Cook, Lisa M. BS, RN
Lisa M. Cook is a clinical educator pursuing a master's degree in nursing education at the University of Hartford, Hartford, CT.
Contact author: firstname.lastname@example.org. Reflections is coordinated by Madeleine Mysko, MA, RN, email@example.com. Illustration by Annelisa Ochoa.
The job description doesn't say you get to choose your patients.
He was a pedophile, just released from jail after 20 years. His diabetes required two different types of insulin. He had acute renal failure and a recent ileostomy.
"They didn't know what to do with him," the previous nurse said, "so they dumped him on our doorstep." It was now my job, as his patient education nurse, to teach him about diabetes and how to care for the ileostomy.
Before I went into his hospital room, I removed my ID badge and put it in my pocket. I was afraid to let this man know how to locate me or my family. I needed to protect my young daughters.
A frail, toothless old man with straggly gray hair turned to look at me as I introduced myself. He was struggling to move from his bed into a wheelchair. I asked if he needed help.
"No, ma'am," he said. "I can do this. It just takes me a while."
When he was settled in the wheelchair, I asked whether he'd given himself insulin injections and if he had a glucometer.
"They let me check my sugars," he replied, "but I never gave myself a shot." He also said that he took care of emptying and changing his own ileostomy bag.
I pulled up a chair and went over some educational pamphlets with him.
"Wow," he said. "They didn't teach me much in there."
When we finished the session, he thanked me and said he'd read the pamphlets so he could ask questions next time.
As I left, I felt ashamed that I'd taken off my ID badge. After all, I was a nurse, and he wasn't the first ex-convict I'd cared for.
"You really did come back," he said, the next time I visited.
"I told you I would."
"When you're where I was," he said, "you really don't trust people."
He had many good and relevant questions. I taught him how to use a multidose insulin pen. He caught on quickly. Our plan of care was that he would give himself insulin shots with nursing supervision, and I would follow up on his progress.
During my visits over the next two weeks, he would occasionally open up and talk about himself. "I was drinking with my friends and one thing led to another. . . . I didn't worry about what happened to me while I was in there. . . . I deserved everything I got. . . . I ruined a lot of lives with what I did."
Why was he telling me these things? His victim had been a child. I wanted to get away from him. It made me sick to think of the pain and suffering of that child and the family.
On my third or fourth visit he spoke of his childhood, how his father had beaten him. He said he'd joined the army at 15, and still remembered the look on the face of the first person he shot in the Korean War. He had been a POW, and had seen his friend shot after they'd both attempted to escape. He had learned to survive, he said, in "that hole." Once, when he bit down on something hard in the rice they gave him, he realized another tooth had fallen out. Apparently, he'd been traded for, and came back to the United States so malnourished he was almost dead.
"This is no different from prison," he told me, looking around his room. "In fact it's worse. There I could get around and go outside."
This is what I wanted to say, but couldn't: "It was you who made those decisions and acted on them. Whose fault is it that now there's no place for you to go? Who wants a convicted sex offender living next to them?"
One day he told me that social services had found him a place to live and he was leaving. He thanked me for all that I'd done. I told him that I really hadn't done anything special; I was just doing my job. But he insisted that I had. We shook hands. As I walked away, I wished him luck.
"Thanks," he said.
Am I still fearful and disgusted after spending time with a pedophile? Yes, I believe I am. Do I still wonder what I'd do if someone hurt my child? Do I still check the sex offender list to see who's living in my neighborhood? Yes, and yes.
But I did provide nursing care for that patient—a pedophile—as well as I could, just as I'd been taught. Because I'm the one who made the decision to become a nurse, and I don't get to choose those placed in my care.
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