I came in contact with my most unforgettable patient during my first year in home care. After working for 20 years in acute care, the intensive care unit, and the postanesthesia care unit, my first year in home care was an entirely new learning experience every day. I had been hired by a small start-up agency as an admissions nurse and case manager. Within my first month in the field, I came to realize that home care was the type of nursing we had learned about in nursing school but were never able to practice in the hospital setting. I now had the time to sit and listen to my patients and to have an effect on their healthcare decisions. For the first time, I wasn't trying to teach patients who were groggy, overwhelmed, or anxious to leave. For the most part, my patients and their families were interested in learning, and actually looked forward to my visits. Every day brought new challenges and new rewards.
One evening, while on call, I received a call from a woman who sounded extremely anxious. I inquired regarding her name and her doctor's name and found neither on our patient roster. When I inquired as to how she got my number, she said she had been discharged from the hospital that afternoon. She had gotten our agency number from her doctor, who said a "nurse would come and take care of everything." At that point she began to cry, and what she said next is what I will never forget. She said, "I was just diagnosed with diabetes, and they sent me home. I don't know what to eat. I don't know what to do, and I'm afraid I'm going to die."
A million things were going through my head at that moment: I was thinking of signs and symptoms of insulin shock, and diabetic coma, and should I call 911 or her doctor, or just go to her house myself. I finally said, "First of all calm down; take a deep breath; tell me what you had to eat this evening and how are you feeling right now." Fortunately, she was feeling physically okay and had eaten a sensible dinner. I reassured her that everything was going to be fine and that I would call her doctor and make arrangements to get her on my schedule for the morning. I asked her if she had received instructions about a bedtime snack, and she said she was told to have graham crackers and milk. I told her to have her snack and that she could relax; I would see her first thing in the morning, and I would come every day until she felt she could manage her diabetes herself.
I have contributed to saving many lives in both the ICU and postanesthesia recovery, but none of those "exciting" cases ever gave me as much satisfaction as teaching Mrs. X to understand, manage, and be independent with her diabetic care.