A Thousand Firsts

I recently mentioned to one of my fellow nurses that I loved being a teacher because I could have the same experience for the time a thousand times. Teaching and performing even the most basic of skills never gets old. It's so much easier to remove surgical staples when you get to do it with somebody who's so excited about it you know they'll be talking about it for days to their roommates.
This week it was a little different however. One of my students experienced her first death. The patient was a middle aged Chinese woman. Cancer had caused her body to waste away so that she looked like a skeleton with skin lying in the bed. He husband was so attentive, he had been at her bedside for days.
I had gone in to see this patient a few times and had had a brief discussion about end-of-life care with my student. On Friday morning as I was assisting another student with IV medication, I saw the first one standing outside the room. I quickly finished with the medication and went out to talk with her.
Tears streamed down her face as she told me that her patient had just died. "She hadn't taken a breath for several minutes so I listened to her heart. I could faintly hear something at first but then it just faded away. What do I do for her husband? Is it OK to cry with a family? I'm trying to pull myself together..."
Yes, unfortunately as a nursing instructor you experience death a 1000 times for the first time too. They ask questions like: "Why did this happen? What will they do now? This just doesn't seem fair. It seems odd that in a few minutes I will have to see my other patient in another room and carry on like nothing has happened when I know their whole world has changed."
All my "teacher words," no matter how true or how profound, can't take away the pain and shock of losing your first patient. So there we sat in the break room behind the door. After few minutes of sobbing and a bit of talking, she fixed her makeup and went back into the room just in time to help her husband dress her in a beautiful Chinese robe before the rest of the family came to bid her farewell.

There's and App For That?

This morning while traipsing across the hospital I noticed signs announcing the new Da Vinci surgical system that had just arrived. The sign said that they would have the machine on display for demonstration in the hospital lobby this afternoon. My nursing students are on Medical/Surgical rotations and are rotating through the operating room. I thought they would be excited to learn about the new system so I snuck downstairs and asked the company reps if I could bring them by. Of course the reps are excited to talk about their product to anybody who will listen so they had no problem with it.
I arranged for the students to meet in the lobby for post clinical conference. They played with it for a few minutes and managed to complete the tasks of displacing and replacing a series of rubber bands on tiny cones in a matter of minutes. My one and only male student says, "That's cool, now what are we doing?" Another one says, "There's an app for that!"
A quiet Chinese student just stands staring, "This is the cool thing you wanted to show us? I'm shuddering as I picture all the video game geeks becoming surgeons."
Well, you win some and you lose some... I let them go home a few minutes early and I stayed the extra time to play with the "robot surgeon."

Peanut Butter Milkshake and a Walk in the Park

A peanut butter milkshake and walk in the park, those were my "self care" activities of choice following my phone interview for the WSU PhD program this morning. I had been dreading that interview for over a week, why couldn't I just drive to Spokane and do the interview in person. It doesn't matter now... at least it's over.
Since for some odd reason I don't have a phone in my office and the functionality of my cell in this building is rather dubious, I used the dean's office to make the call. I think in some ways sitting at his huge desk surrounded by all of his post-it notes to self and numerous degrees made the process more intimidating.
Now we wait...

Ineffective Individual Coping on Whose Part?

He came to us around Thanksgiving, he was on death's door. Mr. Jones (not his real name of course) had been dealing with a congenital heart abnormality all his life, and now at age 50 something it was catching up with him. I remember the evening he came us. With his breathing and circulation were controlled by machines, it appeared that his only hope was a heart transplant.
After several days in intensive care, Mr. Jones recovered enough to breath on his own. His prognosis was starting to look a little better. It wasn't long, however, before he experienced another setback, a massive stroke, a major risk for patients with ventricular assist devices. By Christmas his brain function was very minimal. Even so, his wife Sue, faithfully sat his bedside. Because she wouldn't "pull the plug," some of the nurses had her pegged as "in denial" and gave her a nursing diagnosis of "ineffective individual coping."
I found myself as his assigned nurse on several occassions. On the days I wasn't too incredibly busy I chatted with Sue as I changed dressings and IV lines. I found out that she was a high school language arts teacher, that she was a mother of 3 young women, that she had met Mr. Jones while they attented college in Canada... I found Mrs. Jones to be a very pleasant woman with a great head on her shoulders who just happened to be going through a very difficult time.
Last week I was assigned to a different hall. I was charting and watching monitors when Mrs. Jones walked by. We greeted one another in passing and I asked how she was doing. She told she that she had decided to see a counselor as a way of taking care of herself so she would have someone to talk to. "I'm doing it to be fair for my girls. They are already greaving enough over their father, they don't need to worry about me too..."
She told me about how when she went to meet with the counselor, she noticed that the counselor seemed uneasy. "So basically you're greaving over your husband before he's even dead?" Mrs. Jones was a little surprised by this unexpected response from a "mental health professional" so responded to this remark by asking, "You don't like me, do you? Am I making you uncomfortable."
The counselor responded with this: "I don't like myself when I can't help people."
Wow, that really hit the nail on the head. It isn't Mrs. Jones who has the "ineffective individual coping."
"I'm trying to keep at least one foot in real life. I want to do what's best for my girls and those I have left," she said as we finished the conversation and parted ways.