This month’s Reflections essay, “Someone’s Son,” is by Jami Carder, now an RN case manager at the Visiting Nurse Association of Cape Cod. In it, she looks back to a formative nursing experience.

I started my nursing career as a floor nurse. Our patients were complex, and though it seemed we never had enough time or staff, it was important to give them the care they needed and deserved…. [I]t was frustrating to feel that any time was being ‘wasted’…. I remember complaining, at such times, about not being able to take care of my other patients who were ‘really sick.’

By Eric Collins/ecol-art.com.

Who ‘deserves’ care?

Wasted here is meant as code for spending valuable patient care time on patients who are sick because of unhealthy behaviors: in this essay, substance abuse. But we might also then include smoking, overeating, lack of exercise, and so on.

The potential list of unhealthy behaviors is long. And the question of choice is slippery, to say the least. It’s always before us in our personal lives, moment to moment—and by extension, for nurses at the bedside, and in how we as a society think about health care and who ‘deserves’ it.

Levels of Care

Nurses know they must take care of every patient with professionalism. But are there levels of possible care? Carder tells the story of caring for a patient whose alcoholism is killing him. There comes a moment, as she tends this often unappealing man, when she realizes she herself has a choice. She can see this man as a problem to be managed and dealt with, or as a human being, as “someone’s son.”

She can be present with this man at a deeper level, or she can stay in a rigidly defensive stance, and never really see him at all. The short essay is free, and well worth taking a moment or two to read.