THE HUMAN SPIRIT IS precious; strong and fragile at the same time. Nursing has given me a perspective on this spirit that I would've missed had I chosen a different path. In my career of more than 30 years, I've seen the effect a nurse can have on that spirit and recognize that often it's the little things we do that impact our patients most.
Strength of spirit
The first 10 years of my career were spent as a clinical nurse in an inpatient unit. Admissions to the unit were diverse and included patients in hospice care. It was here patients often learned of a diagnosis of cancer, recuperated after surgery, and endured whatever course of treatment followed. By the time patients were admitted for hospice care, they were well known to our staff.
Such was the case with BH, 36, a mother of two children. After a Whipple procedure (pancreaticoduodenectomy) for pancreatic cancer and a course of chemotherapy, she enjoyed a 2-year remission that allowed her to travel to the Grand Canyon with her family and create 2 more years of memories for her young boys. Sadly, the remission ended and BH was admitted for hospice care. Her parents, who lived across the country, were on their way when she slipped into a coma. Her family remained at her bedside, talking to her, accepting she wouldn't answer but hoping she could hear them.
The day after BH's parents arrived, I was at the nurse's station when I heard a loud yell from her room. I ran to the room to hear her yell, "Dad!" He ran to her bedside. Gasping for breath between each word, she yelled, "I ... love ... you!" Yelling was the only way she could get the words out. She hollered out again: "Mom! I ... love ... you!" I quickly backed out of the room, allowing the moment to be theirs without intrusion, but privileged to witness the incredible strength of her spirit to declare something so important to her. BH soon slipped back into a coma, never to speak again.
Retaining dignity
A simple act can preserve the dignity of the human spirit. Mr. R was another hospice patient who was known to our staff when admitted. Healthcare provider orders included "shave patient." This became our ritual each time I cared for him. When he became too weak to speak, he'd pantomime his request for a shave. This was just a simple act by me but it was so important to Mr. R, allowing him to retain his dignity and just a little control in a situation that stripped all other control from him.
Human touch
The smallest act of kindness can mean so much to a patient. Fear can be overwhelming for patients facing a life-altering illness and can be intensified by personal issues. The simple touch of another can help calm that fear.
Mr. L was the first patient admitted to our unit with a diagnosis of AIDS. This was early in the AIDS epidemic and despite all the literature regarding transmission, many in healthcare felt uneasy about the potential for becoming infected by the virus.
I was assigned as his primary nurse. After giving him time to get settled, I introduced myself and we talked, getting to know each other a little. Mr. L confessed he felt very anxious about his parents, who were coming that night to visit. He told me, "I not only have to break the news that I have AIDS, but they don't even know I'm gay." I offered the only thing I could: "Do you need a hug?" He immediately, almost hungrily, accepted the offer and confided, "You're the first person to touch me in weeks, since I was told I had AIDS." My heart ached realizing the unnecessary isolation he'd endured when just the simple touch of another would have meant so much.
Immeasurable impact
The interventions nurses make on a daily basis, some potentially lifesaving, can't be minimized. But it's just as important to acknowledge the value of all the "simple" acts we perform every day: things you may not find in a nursing textbook or require an advanced degree but define the reason we chose this profession in the first place, to care for and about others. The simple act of a hug, the touch of your hand on theirs, a soothing voice over the phone, or just knowing when to listen, affects our patients in ways that can't be measured. It's been more than 20 years since I worked in that inpatient unit and I vividly remember these patients and many others-not because of any impact I had on them, but because of the impact they had on me.