A 12-hour hospital shift makes for a full day, face-to-face with the most stark and immutable truths; yet the satisfactions are enormous. The war against disease, ignorance and despair involves endless lost battles and missed opportunities. People make mistakes, lose faith, trust bad judgment and reject sound wisdom. Bodies fail, minds waver and ebb, and hearts overflow or freeze with fear. Working in a hospital throws you right into the middle of that war, with all the adrenalin that war entails.
With the enemy confined to bed, it’s not a war that requires much travel; the combat happens in the space between clinician and patient, between comfort and fear, knowledge and questioning, hope and despair. The weapons are mostly words, backed up with the cavalry of therapeutic procedures, medications and other therapies that we level against the dreadful spectres of illness and death.
Today I was the assigned nurse for 5 patients, each of whom had his or her own story to tell. As I entered each room I had to pause and sweep my mind clear—because for this patient on this day I am the only nurse in the hospital, the only clinician with the specific charge of shepherding him through the wilderness of his own fears, the only fully-visible warrior in his army.
As I stepped into the room of the courtly elderly gentleman whose kidneys had surprised everyone by suddenly shutting down and leaving him to the mercies of dialysis, I had to detach from the garrulous, orange-haired woman of the same age who, next door, required my assistance to get to the bedside commode every few minutes as her intestinal infection raged against the antibiotics. My young father who had just found a non-narcotic solution to a decade of intractable back pain by having a spinal stimulator surgically implanted was grinding his teeth in frustration because the device had proved a magnet for infection and had to be removed. My Vietnam veteran, now nearly-bedridden with COPD from smoking and metastasized prostate cancer, had to give way to the sweet, albeit nonverbal woman who needed to get some dextrose added to her intravenous fluids so that her blood sugar wouldn’t drop dangerously low while she was too weak to swallow.
Driving in to the hospital before a shift is always a breathless time, torn between dread and anticipation as 7:00 a.m. approaches. Will the unit be understaffed? Will the patients be alert and oriented? Combative? Terrified? Dying? Will I be able to assume and maintain the right assortment of multiple personalities to suit each patient and their family members? Will I be able to remember which personality goes with each room? Will the patient I had yesterday be stronger or weaker today? Will the doctors listen to me? Will I remember everything I need to remember and document everything that I did? These are the questions that shape our approach to every day that we work, and that engage us until the moment we clock out.
The joy of nursing is that it strips away the barriers between people and leaves us in the most human of situations—the strong helping the weak. We get to laugh with our patients, and to embrace them. We defuse the crippling chains of embarrassment and dispel fears with words of encouragement and clarification. We bring giggles to the lips of the frighteningly ill, and peace to those whose battle is nearing its close. There is no substitute for it. It wrings our hearts because that’s what hearts are for. It taxes our minds and makes our backs and arms ache because we are made to help one another regain our strength and independence when we are brought low. Nurses are not made accidentally. One doesn’t end up doing this on a whim or by chance. We do it because we get to see the battles first-hand, to fight on behalf of those too ill or weak to fight for themselves, and it fills us with life.
As I sit here with my glass of wine and my weary feet, I can’t think of any more rewarding way to spend a day. Sisters and brothers who were nurses with me today, sleep well. We earned it.
©Mary Braden 2013