There’s nothing like a dying patient to put things in perspective. Where I work, we have all kinds of patients. Palliative patients share halls with patients under 50, sometimes younger. As the nurse, It’s quite difficult to change your mindset from one room to another, but if you don’t, you end up speaking down to someone unintentionally. Or shouting at someone who can hear you perfectly well. I think the biggest obstical though, at least for me, was heat. Well not directly I guess….
Let me put it to you this way. It’s 28C outside and you have been running around all shift. You’re hot. No, you’re melting. Now down the hall, you see a patient buzzing, so you go and see what they need. What they ask for, is a blanket. Looking at the patient, you can see they are already wearing pyjamas and are curled under a blanket, as well as sporting a classy throw rug over their knees. On top of that, they are flushed and sweaty. There’s not a chance in hell I’m going to heap another blanket on top of that.
I make my excuses and leave the room, Convinced I am acting in their best interests.
This is where I have to take a step back.
I am not her.
Who am I to decide that someone is too hot to have another blanket? Just because the heat is currently killing me, that doesn’t mean she is having the same issues.
I step back into the room and look again. This time, the flushed face is clearly grimacing. Fingers are clutching at the one blanket covering her shivering form. She isn’t cold, she’s in pain, She’s seeking any form of comfort she can find.
Needless to say, she got her blanket and her medication to settle the pain that plagued her. I found ten minutes in my day to sit with her and give her the comfort she needed.
She slipped away soon after that.
Looking back I like to think I learned from that. My feelings have no bearing on my residents. Now, I don’t go around giving blankets to overheating patients that ask for them. Some of them have no internal guage to tell them enough and will happily ask for blanket after blanket untill they sweat themselves out of the chair. What it has taught me, is to assess every case individually. Different things affect individuals differently. Some pain thresholds are completely different to mine.
If you are just starting out in a nursing proffession, there is a reason they stress the difference between subjective and objective data. My advice would be, take a step back and don’t put yourselves in their shoes. They won’t always fit.
(Footnote: I always assess a patient for pain. I just wanted to use an extreem case to highlight the importance of always looking at the whole picture!)