Sometimes I wonder why I chose nursing as a career. It can be the most thankless, brutal, physically challenging work. The pay sucks; the hours suck. We have to give up our holidays and work swing shifts all the time, often without enough staff. The tasks we do, every day, seem like a part to an endless journey where we don’t see the light at the end of our patients tunnels.
The mundane tasks I perform every shift I work can be frustrating. Nursing staff look at the patient in terms of what their DX is; how much time they will require and who else will be on the assignment; we look at the meds and treatments before we see the person. At times, the patients become the sum of their injuries and we lose sight of the humanity that exists within.
I’ve been here before- being bored, unchallenged. Always, something happens that reminds me why I chose this work over so many other more lucrative and productive fields. I could have been a teacher. Or a doctor. Or an engineer. But I chose nursing because of the difference it made in my life one time.
Working with young adults who made bad decisions is tough. Knowing the histories of these people can really upset me. I often wish I could go back in time, just a few weeks, to warn these kids of what is in store for them if they continue down the roads they so often choose to take. It’s always the boys too- who tend to get into accidents. For every female patient we admit who has been involved in an alcohol related accident, we admit 7 males. Usually they were not only drinking, but doing some form of drug as well.
When I look at the pictures of these kids- recent high school graduates so many of them- I see the potential for a future husband to some lucky-in-love girl; I see a father to some awesome children; I see a person with so much potential. The smiles and happy surroundings seen in so many of these images are in stark contrast to what I see laying in the hospital bed in front of me. A young person, in some stage of coma; battered and bruised beyond recognition. Attached to machines and tubes. On multiple forms of life support. Alarms that go off constantly; lights always on, staff constantly checking their vital signs. What an existence.
They are all of high acuity- and require intense nursing care. At any moment any one of them can go into a code situation.
The fragile human body can only take so much. But the human spirit can take a lot.
When you’re in a coma you are alive. There comes a time when you wake up to dark and unknown surroundings. You can’t speak; you can’t open your eyes; you can’t move. You are in pain. You feel every poke and prodding; you experience a full array of feelings- emotionally and physically- and you have no control over anything. And you hear everything that goes on around you.
When you’re in a coma, you’re often hooked up to so many machines that make noises, you cannot sleep. Strange as it sounds, one can be asleep yet not. I know because I have been there.
A young man came to my facility about 6 months ago- he had been thrown through the windshield, tossed 200 feet and his body slammed into a tree. The car followed him and pinned him to that tree. He broke every bone in his body; he lost the frontal portions of his head. But he lived. He went to a Boston hospital for the initial care and two weeks post trauma he was admitted to my unit. He’s been in a coma since impact.
He has been under my care every shift I work. I have watched his wounds heal. The infections have gone away. The casts are gone and he’s been living in suspended animation ever since. No amount of sensory stimulation seems to have helped him. His level of coma is deeper than most. This never matters.
We always assume our comatose patients can hear everything, feel everything, experience everything. Because those who have been in these states, and who wake up from it, tell us what they heard, felt. Every shift I worked with this kid- I always orientated him to where he is, why, what happened to him, what his condition is; more than this, I always shared the latest news with him. I took risks when I shut off the trach humidifier so that he could hear what I was saying to him; reading the sports sections of local news papers and news from his local town. I placed special headphones over his ears (no small feat when their head is covered in dressings and full of stitches- or when they have no scull) and played his favorite music. After I finished his cares, I would rub small amounts of his preferred after shave stuff on him (in spite of my hatred of these smells). I would add flavoring gels to his lip ointment so that he could taste things. And everything I did with him- I would tell him ahead of time…and warn him when things would hurt.
Working with patients who are in a coma can be downright depressing- so much work is involved and often we don’t see any results from the effort.
Sunday my patient woke up.
I noticed his vital signs were more active than usual. His closed eyes were making random movements- I’ve seen this before. I knew something was going to happen- a seizure, or brain storm episode. I could have attached more probes to him; I could have set up different monitors with special alarms to alert us to a physical change. Instead I chose to stay with him. One on one. My co workers were not impressed with me because this meant they had to pick up my other patient. Tough shit, I told them.
I observed him. Things were happening that indicated he was going to wake up. We called his family, who live three hours away.
His fingers moved. Then the arm. Then his eyes opened. Immediately I dimmed down the lights. The doctors came in and started their little assessments, which meant some pain for my patient…doctors can be the worst when it comes to communicating what they are doing. I had to step in and remind them to talk to our patient- and his eyes found me and in spite of having a huge tube in his mouth, he managed to smile. And his hand touched mine. THAT made my day. And brought me to tears.
I stayed with him for the next 5 hours. We decided NOT to do all the normal care activities in order to allow him some time to absorb his new world. His mother showed up mid afternoon, and we left them alone for an hour.
It’s a miracle, when this happens. Times like these remind me why I decided to ditch the idea of a high powered, high income generating career. Against the advice of so many friends and family, I chose nursing because of the difference you DO make in so many lives. Shattered bodies, lives, shattered dreams and plans…can be healed with the skilled hands and touch of a nurse who cares for her patients. Many nurses do not truly care; they complain and whine about this work and become bitter nazi like bitches. I have to fast check myself every now and again to reaffirm my choice. Sunday, I got a reminder I wouldn’t trade for a billion bucks and all the fame in the world. There is no higher calling than to work in nursing.
