I’m counting it as a blessing that I’m able to see the good in almost every shift combination I work at the hospital.
An early? Oh it’s so lovely to be home by 4.30pm and have a slow, peaceful late afternoon and evening extend before me. A late? I love a morning at home – get up with the family, make breakfast, take Abby to school, potter about with my patchwork and chores then meander on into to work for a 1pm start.
A late followed by an early? Yes, I come home utterly exhausted after that morning shift that followed a late shift with just a few hours in between for sleeping, but it’s almost like getting 2 shifts over in 1 – bargain!
And even when there’s a long stretch of days before me – next week I will work 8 out of 9 days – 4 days on then 1 day off then 4 days on again – I remind myself, with such gratitude, of the lovely days off that will follow. That’s right … I am such a Pollyanna :-)
Mind you, my Pollyanna skills have been put to the test this week with the rather dismal breaking down of our car. Our car will be with the mechanic for the next week and when we pick it up, we will be almost $3,000 poorer. Ugh! That means rides to and from the hospital on the back of Julian’s motorbike, and when he isn’t around, looooong,stuffy, motion sick inducing tram rides.
But then, this afternoon, home from an early and sitting in our back garden with my knitting, a cup of tea, a brisk autumn wind and the late afternoon sun, then later inside preparing supper, I was thinking about the patients I cared for today and realised with a jolt that I needed to practice a bit of what I had preached only a few hours earlier.
In turn, this gave me the opportunity to reflect on my last 10 weeks or nursing, of all that I am adjusting to, the practical experience I am gaining as a nurse, and importantly, how I look at and listen to my patients each day, and how this shapes my relationship with them.
Throughout my degree, we were constantly reminded that each patient we care for is unique. That our nursing and communication with them has to be guided by their individuality and their needs. Whilst I always believed this as a student, it was not until I was standing in a room with four utterly different people before me that I appreciated this.
And I have to add, that in the first few weeks, the whole experience of nursing as a new grad was so indescribably overwhelming that I was probably more focussed on getting all the obs done, all the medications delivered, and actually making it to the end of the shift without having a nervous breakdown than to really notice who my patients were and how best to support them.
This last couple of weeks – things are getting a bit smoother. There are still moments of panic and things that I simply don’t get done and have to hand over at the end of my shift to the nurse taking over from me. But today I was able to tick off each of the tasks on my planner AND find the time to appreciate who each of my patients were and try to meet more than just their physiological needs.
It’s a humbling experience, let me tell you. So I thought I would share just a few of the things I try to practice each day.
Most of my patients are quite old and have several things going wrong for them. Each person deals with this in a different way.
Some are cheerful and make funny little jokes which remind me of my grandad. These patients have an inspiring outlook on life – philosophical about where they are, full of gratitude for what they’ve had, and cooperate with everything you ask them to do. Without fail, each of these patients I’ve met, come from families that share so much love. They speak of their partners and children with such love, appreciation and joy. They want to be at home with them. They look forward to what time they have left, no matter how short or compromised it may be. I so look forward to seeing these patients each day. And with every laugh and little story we share, I am reminded of the incredible power of love. Of how rich love makes our lives and how much it nourishes us. And so, when the shift ends and I am at home, I remember to focus on love ’cause that’s what will make everything else happen.
Other patients – especially when they’ve lost a lot of their independence – look up at me with angry, confused or distant eyes. I totally get this. Being very ill and coming towards the end of life can be horribly undignified. And I’ve noticed that this is even more so when English is not that patient’s first language. I can only imagine how isolating that must feel.
Accidents happen. Bodies need washing. And sometimes all these patients can do is lay there staring up at us, at our mercy, as we roll them from side to side so that we may change their pyjamas and sheets for the 3rd time in as many hours, push pillows under different parts of them in an effort to relieve the pressure their poor old bodies are under, and pull them up the bed so that they may breathe easier. At these moments, I look into their faces and try to imagine who they were before their illness took over. Who they were when they were younger and fitter. What these eyes before me have seen and loved.
Illness does not define a person. Nor do tired and broken bodies. Inside what we see on the bed before us, is a person who has lived – had passions and ambitions, created a family, worked to support them, enjoyed holidays with their partners and children, laughed over family dinners, been enchanted by the arrival of grandchildren. Keeping this at the front of my mind as I care for these patients, really helps me find every bit of compassion and love I have, no matter how awkward or unpleasant the task at hand may be. I hope they feel this.
Other patients are much younger and yet are confronted by very serious illnesses and a future that is full of medical intervention and uncertainty. These are the patients I truly have to listen to closely because it is their experience, not mine, and I need to make sure I am very sensitive to this.
Some of these patients have experienced a life so completely different to my own and can be a bit difficult to care for on a psychosocial level. They might not take responsibility for their own wellbeing and no matter how hard we try, make very little progress. I can’t imagine what it would be like to walk in their shoes. So I listen. And listen. And then listen some more. I imagine them as they were when they were little and wonder what forces shaped them, what they struggled with. Some might think this is naive – or even patronising – as adults make their own choices in life. Yes, that’s true. But as Abby would describe it, there’s always a back story somewhere. Working to catch a glimpse of that backstory gives me patience and empathy. That goes a long way towards creating a rapport and caring relationship with someone I have so little in common with.
Other patients are terribly anxious and afraid of what might come next. Again, it’s really important to gauge their approach to life and what’s important to them. For some, they’ve rationalised all of what’s before them according to their belief system and simply need to be listened to with compassion and respect. No point sharing Pema Chodron with someone for whom control and structure is essential.
But yesterday I cared for a patient who was so very anxious and it became obvious a bit of Pema could be comforting. So we talked about understanding that some things are just beyond our control and thus, letting go of them can actually help us feel a little less uptight. We talked about how we can choose how we respond to situations – we can be overwhelmed by them or look at them as another step on the journey. We laughed at how this choice might feel a bit contrived at first but how with practice, it can become easier and feel more genuine.
And I shared a strategy that I find really does work for me … that the experience at hand – be it life changing surgery or a broken down car – might feel horrible and overwhelming. It might make us feel anxious, our stomach tied up in knots, our breathing faster, and make it difficult to think of anything else. But we don’t need to turn these feelings off. They are what they are and are a perfectly reasonable response to the situation at hand. Instead, I try to acknowledge these feelings – just sit with them – and then remind myself that they won’t hurt me and sooner or later, the experience at hand will be resolved and the feelings will go.
My patient really liked this idea and shared later that it had helped make their day a bit more bearable. Given all that is standing before this patient, and all that they’ve been through, it was very humbling that something I shared had made a difference.
So you know, a broken down car is just what is happening at this moment. It too will pass and life in Bootville will return to normal. Shifts will be late and early, stressful and rewarding. Weeks will be long. But there will be lots of love. There will lots of time with my family. Dreams and plans will continue to grow. Suppers will get cooked. Jumpers will be knitted.
And just think of all the moments I have before me to grow in experience and knowledge. All the fascinating and lovely people I will meet and care for. All the opportunities I will have to give. All the times I will stumble, fail and learn.
This nursing life is a rich one indeed.