“I wish I could cry with you, but I can’t”
I just saw the doctor walk out of the room…the room of your husband on a ventilator, who after 12 days of no improvements, has had setback after setback. I talked to the doctor before he walked into the room. I know what he told you.
Forgive me. I have to avoid you for a short time. I’m going to go do something else for a little while.
You see, I’ve seen that look before, that look on someone’s face where they are about to sob uncontrollably and throw up from the sheer emotional pain. People usually put on a strong face when the doctor delivers the news. And as soon as the physician has vacated the area, they allow themselves to break down.
But guess who is still in the room?
Through their tears, they ask us the questions they were either too shocked or too scared to ask the doctor. Somehow, what we say stings even more.
Shift after shift, we see lives permanently altered. We see people walk into the hospital with hope and we see them walk out with despair.
It never gets easier to do this. You just get used to it. You figure out how to do it.
So, I’m sorry. I’m sorry to the wife who needs me right now. I know you have questions you want to ask me. Questions you didn’t think to ask the doctor. Questions you didn’t want to ask him because you didn’t want him to think you were stupid. Things you want me to explain. I know you want my honest opinion.
I need to collect myself first before I walk into your husband’s hospital room. I need to put up my wall. I need to mentally prepare myself to not compare you and your husband to my mother and father. I need to disconnect the dots.
I have to do that because as soon as I’m done being there for you, I have to go see my other patient. My patient who will probably recover from the massive stroke he suffered, but is a little down today. I have to go in with a smile on my face and tell him that he’s doing great. I have to be happy for him. I have to motivate him. I have to inspire him.
So, please forgive me. I know that because I’m not emotionally upset with you right now, I may look cold and heartless. I promise I’m not. It is out of self-preservation that I am not going into that deep, dark pit of despair with you right now. I’m going to get as close as I can without losing it. I’m going to take a ladder down into that pit with you, but I’m going to stay on that last step. I’m going to stay on that step because I have to be able to quickly climb out on a moment’s notice for the man in the room next door.
You see, I’ve gotten pretty good at that. I’ve gotten really good at lowering myself into that pit and getting as close as I can to your pain, but not quite there. And I’ve got even better at running up that ladder and out as fast as I can.
I’ve gotten good at that because I’ve had to. If I take that last step, I cannot continue on. I cannot do my job. I cannot be there for any other patients. I cannot talk to physicians and coordinate your husband’s care or the care of any others. I cannot hold myself up. All I will think about is my husband dying. Or my father. Or my mother.
So, I put up my wall. My boundary of empathy. I will get as close as I possibly can for you. I want to support you. I want to be there for you. I want you to feel cared for. So I will give you as much as I can bear. I pray that will do, for I have no more left.
Here’s a comment from a fellow nurse that I really appreciated and identified with, and thought you might as well.
Nurses can often be labeled as cold, un-empathetic and jaded. But if I were to fall apart for every patient who rates their pain 10/10, or every patient who shares with me how their mother, sister, grandfather died of the same disease we are getting ready to test them for today, then I wouldn’t be able to ease the anxiety of my next terrified patient in pre-op by making him laugh, or have the presence of mind to comfort the patient after him in recovery, who will look up at me with tears in her eyes and tell me how she dreamed of her deceased husband while under anesthesia. So when I come to your bedside to start your IV, after having just assisted in a code blue (that you will never know occurred), forgive me if I don’t immediately relate with your disapproval that we don’t use “tiny butterfly needles.”
And some non-nurses may ask why? Why is it that I can’t bear the pain of one person while simultaneously sharing in the joys of the next?
Isn’t that my job?
Isn’t that what I’m trained to do?
But there isn’t a course in nursing school (or on this planet) that teaches us how to do this.
What I am trained to do is to keep my patients safe by checking and rechecking their physicians’ orders to ensure they’re administered correctly. To be their advocate. To manage my time so that every single patient I come into contact with receives my very best. To be clear in my instructions. To keep current with new developments and advancements in my clinical area.
All the while hoping that a few weeks from now, my manager won’t pull me aside to discuss a patient satisfaction survey that says the patient felt rushed, or felt unimportant because I mispronounced his/her name. Or worse, to have one of the physicians I work with complain to my manager that their patient wasn’t admitted quickly enough.
Working in high-volume outpatient surgery, I oftentimes touch over 50 patients a day, five to six days a week, year after year. The only way I can continue to do it, and do it well, is to guard myself from feeling every single emotion my patients are feeling. If their current emotional state weighs so heavily for one single patient to bear, imagine how much it might weigh on me alone, 250 times a week, or 1,300 time per year. Year after year.
I love what I do. And I do it with a guarded heart. Knowing that the very best I can do for all my patients is to simultaneously protect myself. Yesterday, today and again tomorrow.
Learning how to be a great nurse at the bedside while maintaining your sanity at home is no easy task. Becoming Nursey: From Code Blues to Code Browns, How to Take Care of Your Patients and Yourself talks about how to realistically live as a nurse, both at home and at the bedside…with a little humor and some shenanigans along the way. Get ready: It’s about to get real, real nursey. You can get your own copy at at NurseEyeRoll.com (PDF), Amazon (paperback) or Goodreads(ebook).
Kati Kleber BSN, RN CCRN is a a nationally certified critical care nurse located in Charlotte, NC. She is the Nurse Advisor and Editorial Director of the #ProtectNurses initiative, and will be guiding the content we curate, create, and share back with you. Kleber, aka Nurse Eyeroll, is a popular blogger, the voice behind the wildly successful #ProTips series, and a frequent speaker on nursing leadership. You can buy her book "Becoming Nursey" at nurseeyeroll.com, Amazon, Barnes and Noble, and other sites. She also has two more books in the works, which will be published by the American Nurses Association and on shelves Feb. 2016!
By Kati Kleber BSN, RN