Nurses and the Bigger Picture

Yesterday, as I was finishing prepping my patient for surgery, he looked at me and asked, “Have you ever had those days when something set you off early in the morning and it threw you off for the day”. I smiled, snickered and replied, “All the time”.  He told me that a night shift staff member had come into his room in the wee hours of the morning to do a quick procedure, one that he does for himself at home. He said the staff member really hurt him and that when he told her so and tried to explain to her how he does it at home so it doesn’t hurt but she was insensitive about it and didn’t want to listen to him. He went on to tell me that when he was filling out his menu order for yesterday, he ordered blueberry pancakes for yesterday’s breakfast. He knew he wouldn’t be able to eat breakfast because he was going in for surgery but said he’d look forward to warming up the blueberry pancakes when he returned to his room after surgery. He said while he was in the bathroom, a member of the kitchen staff came and took his tray, uneaten without waiting for him to come out of the bathroom to ask if he wanted to save the tray for later. He expressed to me how disappointed he was that he wasn’t going to get those blueberry pancakes. He also described to me on another occasion, during a treatment, he had to repeatedly remind a member of his health care team multiple times to be careful with a tube that was in his body.

This patient was an admitted inpatient that had come to my unit to be prepped for surgery. I’d taken care of him several times recently as he had developed a problem that required multiple surgical procedures. He always opened up to me about different aspects of his life. I liked him and I knew he’d been through a lot recently. Today, I could see it in his eyes. He was down in the dump and my heart ached for him.

Many things went through my mind as I listened to this man. First, my heart was filled with gratitude that he chose me to vent his frustrations to. To me it meant we had made a connection somewhere in the care I provided for him. From that point, I was determined to help him as best I could in this situation.

I thought about my own experience as an inpatient in the hospital and similar things that bothered me about that hospital stay. My son was born six weeks prematurely via emergency c-section because I was critically ill. Things happened quickly to deliver my son and it saved our lives. I remembered that my husband told me he could hear me screaming “Ouch you mother fuckers” from where he was standing in the hallway outside the operating room when they rammed the epidural needle in my back without numbing my skin or giving me any warning. I remembered throwing a terrible terrible phlebotomist out of my room in the middle of the night because his skills sucked and he was too rough with me. The morning after my son was born, residents coming into my room and ripping my bandage off my c-section incision, and then rolling me over, ripped the epidural bandage off and removed the epidural.

On that same day, my sickest day, I had a nurse that was a bitch from hell. There were many instances that day where she clearly lacked compassion when I needed it the most. I was sick and afraid. I was on a stretcher for 36 hours in a holding area outside of the operating room in case they had to wheel me back in to do an emergency hysterectomy. I couldn’t figure out what was more uncomfortable, my c-section incision or my neck and back from that stretcher. I tried so hard to keep my mind focused because the medication they were giving me made me feel so foggy. I can still see the look of disgust on the night nurse’s face when she relieved bitch from hell nurse and saw that I was still on the stretcher coming up on 36 hours postpartum. She put me on an egg crate mattress and in a bed and I slept six hours. It was the best sleep I’d had in days and that egg crate mattress act of kindness that will never be forgotten.

I was an RN for four years when my son was born so I understood everything that they were doing but that doesn’t matter when you are 28 with a premature newborn and both of your lives had been in danger. I had such a textbook case of Pre-Eclampsia and HELLP Syndrome, that every resident and student nurse wanted to get their hands on me. I felt like a slab of meat in a butcher shop. I knew exactly where my patient was coming from. That egg crate mattress for me was like the blueberry pancakes he was looking forward to.

I told my patient briefly about my experience with my son’s birth but more about a lecture we had in nursing school that I never forgot. My instructor was trying to teach us about giving patients a little bit of control of their care while in the hospital and making sure we remember to do the little things that are so appreciated. She expressed the importance as a psychological aspect of care and always advised us to look at “the bigger picture” when providing patient care. She shared with us that once she had a spider bite, developed cellulitis and had to be admitted to the hospital. She said the moment she put the hospital gown on, she flipped out because she knew she was relinquishing control of her body to the health care providers at the hospital and that was difficult for her.

I never forgot that lecture and after I returned from maternity leave I made sure that my care reflected remembering to give them some form of control over their care and to do the little things for my patients that made them human. Every patient deserves that. As for my patient yesterday, I gave him some suggestions as to how he can verbalize his needs for his care. After he was taken into surgery I called the nurse that was taking care of him on the floor. I filled her in on some of his frustrations, a little background information on him, enlightened her on his “bigger picture”  and encouraged her to give him a little more TLC. I hope she listened.

The moral to this story is, don’t forget to look at the bigger picture. We get so tied up with completing tasks because we are busy and many times in a time crunch, we overlook the simplest things that would put a smile on someone’s face, make their day just a little better and their situation just a little more tolerable.