A Valuable Lesson on Loss

Submitted by Rachel L. Norris, RN

Tags: independence Lessons Learned loss Manuscript patient care patient experience reflection

A Valuable Lesson on Loss

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I work for a rural home care nursing agency.  I received my assignment for the day, including an evaluation on a traumatic wound.  The patient was a ninety-one year old man who had recently been discharged from a Skilled Nursing Facility following a lengthy stay at multiple acute care hospitals.  His referral information included that he was in a bicycle accident in Boston three months prior.  This accident left him with multiple contusions, fractures, and lacerations.  He was in a full torso and neck brace and required assistance with most activities.  I could only imagine what I was getting myself into.  What normal 91 year old makes that 100 plus mile endeavor?

I entered this gentleman’s home, and found him typing away on his laptop.  Maps and old journals surrounded him.  He proceeded to explain to me that he was writing manuscript for the insurance company. He explained that the insurance company did not feel that his bicycle accident was a loss, because his insurance company pegged him as an 91 year old “senile” man, whom ventured on a 120 mile round trip bike ride from his home to Boston, MA and back again.  He told me that his insurance company thought that he was crazy, stole some neighbor’s bike, fell into a demented stupor and begin aimlessly riding the bicycle.

He looked at me with his sternly arched, bruised eyebrow and said, “You look young, and you have your whole life ahead of you.  If this would’ve happened to you, the insurance company would’ve appointed that a huge loss.  Not me.”  He explained the independence he has lost, never mind that this injury had put a damper on prime skiing time.

He then began to recount his multiple cross country bicycle journeys and skiing trips.  He was referencing his decade old journals, logs and maps to recount his adventures.  His goal was to prove to the insurance company that he chose to get on his bicycle that morning to celebrate his 91st birthday.  He even called the state police to determine any forbidden roads along his route.  He was following all the necessary safety measures.

I felt ashamed.  Prior to meeting him, I also had him pegged as irrational.  I looked up to his dining room wall and saw a photograph of approximately 30 people of all ages on bicycles.  There were even children with training wheels on their bikes.  In the center of the photo was my patient.  This was his family photo.

I was completing his visit and reviewing his care plan goals.  I then asked him his goal.  He sat stoic and serious for a moment.  He peered at me over his glasses, which rested gently on his nose.  He proudly stated, “you know, for my 92nd birthday, I think I may trek to the Canadian border.”  Normally, my nursing instincts would’ve kicked in and I would begin education on safety and disease process management.  Instead, I looked at this strong, proud, passionate man and knew he would reach that goal.