Sutures
Submitted by Dana Oppenheimer RN, BSN
Tags: advice connecting with patients connections growth nursing experiences transformation workday
Life is a series of bridges.
I know this metaphor is difficult to understand in the context of the United States, where there is a severe lack of bridges. In Europe, bridges have become destinations—The London Bridge, The Charles (Prague), The Stone Bridge (Regensburg)— these are staples of European culture. These bridges are an integral part in the history of major cities, as they became the impetus for major trade routes over which culture and soldiers passed for centuries. They continue to make each city unique. There are even cities built entirely on water, like Venice and Amsterdam.
Bridges are movement; one side to another; a journey; a transformation; always with the other side in sight. Life is a series of connections we need to make, from one moment to the next; from one relationship or job to another. We all consider our lives a series of important events between which is filled random menial life tasks and chores. Bridges are the in-between part of life, how we get from one important moment to another.
But something we don’t often recognize is that the bridge is a moment in itself. The bridge can offer a completely different experience based upon what it is crossing or what it is made of. For example, consider your run-of-the-mill Indiana Jones Bridge. It’s made up of scrap material, maybe some old branches and boards held together by twine and roots. It’s always traversing some class five white water rapids or a spewing volcano river. While adventurous, the point is, I’d much rather walk across a sturdy stone bridge, preferably of the European stock, lined with beautiful statues and a tower on either side, just for some added drama.
That’s right, I am presenting the idea that every single day, filled with it’s mundane tasks can be made to feel like an extravagant early morning stroll across the mysterious and romantic fog laden cobblestones. Seriously, try and walk The Charles and not be inspired. But I digress…
I’m not saying brushing my teeth and taking the trash out arouse some passionately tender feelings in me. But I try and envision each day as it’s own bridge, with a glimpse of happiness on the other side. If I start thinking of my day as a bridge, instead of lumping entire seasons into one crowded crossing, I begin to value life a little more. I don’t know how, but it works.
"Wisely and slow; they stumble that run fast" Romeo and Juliet
I used to always think about the next event in my life as a series. First it was finishing nursing school, then it was getting a job, then getting married, then buying a place, then painting, redecorating, getting a new job starting a family, losing weight, growing out my hair. Ugh, makes me anxious just thinking about it.
Now, instead of thinking about each moment as an important life event and subsequently planning each step of that event, I think about each day as the only important event I need to think about. What ends up happening is that my mind creates a thought of what I need to do, usually comprised of one or two things (grocery store and oil change), instead of a whole list. I make a plan on when I am going to do those one or two things and then I move on from thinking about it altogether. Voila, life becomes experiential bliss. The rest of my day is free for me to do whatever I feel like or comes to me. Even when I have to work, its all about the one thing I might need to bring to work or get done (bring form, go to HR), and then I just go, letting myself experience the workday as it unfolds instead of planning out all the little parts of the day I have to get through.
“Finish each day and be done with it. You have done what you could… Tomorrow is a new day. You shall begin it serenely and with too high a spirit to be encumbered with your old nonsense,” Ralph Waldo Emerson
Okay so let’s bring this bridge concept back to nursing. Bridges are to life as sutures are to nursing (wow, that brings me back to my SAT days). Just as a bridge connects, so do sutures, pulling the banks of skin together, willing those two sides to become one. As a nurse, I am literally the communication bridge from patient to doctor— from illness to treatment. I am figuratively a bridge in that I am the creator of a vision— the vision of health that my patient will learn to work towards. This vision is sometimes a drastically altered viewpoint from what the patient has expected from the start, so I often have a to do a convincing job portraying that future experience for the patient.
Once I had a patient that had been involved in a farming accident. He was from Nebraska and his right leg had been chewed off by a beet-picker (whatever that is). I took care of him for a couple of weeks, during which he had surgery to restore what was left of the muscle from his limb. He did well for a while after the surgery, but eventually infection reared its ugly head and he would need the entirety of his leg surgically removed.
This required a drastic perspective shift. He had always envisioned leaving the hospital with a limp and a less dense version of the appendage he had knowingly come to depend upon. Now, he was set with the task of envisioning a life on the farm without that limb entirely. How could he manage?
Enter: amazing healthcare team. Everyone involved in his care was working on the same task— doctors, physical therapists, nurses, all working to create a vision of his new life as a one-legged farmer. We created this image by showing him his new abilities: This is how you get out of bed in the morning; this is how you go to the bathroom; this is how you pick up that shoe you dropped. We also discussed the realities of daily life and how crutches and a wheelchair would figure into different physical tasks. We openly discussed how his job and family would be impacted. Eventually, mixed with the amazing courage of this man, we created a realistic life for this man to return to. We became the human sutures to his recovery.
As ‘every’ nurses, we need to think about the ways in which we enable the people in our lives to get where they need to be and experience life in a way that is bearable. This doesn’t mean we have to do anything heroic. I think of my husband, who takes the dogs out every morning, thereby giving me that extra half-an-hour of glorious Zzz’s that I need to feel refreshed and handle the day. These actions are small, but they are meant to help others get from one side of the day to the other— crossing by way of a sturdy form of Venetian grandeur, rather than a tree trunk.
Sometimes we will be required to do things that are extremely uncomfortable for us, or even scary, but they will still be simple in nature and they will always leave us connected to others in an unbreakable way.
In this blog, there are many stories about patients that I have had. But the most difficult times I ever had to take care of patients were people in my own family. These were individuals who I had met and come to know outside of the hospital walls. It is startling to see those people stripped of their clothes and hung out to dry in loose hospital gowns. You struggle with unfamiliar territory, the imitation lighting, the pale face.
My now-husband’s mom suffered from a rare illness called paraneoplastic syndrome. I helplessly watched as the disease relentlessly took all of her abilities from her. My husband and his entire family lost their entire world over a period of six-months, in which they were in and out of four different hospitals, countless procedures and hospital rooms. After her passing, they were left to put their lives back together, piece-by-piece, always with that large gaping hole reminding them of her absence.
During those last months she had to be spoon-fed by others. I spent several visits helping her with this task, but the one moment I will never forget was giving her last meal.
At the time, she was in a hospice facility, and we all were excited when she could muster up strength for some spoonfuls of sustenance— it meant there was something tangible we could give her, a way to help her, despite the horrifying situation. As my husband ran to Chick-Fillet to get her a shake, I stayed behind and started to feed her. As I spooned little puddles of Gatorade to her lips, she started to cry. Her whole body began to shake and the frustration of her muffled sobs marked her eyes. She had great difficulty talking, but she painstakingly told me that she was scared.
What followed was one of the bravest things that I have ever done. I told her with a firmness of belief that everything would be okay. In that moment, she and I accepted the absolute truth behind my words. She reached out for my hand and smiled at me calmly. She never spoke to me ever again, but I knew that moment was the ultimate sacrifice in everything I had ever learned as a human being. I let go of all the doubt and suffering I had lived and accepted as a part of life, and wholly consented that there was nothing to be afraid of anymore, everything would be okay. I did this for her, and, to this day, it is an unbreakable bond between us.
The thing about bridges is that once you have crossed them, they don’t cease to exist. The connections we make and the journeys we complete never leave us, just like scars from sutured wounds. It is the bridges that fill our lives with unforgettable moments and make up who we are.
Dana Oppenheimer is an endoscopy RN practicing in Boulder, CO. She graduated Phi Beta Kappa with her B.A in English Literature from the University of Colorado and received her Bachelors in Nursing from Regis University in Denver, CO.