“There is nothing golden about the golden years”.
These words are softly spoken to me as I attempt to start an IV on a very confused, agitated patient. His wife stands beside the bed, looking exhausted and remorseful. They’ve been married for 25 years. He has no idea who he is or where he is at and she is overwhelmed at his current state.
I calmly caress his arm, I tell him where he is and who I am. I tell him I am here to help him and that he is safe with me. I tell him I want to make him feel better. “He’s doesn’t understand what you are saying to him”. I cradle his face for a moment, he opens his ocean-blue eyes slightly, peering past his NG tube, and stop looking for my access. “Sometimes,” I speak softly, “Even if we don’t think they hear us, that one moment of lucidity may come while I am talking to him and he will hear comforting words”. I paused slightly. Without even realizing it I uttered “And it makes me feel better to say it too”. She smiled. 
I am not sure if the smile was because I was speaking to her husband in the same manner as any other patient or if she was relieved by the fact that I am human as well. Her entire disposition changed when she realized that she was not the only one upset by her husbands current state. She was not the only one who was anxious about the procedures and interventions I would be performing. She was not the only one worried about her husbands safety. She also knew that even though I am nurse, I am the professional, that I also needed strength to perform my responsibilities.
One more caress of his left hand, one more swab of the alcohol, a swab of the chloraprep. Tourniquet in place, vein visible, palpable ready. I slowly insert the pink tipped needle into the vein. He is relaxed and cooperative. The familiar red splash fills the tip of the cathalon and a burst of endorphins overcomes me. “Got it”. I thought. But the battle wasn’t over. I thread the cathalon slowly, he still remains still. I retract the needle with a quick pop via the spring-loaded mechanism… I’ve lost it. My blood return as stopped. I attach the primed veni-loop breath a sigh of hope and attempt to flush and guide the cathlon. The patient moves his arm slightly. I am upset initially, but then pleased. The blood flow returns, the cathlon is flush, and I have my access. “Thank you”. I said to my patient. Somehow, I don’t know how, he helped me.
I secured the int with carefully torn pieces of tape. Tegaderm applied. Flushed again. It’s a beautiful INT. Back of the left hand, no interference in function of his hand or device with change in position. I attach the primed IV tubing and start the infusion of the fluids. I run the tubing through his sleeve and behind him so he does not see the tubing. Out of site is often out of mind. I replace his mitten. For a few moments he appears at peace.
His wife is thankful and hopeful. She is nervous that he will remove the lines. “Have faith”. I say to her. “Lets hope for the best” I say without even thinking. “Ok”, she says, “Thank you”.
I cleaned up the debris from the insertion, asked his wife if there was anything I could do for her. “No, thank you” she said and she relaxed in the bedside chair.
I step outside the room, endorphins still in full effect.
“I did it”, I thought. Somehow everything came into place and I was able to succeed. These tiny victories are what makes me proud to be a nurse.
Did my calming words have any effect on the situation? Absolutely. I feel in my heart that he heard what he needed to hear and did his best to be as compliant as he could. I also know that sometimes you have to talk yourself through difficulties, and even though I didn’t realize it, that is exactly what I was doing.
Talk to your patients. Give them words of hope, serenity, and honesty. Don’t forget that they are still in there, somewhere, no matter how far gone they may appear. You need to talk to them. You need it nearly as much as they do.
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What you do is an honorable and noble profession and if it didn't make you feel good, you would be in the wrong field. People say to me, "That doctor is an arrogant ass. He thinks he is God." My response is this each and every time. "I WANT my doctors to think their crap doesn't stink. I WANT the arrogant doctor because he/she is the one who will fight for me and take good care of me." As an EMT, I will be the first to tell anyone that I am among the best out there. Arrogent? Maybe. Conceited? I don't know. Confident? Most often. Proud? Oh, you bet! There is no shame in giving in to your calling in life and knowing that you are damn good at it and being damn good at it makes you so happy. I am glad you are happy when you do well. Pat yourself on the back and smile because the world needs more nurses like you. Too many are miserable old hags who remind me of Mrs. Ballbricker on Porkeys! (If you don't know who she is, watch the movie. Classic)!
thank you. I sometimes feel guilt for how good some aspects of my care make me feel. I dont know why. Its not like if I enjoy my work, or accomplishing a task its any less noble.
Thats the thinker in me. Constantly going through things in my mind.
It was nice to see the transition in her from fear to relief. So rewarding.
As an EMT who works with the elderly almost daily and a psych major working towards her masters in mental health counseling with a concentration in gerontology, I thank you! I know your point was to treat ALL patients as if they could hear. They probably can. We as caregivers DO need to talk to them for ourselves as much as for them. But I also want to thank you for the care and concern you showed this older couple. Thank you for showing them the respect and compassion they deserve!