Illustration by Eric Collins / ecol-art.com
“What kind of life is that? That’s not how I would want to live.”
In AJN‘s September Reflections essay, “His Wonderful Life,” nurse Elizabeth Buckley interrogates her own judgmental response to a patient with a bluff, abrasive personality (he calls her ‘Nurse Ratchet during their first encounter) who requires nearly nonstop care to stay alive.
The patient has little hope of a meaningful recovery even if he survives the current hospitalization. The reader is surprised when, after a first grueling night of touch-and-go care, the author decides to take him on as her primary patient because she thinks it might be “a good learning opportunity.” (“I texted my friend who worked the day shift to sign me up; she replied that I was crazy.”)
A good life is in the eye of the beholder.
‘Philip,’ obese and with progressive dyspnea and multiple comorbidities, is sure he’ll soon be able to return to his bedbound existence at home watching old movies and chatting on Facebook; the physicians and other nurses are less hopeful. Gradually, over the course of five nights, the author’s respect and affection for the patient grows. He loves his life, however narrow it may seem to an outside observer.
In reflecting on this experience, Buckley eloquently expresses her deepening understanding of the truism that each person is different—and that it’s never the nurse’s place to judge:
“Sometimes we forget that even though we may not think a patient’s usual quality of life is worth the suffering and hard work involved in keeping it going, this is not our decision. . . . We are here for the patients and their families, to support them through illness and get them to where they hope to go.”
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Just yesterday I was talking to the 13-year-old daughter of a friend about different perspectives. I was telling her that sometimes teens see things that may seem small to others as a big deal. I explained to her that it’s not just teenagers, that see things one way, while others have a different perception of the situation. I told her that it really does not matter if it is a big deal or not to someone else. What matters is how the person having the experience feels. It is the same with a patient. Patients, like teenagers are experiencing a sensitive period in their life, in which they feel vulnerable and insecure. It is our job as health care givers to help them ease their pain and come out of the situation in the most positive format possible. A bad experience or reaction from the person they are placing their trust in could change their outlook in the future. Nurses are not just there to slap on a band aid or administer a medication. The way we do it makes a difference as well. We are not there to give our opinion, only our advice and help them get as well as possible. We cannot change people, only guide them. After all, we all have free will and hope that when the patient goes home, they make the lifestyle changes needed to live happy, fulfilling, and health lives. Therefore, as stated by the blog, the quality of life really is whatever the patient believes. It is not the nurse’s place to judge or try to control what the patient does. If a patient calls you “Nurse Ratchet”, than it is best to take it with a grain of salt and have a sense of humor. After all, they are the one that is ill and deserve our respect regardless of what choices they make.