Friday, June 11, 2010

In most jobs, the good must be taken with the bad. Sometimes it seems as if for every good moment, there are three that cause you to beat your head against the wall and ask yourself "why am I doing this?"

As a nurse, sometimes I care more about my patients than it seems like my patients care about themselves. We try to teach them healthy diet habits when all they want is something that tastes good. We encourage physical activity when they'd just assume be a couch potato. We attempt to ensure their safety, but as fast as we implement safeguards they find ways of circumventing our precautions. When we confront them with the risks of their actions, our patients sometimes feel their independence is being threatened, their judgment is being questioned, their autonomy is being shaken at its foundation.

Our emphasis on "patient rights" is sometimes detrimental to the patient. Yes, it is their right to leave AMA (against medical advice), but that could mean they die in the parking lot of a massive heart attack. It is their right to choose not to have their leg amputated, but by doing so they could end up with osteomylitis causing their death. It is their right not to follow our safety guidelines, but a fall with injury could result that places the patient in tremendous pain and perhaps threatens their life. But, as is often said around my workplace, they have a right to fall.

So that's the bad. And when you battle these issues day in and day out, often times with the same patients and the same families, whose independent streak is a little brighter than the noonday sun, it's tempting to say "if they don't care, why should I?" I've said it. Die. Kill yourself. You don't care about your life, why should I go to the trouble to care for you?

But then they say or do something that leaves you outside the room shaking your head asking, where did that come from? Like when they open up to you about a fear that plagues them. Or when they tell you about a dear family member long since passed away. Or when they tell you some story about their past that gives you a little glimpse into what made them who they are.

It's tempting to see our patients as little grey headed wrinkled people, permanently stuck in wheelchairs, with the little old people voice I learned to identify even through the drive through at McD's. (Automatic senior coffee from me if you sound old in the drive through and order a fish sandwich.) It's sometimes hard to imagine these people in fast cars, listening to the latest hits on the radio, chasing the elusive dollar and raising a family. No wonder they criticize the greens; they used to raise them and cook them for a family of 1o. No wonder they complain the chicken's not cooked right; they used to catch the live thing, pluck it, and make the best chicken and dumplings in the south, at least according to her husband.

And when you remember that, see them for something more than just a wrinkled body, you wonder if maybe you should care, even if they don't.

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