Thursday, September 5, 2013

The wisdom of reflection

He sat on his mother’s lap clinging to her for dear life as he screamed in fear.  The hospital bed seemed to hug them as they sat in the center of it, leaning against the head of the bed that was at a 75 degree angle. His little body was shaking and his large dark eyes darted from one nurse to the other as they prepared to take out his existing IV and replace it with a new one. “No, No,” he cried. “Mom, mom,” he pleaded between screams and sobs.  His young mother was desperately trying to sooth his fear while suppressing her own.  She was tired, and her eyes betrayed her calm exterior as they were filled with sadness and protective instincts for her child. 

I watched them.  I prayed for them.  I desperately wanted to take this experience away from them.  This young patient is only 21 months old.  He is my grandson.  She is my daughter.  I was not there to be his nurse but to be their protector and guide through this experience and I felt like a failure.  I wanted to grab him and run away.  I wanted to cry. 

The nurses approached them cheerfully and tried very hard to sooth him by explaining things and by quickly and skillfully doing their job.  He would have none of it!  While he was a good trooper he was scared.  Fear is hard thing to watch your grandson and son struggle with.  The doctors were very good at providing us with timely updates and filled us in often of their concerns and thoughts as treatment progressed.  Added to the current fear of being in the hospital with a sick 21 month old, was the knowledge that the doctors were concerned that possibly our amazing little man “might possibly have lymphoma” because of his lab values…something they were looking into…

He was hospitalized after a week of strept throat that wasn’t treated or diagnosed by his pediatrician despite my daughter visiting the office 2x that week with her child who had a fever of 101 every day, consecutively all week.  As a result, he developed a large abscess posterior to his parotid gland that was drained of 15cc of bacteria after the second admit day.  He had to receive IV Vancomycin until they knew what the cultured drainage was growing.  He was sick of being sick and sick of being trapped in a small room with people accosting him! 

My daughter is a wonderful mother, she gets her protective instincts from me…anyone who knows me will know that I take protecting those in my care very seriously…as does she.  I watched her with awe and admiration as she loved, protected and cared for her son.  I watched in awe at my grandson who could still show curiosity, kindness and have fun during the times he wasn’t in pain or fearful.  The ability of being able to adapt to his situation was inspiring.  My son-in-law was equally strong as he provided his own brand of presence to the situation.  Watching them together parent their child in this very stressful situation gave me peace as I saw the strength and love they have for their child and one another.

Being an ER nurse I of course understood why all the medical interventions were needed.  As his grandmother, and my daughter’s mother, I was scared, angry and protective.  My husband and our family that was home in Maine were also sitting on pins and needles as they waited and worried about this precious little boy of ours. The experience reinforced a few things for me.  As a nurse it is our job to skillfully and compassionately provide our patients and their families with the treatment and care they are prescribed.  It is our responsibility to bring them accurate and knowledgeable information in a timely and routine fashion; giving them time to ask questions and to answer those questions without impatience or judgment.  It is our duty to care about the situation they are in and to convey that with a kind presence, a caring touch and to give them moments of our uninterrupted time to show them they are not alone. It is our calling to see the patient and the family as human beings in a scary situation.  There is also a piece that hit home for me…those family members and friends that continually come in to see their loved one are coming out of concern and they offer hope and distraction from fear for the patient and family. I challenge anyone reading this who is a nurse to reflect on your practice and be sure that you are truly the nurse you were meant to be.  Your presence is vital to the mental and physical wellbeing of your patients and their families. 

Lynchburg General Hospital in Lynchburg Virginia has an amazing pediatric unit filled with compassionate and truly skilled nurses who did all of the above with grace and humility.  The doctors were equally skilled at their job and also did it with much compassion.  My grandson fully recovered and is now running around at breakneck speed as usual!  He does not have lymphoma! Thank you Jesus.