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I knew nursing wouldn’t be a glamorous career, but I believed it would be a good fit because I loved people. Three years of college training and six months into my first registered nurse job, I discovered a glitch in my plan.
I really didn’t love all people.
I could easily love the grateful, the kind and the appreciative patients. Could I love the gentle-hearted and the soft-spoken patients? Slam dunk. And the smiling, the clean and the good-smelling patients? Check.
The dirty, the yelling, the vulgar, the disgusting or violent patients: not so much. Did I love the ones calling me names? That was a definite no.
Not only did these patients’ behaviors clash with my personality and disposition, they flat-out scared the daylights out of me. Many times I was either brought to tears, my hands shook while I provided care or I literally froze in my steps.
I transferred into the intensive care unit (ICU) thinking it would be a more rewarding department for me to work. I enjoyed the technology, the fast pace and the complexity of providing nursing care to critically ill people.
Three days into orientation to my new role, a woman was admitted into the unit after a drug overdose. She was combative, confused and angry. She was screaming obscenities and calling people crude names. Her hands were restrained but her legs were swinging and kicking at anyone in her range.
Her stained and ripped clothing and dirty skin told us she was homeless, or at least living like a homeless person. But the stench that filled the room was something so rotten I didn’t recognize it as an odor I had smelled before.
We quickly identified the source. Her groin area was covered in layers upon layers of maggots. It was unclear whether it was infection or disease or just filth attracting and feeding those nasty larvae. Her nurse, Sue, prepared to scrub her entire body clean.
As Sue’s assistant that day, I restrained the patient’s limbs, changed bath water, fetched more linens and emptied trash liners. For 2 ½ hours, Sue scrubbed. And for 2 ½ hours the patient screamed and yelled and kicked and spit. It was one of the most wretched things I had ever witnessed.
At one point I asked Sue, “Why are you doing this to her? She doesn’t want this!”
She told me I needed to provide comfort in a way that was truly comforting to the patient, not to me.
As I provided care to her, I learned. For this patient, it wasn’t going to be hand-holding, prayers or a soft pillow. It certainly wasn’t always going to be the "fluffy" stuff I learned in nursing school. We couldn’t change her life. But a bath would definitely make her more comfortable.
Later that night, I observed an amazing sight. She rested, comfortably.
We didn’t get a smile, a thank-you or even eye contact from this patient. But we did see her vital signs stabilize, her kicking stop and her body rest.
Almost 25 years later, I still remember this patient resting in her bed. She was the patient who taught me that if we look at humanity and do not see hope, then it is our job to put the hope into humanity.
She was the patient who taught me to embrace the humility of providing comfort genuinely appropriate for them.
Working with this patient helped me grow into the nurse I am today because:
It taught me that offensive odors can represent suffering. Following my nose allowed me to provide nursing measures that gave true comfort for incontinence, infected wounds, gastrointestinal bleeding, drug or alcohol abuse, mental illness, and financial instability. It’s a symptom, not the root cause. Judging the symptom isn’t helpful to either of us.
It taught me that I could make a positive difference in someone’s life even when I couldn’t improve their life situation or change dangerous lifestyle choices. To advocate for the patient did not mean I gave approval of their choices, nor did it put me in danger.
Learning this lesson allowed me to give respect to my stroke patient who was a federal prisoner, dignity to the prostitute dying of AIDS, and mercy to the drunken man with the pelvic fracture obtained in a crash that killed a grandmother who had five grandchildren.
It taught me that nursing was a messy job. There were days when I was up to my elbows in body fluids. There have also been days when I was knee-deep in emotionally charged family discussions or disagreements about where to place their loved one after discharge from the hospital. And I have even been in over my head with grief, at the tragic loss of precious children from accidents and illness.
Love for my job came from learning how to put hope into humanity. Determining the hope came from humbly loving everything about the patient, so I could truly care for and comfort them.
Nursing is definitely messy, but being willing to be in the trenches with the patient provides the intangible rewards for me to really appreciate being of service as a nurse.