Learning to Observe, Observing to Learn

Street Art, unknown artist. photo: jparadisi

Here’s a collection of loose observations I made last week:

  • People who lie or cheat believe that everyone else in the world does too.
  • People who feel paralyzing guilt over a mistake they made believe they are the only one in the world who’s made one.
  • Nursing students and new grads still believe in patient centered care and patient advocacy (Thanks Nurse2be for writing about one of my posts. I feel relevant).
  • Precepting is an opportunity to develop a colleague I love to work with.
  • I am a preceptor even when I don’t have an orientee. What do I teach coworkers about nursing culture through my nursing practice and behavior?
  • A patient and I commiserated over frustrations with health care. I said, “I’d like to change it, but they won’t let me be queen.” He touched the ring on my left hand under the nitrile glove I wore, and said, “You have this ring; you’re somebody’s queen.”
  • Nursing is my profession, but it does not define my entire life. Good shifts, bad shifts, when I leave the clinic I return to the life I create.
  • It’s all about choices.

It Ain’t no Sin to be Glad You’re Alive

Bathing Sparrow (sorry it's hard to see) photo:JParadisi 2010

After weeks of daily rain, the sun was shining in a brilliant blue sky and the weatherman promised the warm weather would last all weekend.  My coworkers were feeling fine too: in the staff lounge, two of them sang “If I can’t have you, I don’t want nobody baby” and I joined in as the third Bee Gee, before traipsing to blood bank to retrieve a couple of units for a transfusion. On the way, I passed a surgery tech wearing cap and scrubs, who started dancing in the hospital hallway to the tune of his ringing cell phone. We both laughed when he caught me watching. I was still smiling when a woman stepped out of the elevator, looking haggard and sad. She was not hospital staff, and her sorrow reminded me that many people in the hospital were not having a good day at all. I quickly doused the smile and flipped on my professional demeanor switch.

It’s part of the job when you are a nurse. It’s not enough to like people and have excellent skills. Nurses need the ability to separate their personal lives from their jobs. Don’t bring your own drama in, and don’t take the drama of others out. This is a valuable survival technique for longevity in health care. I’m pretty good at it, but occasionally worlds collide.

Like this morning. My oncology patient mentioned she sure missed having a glass of wine once in awhile. We joked about it before I went into the room of my next patient. Filling out the admission record, I asked the required question: “Do you drink alcohol?” I was unprepared for the ferocity of my patient’s reaction, as she explained emphatically that she does not drink alcohol, and it ought to be illegal to drink it. I stopped the admission process, sat down on the rolly stool in the room, and listened to her. When she finished, her glaring eyes dared me to contradict her. I quietly asked, “Have you or someone you love been harmed by someone drinking alcohol?” She had. Or rather, her son was in an automobile accident caused by a drunk driver. Now he is ventilator-dependent and confined to a wheel chair for the rest of his life.

Joking with one patient about an anticipated glass of wine as a reward for going through chemo is supportive. Bringing the topic up with another patient is traumatic. Nursing requires the ability to respond thoughtfully to either patient, sometimes within the span of a few footsteps.

While warming myself in the sunlight on a bench in a neighborhood park after work, I thought about all of this, reminded of how good it is to be alive and healthy. At the end of even difficult shifts, nurses leave the hospital behind while the patients stay there and endure.

Next to the bench, a sparrow bathed itself in a tiny pond. I watched him scatter water droplets that glittered like diamonds in the bright sun, thoroughly enjoying himself on a beautiful day. He wasn’t paying attention to me. He wasn’t thinking about patients, car accidents, cancer, or a glass of wine. He was just enjoying the moment.

…it ain’t no sin to be glad you’re alive.” (Bruce Springsteen)