Submitted by The Birthplace at Telfair by Pamela J. Rahn, RN
I suppose there are many different reasons why people become nurses. Some do it for the money. Others do it for the prestige that is associated with it. But I think it is pretty safe to say that most people become nurses to ‘help patients get better.’ The irony of the situation is that most patients in turn ‘help nurses get better.’ Let me explain.
I was working 7pm to 7am in The Birthplace at Telfair-Post Partum Unit. As I approached my unit on this certain night, I heard the day shift nurses discussing patient assignments and expressing the need for someone with medical-surgical experience to care for the patient in room 347. For the purpose of sharing this story, I will refer to this patient as Jane. Jane had endured an emergency C-section the day before because of complications associated with pulmonary edema. Her new baby boy was healthy and settled into the newborn nursery until the time came when Jane would be well enough to care for him. Having had some experience with patients with pulmonary edema, I agreed to take care of Jane for the night.
Halfway through report, a family member came out and said that Jane needed to see her nurse. I explained to her that I would be Jane’s nurse throughout the night, and just as soon as we finished report I would come in and see her. Satisfied with my response, the family member smiled, nodded her head and returned to Jane’s room.
At the end of report, I had a much clearer picture of exactly how sick Jane was. There were a wide variety of things hindering her recovery. The following is a brief account of the most obvious problems. As a result of the pulmonary edema, she was having a hard time breathing. She was in a great deal of pain from having had a c-section only 24 hours earlier. She was nauseated and vomiting, rendering her unable to keep down pain pills. She was unable to receive medications through an IV because she had accidentally pulled it out earlier in the day. And the last complicating factor was that she had voided almost 4 liters of urine over the last 12 hours without the convenience of a Foley catheter.
Before I stepped into Jane’s room, I knew I had my work cut out for me. But more importantly, she had her work cut out for her. I went into her room to do a quick assessment and introduce myself, only to find Jane’s situation worse than I had imagined. She was slouched down in her bed, struggling to breathe and had just vomited all over herself and her bed.
I began by quickly introducing myself and telling her what I planned to do to help her. I explained that I would help her sit on the side of the bed first. Once she felt ready, I would assist her into a chair, because sitting up straight would help her breathe easier. Once she was situated, I planned to call her doctor and get a few orders that would, in my judgment, allow me to give her the best nursing care; for example, an order to reinsert her Foley catheter if needed, and an order for an injection of Demerol and Phenergan if needed. From there I would see how her condition changed.
I gave her a few seconds to comprehend all that I had just told her. At that point my plan became our plan because we were in this together. We then proceeded with our plan. With much effort, we managed to get her seated on the side of the bed at which point she began to cry. I was trying to recall everything that I had been taught about pulmonary edema so that I could do whatever needed to be done to facilitate her recovery. I was searching for that certain something that I could do to make her condition improve. As I stood there contemplating the situation, I felt an overwhelming urge to hug her. This feeling took me very much by surprise. Don’t get me wrong, I am a very caring person-but I suddenly found myself hugging this complete stranger that I had met a maximum of 5 minutes ago.
I thought to myself, “Boy, she must think I have flipped my lid.” At any rate, I held her as she cried, and I said to her, “You didn’t bargain for all of this did you? All you wanted was a baby!” She tearfully acknowledged my statement and remained leaning against me as she cried. I told her when she was ready we would transfer to the chair, and I would help her get cleaned up.
Over the next 20 minutes I got her situated in a wooden rocking chair, spoke with her doctor, received the orders, and got her cleaned up. We discussed our plan , and then talked about our options. I told her that we could reinsert the Foley if needed, and that I could give her a shot of pain medicine if she continued vomiting. Then I said to her, “ No matter what, I promise you will be feeling better before I leave here in the morning.” I don’t know what possessed me to say that, but evidently that’s what she needed to hear. Earlier she had appeared as though she was beginning to give up hope that she would ever be well again, but from this moment on she began to progress.
I returned to her room around 10pm to check on her and offer reinsertion of the Foley catheter. She said, “No, I’m feeling a little better. Can I just walk to the bathroom?” I agreed, and she did just that. Her sister and I assisted her, but she did it-the first big step on her road to recovery. Leaving the bathroom, I offered to help her to the bed where she could rest a little while. She refused stating she felt much better sitting up and would like to return to the chair. So, back to the chair we went.
The turnaround that Jane made that night was remarkable. By morning she was walking to and from the bathroom completely by herself. She was breathing easier, was free from nausea and vomiting, and her pain was under control. Before I left her that morning I had to hug her and tell her how proud I was of her. This hug was very different from the one that occurred only 11 hours earlier though. We had come to know each other. We had come to respect each other. But most of all, we had come to care for each other.
I had no idea how much I had learned that night until I had the opportunity to sit for a while and reflect on everything that had happened. I learned a lot, but the content was not quantity-it was quality. I knew before I went to work that night about pulmonary edema-its causes and treatments. I knew how to care for a 24-hour post-op c-section patient. Therefore, it wasn’t very difficult for me to combine the two plans of care and be able to successfully care for this patient.
What I learned that night was the value of caring, and the value of showing my patients that I care. By caring for Jane and showing her that I care for her, I was able to give her the encouragement she needed to begin her recovery. She was able to feel like she was not alone in this venture, and that I was going to help her get better. Unfortunately, the lesson that I learned that night cannot be found in a textbook. As important as it is, you must actually experience something like this in order to be able to appreciate its significance to the nursing profession.
Two days later I called room 347 to check on Jane. She answered the phone with such enthusiasm that I was unsure if it was her. Sure enough it was Jane, and she was packing up getting ready to go home. She knew exactly who I was and thanked me repeatedly for everything I did to help her get better that night. I just wish I could tell her how our night together helped me to ‘get better’ too. I truly believe I am a better nurse today because of Jane and all that she taught me that night.