Time for a New Post...

Well it's late night but I've got some of that second wind energy left to burn... I just got off shift and I've been itching to put up a new post, but to be honest I just haven't had the time to sit down and let it all out. I feel like so much has happened in these few short weeks I've been working on the hospital, that when I try and recall a memory to put down I'm drawing blanks. I did experience the loss of my first patient a little while back, but I'd like to save that blog for a later time when I'm able to sink in to the emotions and really go back to that night. For now I think I'm going to stick to a little less solemn topic which we all feel the pain of on a daily basis... family members with limited understanding...



It's a difficult role playing the family member of a patient who is incapacitated or severely ill, I will admit, but it's especially difficult for you as a nurse, or even a human being, to interact with a family member who just won't seem to go away, or just doesn't get it. You know the one's who don't leave the bedside and if they do, pace just inches outside the curtan while you're in the room trying to turn the patient. Or how about the one's who nervously call every hour or so to check on the unchanged progress of their loved one? If you don't know them then beware... they're out there! And they're harmless, but don't they just seem to make your job that much difficult to do? I feel like I'm still green enough, and maybe even naive enough, to say that I haven't quite developed those calus's the older nurses might have in response to these certain people. And by calus's I mean an ability to tend to the families needs with enough compassion to keep them content, but also enough distance to keep your own sanity. It's almost in our job description to posess the ability to get close enough to really care for a patient and their family, but remain detatched just enough so as not to be drained emotionally with every new face. It's tough. It's truly tough to know when you've given enough, and when you're being cold, and being able to distinguish between the two is not something they teach you in nursing school. But it truly is a talent learning to deal with these people, because often we find that their lack of understanding or constant tampering with the patient and their healing is hindering the progress of that patient.

I've actually got two stories related to this similar type of topic, one happening tonight. General rundown... patient came in a few days ago because of a twisted bowel which was eventually resectioned. Pt was intubated, A line in, etc. etc... She really is a lovely person, but has a son no better than a gnat. He's just always around, which is great because it's so rare to find a family member so caring and supportive of their loved one, but he's difficult to deal with... he's just that typical "uh it's the patient in bed 4's son calling again" kind of family member. So much to the point that we had to ask him to stop being so physically affectionate because his holding her hand all the time was misplacing the location of the transducer of her A line. He needs to know every drug, needs to know exactly when this happened and why this happened, and if the head of her bed is elevated 3 degrees lower than it should be, he'll let you know about it.

How he made our job tough though, is because of something that happened today. The patient was in need of blood because of a low H and H, but was not willing to sign consent for the blood (nor was the daughter) and would not make the decision because only the son could. Now to me that seems strange considering it's her body (Hell if it was my body, I would have had them hanging the bag while I was searching my purse for a pen). But the son was just so up in his mother's business I almost felt like calling LDRP to come cut the umbilical cord. I thought the nurse I was working with handled him very well as she was inviting but very "this is how things are, you can't be doing this." I was really impressed... and her response to him is why I'm typing about the situation. The people on my floor have been incredible with family members, so much sometimes I'm surprised, but in my teachings I have encountered quite a few who fell very short of this standard.

I think it's extremely important to keep the perspective of that family member in mind, which is sometimes hard to do when our job requires us to be sympathetic, not empathetic. The way they teach us to practice almost sets us up for contradiction because we can't really embody the emotions of that family member at that time. We can't get tied up in the anxiety or the fear or the sadness, we need to be the people who keep it together for them and keep the medical perspective a reality. We can, however, keep that brief glimpse of what they're feeling in mind, and I know that when that person comes in through the door that's your dads age or your brothers age, you can't help but get a little bent out of shape thinking "what if it was them?" Maybe I don't have much of a point, but if anything try and take from this the reality that we can become cold and detatched at times and we can forget what it's like to be that family member. One of the most incredible things I experienced was when my preceptor cried with the death of our patient because of the recent loss of her father.

I can't tell you how to react to these people who unknowingly crawl under our skin because I'm not even sure how I'm going to handle them some day. But if you feel like maybe nursing has got the best of you and you're running with the crabby crowd, then reevaluate how you're dealing with these certain situations, and if it's not how you would want to be treated, then fix it. Worry about the things you can control.