and held her hand, I saw fear and sadness and desperation. As her breathing treatment began to take effect and she could breathe easier, she started to relax. Her fear turned to exhaustion. She told he how she hadn’t slept since her husband passed. She told me that the last time she used her prescription pain pills was 15 days ago, but she used heroin the day after her husband died. She told me that she was afraid she wouldn’t have a home in the next two months and that her utilities were too much for her to pay, and that she couldn’t always afford to go to the doctor when she needed to so she waited until now to come in. By “now” she meant she had to wait until she was septic.

Jane made me think about my response to a patient I read about on paper before meeting the person who comes to us for care. Someone’s background on paper can be so ugly until you meet them and realize how beautiful their soul is. I can’t imagine how heavy of a burden an addiction is to bear, but this woman was thoroughly exhausted and desperate. She didn’t want opioids during her stay because she was afraid of them. I had to hold her hand again as they drew blood for her lab work. This was not the woman I had drawn a picture of prior to meeting her. I’m still processing what that means to me, but it’s humbling and beautiful.

I once met another patient who found his wife overdosed in their son’s room. They had been sober together for two years before she relapsed. He went and bought a case of beer that day and couldn’t stop drinking. He came to us because he had no other option and knew he would die if he didn’t see someone. His son was taken from him and he lost his wife. Another patient was paralyzed at a young age and his mom stopped coming to see him in the hospital. Another didn’t believe the extent of her illness until she was intubated and eventually given a tracheostomy. She went from being independent to needing a ventilator to breath and couldn’t move her body because her muscles had atrophied so much during her hospital stay. These patients are among the many who don’t leave as strong an impression, but still affect me in so many ways.

I look at these people and I am overwhelmed by the lives that accompany the burdens of the decisions they’ve made, or the drugs they’ve chosen to use, the people they’ve chosen to love, and the lives they’ve chosen to live. I see through the choices they’ve made to the humans that lie under them and I am amazed at the beauty of the human soul. There have been so many examples of things that I did not expect to learn from nursing, and discovering the beauty that I see in these very ill, sometimes addicted, neglectful, grumpy patients has been one of the best experiences so far.

I’ll end with a man, Thomas, who tried to kill himself with a gunshot wound to the head. He survived and is now tracheostomy dependent to breath, has many pressure wounds that go down to the bone, paralysis on one side of his body, and needs 24 hour care to live. I’ve thought about him often. I can’t imagine being desperate enough to take your own life, and then being resuscitated to a life of breathing through your neck and paralysis. But during his admission he mentioned to me that if he can impact just one life with his journey his struggle will have been all worth it. I watched the love his caregiver put into washing him, and I was so blown away by the capability of the human soul yet again.

Finally a post about being a new nurse and trying to keep it together, but the more I learn the more I realize how unlikely it is that I’ll ever get all of these things into neat little places. These patients are constantly teaching me what it means to be human in the most beautiful way. I’m so grateful that I get to experience this part of life.

 

**Many details about these experiences have been changed to be as anonymous as possible. These experiences have been at different facilities in different states throughout schooling and work.**

 

Author: Trying to Keep it Together

Amanda is new graduate BSN, trying to figure out how to balance life as a new mom, a wife, and a nurse.

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