1. Wukovits, Barbara BSN, RN, BC


Meeting patients where they are in their loneliness and pain can help them heal.


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Patients are often anxious and fearful prior to surgery. As a pain management nurse working closely with the spiritual care team, I have the opportunity to help patients acknowledge these feelings and establish a caring relationship with them. I like to use the phrase "in my pocket of care" to assure patients they will be with me throughout the day. When I see patients after surgery, many ask me if they are still "in my pocket."

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

During the COVID crisis, only emergent surgical procedures were performed at my institution. Members of the spiritual care staff tried either to be physically present or to remotely connect with every admission. A clinical team was designated to work specifically with the ICU COVID patients, providing patient and familial support. We had many COVID-infected patients not requiring ventilation on other isolated units as well. The stress level for everyone was quite high. One morning, I was preparing to go to see patients when a coworker began interrogating me about what I was doing.


"I don't know what you think you are doing," my colleague said. "By giving false hope to people, you are doing them a disservice. People are going to die, and God isn't going to save them. I don't think you are helping here."


I left the office quite shaken. A colleague noticed my distress. In tears, I shared what had just happened. My colleague looked me in the eye and said, "You have value. Don't doubt your purpose." He suggested that I consider my coworker's stress level and try not to personalize the remarks. The wound was too raw at that moment for me to absorb the message. I spent the day reflecting on who I was, what I was doing, and whether there was truth to the accusation. I am a spiritual person and my belief in God is important to me. Yet was I there to just fulfill my own need to be needed or was I actually helping patients during their time of stress?


As I reflected, an inner voice reminded me that the value of an experience is up to the individuals involved. My colleague's brief moment of listening and support was priceless to me.


I saw many patients during this dark period. Most expressed appreciation for my being there trying to understand their distress, pain, and loneliness. Although I was behind a mask and covered with protective equipment, the spirit of the visit came through.


One memorable patient was Mr. P., an emergency admission for a nearly severed foot. He was in pain and I approached him, offering a friendly hand. Since we were of a similar faith, we prayed together. Over time I have found ways to pray with people who have a wide range of relationships to spiritual belief and practice.


Visiting daily, I really got to know Mr. P. On day 4, I noticed a definite change in his demeanor. He said he was just tired. I pulled up a chair and sat with him, not saying anything. After about 10 minutes, he started to cry. He shared that he just received a call about his family. His beloved grandmother had just died, and his father had been admitted to a hospital with COVID-19 symptoms. He was in the midst of a true personal and physical crisis. I stayed with him, just letting him talk, not sure what else there was to do.


"Why?" he asked. "Why is this happening to me?" It was an impossible question and I had no answer. Instead I asked Mr. P. what was meaningful to him. He spoke at length about his grandmother and father and how they had conveyed pride in their heritage, reinforcing the importance of family life. He enjoyed his job, where he excelled as a machinist. But what brought the biggest smile to his face was speaking about his wife and daughter. He shared a video of his baby learning how to walk and playfully laughing as she moved. He cried. Identifying some of the most valuable components in his life seemed to lessen his emotional pain. Mr. P. had a long journey ahead and needed to maintain a sense of purpose to heal. He eventually replaced the "Why me" question with "Where do I go from here?"


Pain is a complex experience. Offering patients an opportunity to express their feelings, listening to their words, looking into their eyes and sensing their uncertainty are all part of the compassionate side of healing. And offering hope and being supportive-as I tried to be with Mr. P. and as my colleague was to me-can be sustaining. It is essential to be genuine and to meet people where they are. My pockets are filled with people's spirits and hopes for healing. I may never know what, if any, part my brief encounters played in patients' outcomes. What truly matters is the effort.