One Nurse's Experience
As a new RN in a large midwestern hospital, I started on the 8 hour night shift of a busy medsurg telemetry floor. Inexperience led me to rely heavily on my psychosocial skills and interactions with patients. After report one night, as I was assessing my patients, I felt particularly drawn to the new elderly lady, Ruth, in the last room at the end of that wing of our unit.
She'd suffered a stroke, was unresponsive, and the off going nurse had given me a mental picture of her grieving husband, who was trying to come to grips with this major life change.
I had all the other 12 patients on that wing of the floor to see safely through the night and they were all asleep. Ruth was fairly easy to care for, requiring turning, suctioning to keep her airway clear, and checking her IV occasionally. Her flaccid right side offered me no resistance as I went about taking her vital signs.
More for myself, really, than for her, I began to talk to her as I worked. I reminded Ruth of where she was and what had happened to her, and what I'd heard was happening with her family, which consisted only of her husband.
I faithfully told her what I was doing, when I was finished, and when I would be back. I told her to rest and let nature begin its repair work in her brain so she could return to her husband, even though I knew that they'd both suffered a brutal blow and nothing would ever be the same for them.
As the week progressed, her condition remained unchanged, but began to deteriorate toward the end of the week. A decision was made by Ruth's husband not to resuscitate her should she die. Each night I would continue encouraging her, talking to her while I worked. She remained seemingly oblivious to my ministrations and care.
By the end of the week, Ruth was no better than when I first saw her.
I realized that I was the one who was upset, learning in report how her increasingly dejected husband was realizing the fatal turn that their life had taken. Her doctor was taking a non-aggressive approach, and evidently spoke daily with her husband, and by the end of the week, it was reported to me that a decision was awaited from Ruth's distraught husband about whether to place a feeding tube and transfer to a nursing home or not.
I felt encouraged by her doctor's care and honesty with Ruth's husband about the gravity of Ruth's prognosis. It was also reported to me that her husband was extremely tortured by his decision, and didn't know which way to go: he didn't want to appear to abandon hope for Ruth, yet he also didn't want to prolong her suffering.
I continued to talk to Ruth nightly about what I knew had transpired during the day, not knowing if her husband talked to her, held her hand, or spoke to her when he was there. By this time, she'd become "Ruthie" to me. I told her that her CT scan...