I had a great 24 hour shift. Although it started out busy with several cases, including picking up three new admissions and a complicated hand laceration, it was not busy for the rest of it, which was a little blessing. And I had great conversations with the night nurses.
We had a patient who was brought in by the police, after she had flown in from a village for medical appointments and needed imaging. She ended up going out into town and getting drunk and not showing up to her appointments. She was found walking in the street and brought in.
Sometimes there is a temptation not to treat drunk people or drug users or people who are mean or angry with the same compassion, dignity and respect that we treat others with. They can easily be ignored and looked down on, because at the end of the day “we can’t help them” and “they make their choices.” Sometimes drunks get sent out without hardly being seen. This patient’s medical care was never given because of her substance abuse condition. She also had a history of seizures, and was going to jail. The question becomes, how much do we do here and now in the ER, and how much do we expect the patient to take responsibility for their own healthcare? We ended up coming up with a compromise, taking care of her immediate complaints of chest pain to rule out anything dangerous and letting her go with instructions to return. I don’t know that she will…I don’t know if it was the right thing. Maybe we should have kept her and did more of a work up for the other medical issues that she was sent in for, although that’s hard on a weekend and they weren’t an emergency. I don’t know.
Following this, I had an amazing conversation with the nurses about life and one of the nurses said, “We are all just one misfortune away from being that person, drunk in an ER bed…You might be just one step of burying your daughter from being the person who comes in with thoughts of suicide, or one event of losing your job from being the person who comes in on drugs or drunk or angry.”
And he knows, because he’s been through it. He told his incredible, beautiful story about losing a twin daughter, and then losing his house to a fire, living in a motel room, losing his wife, quitting his job while working in awful conditions, and feeling that he was completely at the bottom, with nothing but desperation and thinking about ending his life. He is probably one of the most insightful, kind, compassionate nurses I have ever met. He talked about how what really matters in life is that you are happy. How so many of us choose things that don’t bring us happiness or make us feel unhappy. And how not only can we choose more things that make us happy, but we can also choose happiness. We can be happy right here, right now, just because we decide we want to.
He talked of kindness and compassion and what he learned as a nurse manager–how patients will never remember what technical medical knowledge that you told them, and they won’t recommend a friend to a hospital based on the stats of the hospital, but that they will always remember how kind you were. How you sat down with them at the end of the bed and placed a comforting hand on their shoulder. How you touched them in a real, true, reassuring, comforting way. How you greeted them with warmth and kindness. How you showed them they are dignified, important and worthwhile human beings. How you recognized that this is probably the most difficult, painful, scary moment of their life, and you eased the discomfort. How you treated them like you would want to be treated. He also talked of the holistic approach to healthcare and how it is just as important to treat the mind, spirit, emotional conditions as it is to treat the physical body. How sometimes it is just as healing (if not more in some cases) to have someone recognize and address your emotional pain as your physical pain.
I am so grateful for this night shift and the good reminders to practice with more compassion and kindness. I am also grateful I went to a medical school where our motto was “We also treat the human spirit.”
Like Patch Adams said, “You treat a disease, you win you lose. You treat a person, I guarantee you’ll win, no matter what the outcome.”
The Real Patch Adams, another hero