As you’re getting bedside report in your busy intensive care unit, your stomach starts to drop.
“54 year old female… full code… no allergies… here for septic shock from pneumonia… unresponsive… “
Your eyes fixate on the intubated patient, and you start to realize she looks like your mom. Your mom who is 700 miles away. You take a deep breath and tune out to the next minute or two of report. You’re trying to figure out if you can do this today. Is it worth it to change the whole assignment for the unit mid-report? You don’t want to bother anyone…
You take another deep breath and get your game face on, as you decide to try.
Report continues… it just gets worse. Mother of 4, two of which are flying in right now, the other 2 are in the waiting room. They can only handle being in the room for a few minutes at a time. Her husband is here too, which is almost worse to see. You’ve learned how to hold back tears in many situations as an intensive care nurse, but when men cry, all bets are off. Naturally, he has many questions, freaks out every time an alarm goes off, and constantly stays strong for his kids – but doesn’t feel like he needs to be strong for the nurses. The night nurse said he asked her quite a few questions through snot-filled tears when his kids went home to sleep. He can’t bear to leave her alone.
You secretly wished he’d go home for the day. It’s a lot easier to disconnect the dots when there are no visitors.
You’ve learned that family members are strong for each other, but weak for the nurses. That’s how it’s supposed to be though – we’re suppose to be there to support and absorb the pain to help you get through, help facilitate your grief, and help you make more informed decisions. What they don’t tell you though, is that after a while… it gets really hard absorbing everyone’s worst nightmare at just a normal day at work. It’s incredibly difficult to be everything to every patient, to change your mood and emotions instantly at the sound of a call light.
You meet and greet the family and a friend who stopped by, but decide to keep it short. Besides, you’ve got to draw a new set of blood cultures, a lactic acid, hand a new bag of IV fluids, grab a new bag of Levophed and Vasopressin, turn her, assess her, touch base with respiratory therapy, and document all of that.
You decide that focusing on tasks will be what gets you through the day. Maybe that’ll work? Just do short conversations with the family, keep it light, and dive into the tasks.. theoretically, that should keep your head above water and keep you from drowning in empathy.
The shift continues, and you’re pretty sure this guy hates you. You’re not emotionally present. You’re just getting things done as fast as possible and asking if he needs something as you’re halfway out the door. What he doesn’t know is that you’re holding back tears as you’re halfway out the door, because every time you look at his wife’s face, you see your mom… your mom who you haven’t seen in 4 months. Your mom who has supported you through everything, and who you miss terribly. Your mom… who, no matter old she gets, will always be your mom. The same mom who stood up to the sports coach who was really mean to you, who supported your move across the country even though you knew it broke her heart, and who hopped an expensive flight at the drop of a hat when you said you needed her… and never once mentioned how much it cost.
You want to disconnect more. You feel like you must just to get through the next 9 hours. You just want to say you’re sick so you can go home, then call and request never to take care of her again.
You want to, but you know you can’t.
Through the struggle of trying to speak and act normally with a huge lump in your throat, you remember something you read once about this… about how to deal with it.
Yeah… that’s it… gratitude. You start to think about how thankful you are to have had a loving and invested mom your entire life. You think about a few friends who aren’t as fortunate. You think about how her eyes squint when she smiles, and how happy you are to have inherited that wonderful feature. You think about how when people meet her, they instantly know she’s your mom. You think about how hard she laughed when you told her about the time a patient got poop on your face. You smirk a little. That lump felt like a mountain a few minutes ago, and now it’s starting to feel like a molehill.
You take some deep breaths, grab a snack and chug some ice water. You feel a release of emotions; the fog has cleared. A burden has been lifted.
You see him sitting at her bedside, peacefully looking at her. You feel ready now. Ready to do this. Ready to be there.
You walk into her intensive care room, put your hand on hers, and look at him with a gentle face as she lay there motionless…
“So, how long have you guys been married?” you ask.
He smiles, sits up, and starts to tell you all about this amazing person – his wife.
Have you ever connected so much with a patient that it made it difficult to practically care for them? How did you handle it?
The concept of responding with gratitude was adapted from from Dr. Brene Brown’s Book, Daring Greatly: How the Courage to be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. I highly, highly recommend this book.