Friday, August 1, 2008

another first

Today I saw my first body bag.

It was 7am and I was on my way to check in at the nurse's station. The only reason I looked in the room was because there was a security guard standing at the door. As I greeted him I glanced past him and noticed it. It wasn't fancy or anything. The room appeared even more drab than usual, empty and sterile. The housekeeper was washing down the handrails with sanitizer. Two nurses were speaking quietly next to the bag. I went to tell my fellow nursing students what I had found.

It wasn't like I was gawking or anything. It was just very, very real. The day before I had spent a bit of time with this patient, and now she was gone. Dead. In a bag. We had not spoken; she had recently had a major stroke. Her family had been in the room while I was taking her vitals and there was quite a bit of tension, but I couldn't tell why. I guess I know why now.

Yesterday I came in to find my primary patient (a different woman) in worse shape than the day before. She was asleep and shaking and warm to the touch. I took her vitals and found that she had spiked a fever and her oxygen was really low. I checked it three times before I went to get her nurse. We did this and that to get her temperature down and her oxygen up and she improved, but not enough. Her doctor came in and heard fluid in her lungs and ordered tests and sent her to the ICU. Pretty exciting for me. Not so much for the patient. It's a very mixed experience, hoping that people get better and wanting enough sick people to make the job interesting and exciting.

Later at the nurse's station some nurses were saying that she should not have gone to the ICU, that she would have been fine staying there, and that she would be back the next day. The next day (today) she returned to our unit. Trust your nurse.

Today, despite having experienced the death of a patient, was extremely slow. There weren't enough patients or experienced nurses for me to do the usual buddy nurse thing and work with a patient. So I helped bring an 83 year old woman down for cardiac tests. She told me all about her family and some adventures from her childhood. It was really nice. At first I was upset that I wasn't practicing skills, but then I realized that I was practicing just being with patients. After all, they're just people, people who happen to be sick.

I can see how easy it would be to focus on the illness or disease and lose sight of the patient, the person. That's where doctors and nurses are different. Nurses do get to do their own diagnoses, but they're more patient-centered rather than disease-centered. I like that.

The woman who died this morning was quite old. I had not become very attached to her. It's a fine line between caring and getting attached. The Buddha said that attachment is the root of all suffering. I don't think he was talking about the kind of attachment that is caring for someone. It's getting attached to a certain outcome that we desire that causes pain. Like the desire for someone to never die. People die. People we care for die. And sometimes they end up in a bag.

I'm planning on becoming a pediatric nurse. Many nurses won't do it, especially those who have their own children. I don't have any children, which is definitely part of why I've worked with kids. But pediatric nursing will be different than teaching and counseling. Children will suffer. Some will die. I will be there. I will become attached. It will hurt. I know this will be a powerful lesson in being present with another person, present to their life, which is only in that moment. And what a precious moment.

And what an honor it is to be someone's nurse.


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