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The Blame Game

Cramer, Natosha BSN, RN

AJN The American Journal of Nursing: April 2014 - Volume 114 - Issue 4 - p 72
doi: 10.1097/01.NAJ.0000445697.87992.d1

Judging patients for poor life choices is neither right nor professional.

Judging patients for poor life choices is neither right nor professional.

Natosha Cramer lives in Washington State and currently works on a surgical telemetry unit. Contact author: Reflections is coordinated by Madeleine Mysko, MA, RN: Illustration by Annelisa Ochoa.

Figure. I

Figure. I

I was just two hours into my evening shift as a certified nursing assistant when I noticed 12 missed calls on my phone. My mom, aunt, and grandma had been frantically trying to reach me, but my phone had been silenced. I called my mom right away. “Justin overdosed and is in the ICU at your hospital,” she said as soon as she picked up the phone.

Justin is my cousin. A 28-year-old at the time, he had been in and out of jail since his teens, primarily for drug and theft charges. He had mental health problems, plus a congenital tremor disorder that had become apparent early in childhood. After age 18, he'd virtually vanished from the family. We knew that he was living with friends, but we otherwise had no contact with him.

Even though I hadn't seen Justin in nearly 10 years, my gut twisted at the thought of what condition he might be in. Was this overdose purposeful or accidental? I searched for answers that I knew I wasn't going to find. I had to go see him. My supervisor, seeing the sadness in my face, didn't ask any questions as she granted me an early dinner break.

I'd been to the ICU many times, but this time was different. I was no longer a hospital employee, but a patient's family member. The front desk secretary directed me to the room at the end of the hallway. Outside the room, I was approached by Justin's nurse, who introduced himself as Robert. I reciprocated the introduction while peering through Justin's window to see if I could catch a glimpse of him. It had been so long since I had last seen him that I wasn't sure if I would even recognize him.

The nurse explained that Justin had been found unconscious in a cemetery earlier that day. After receiving CPR and being intubated, he'd been transferred to the hospital, where it was determined that he had consumed a large quantity of alcohol and muscle relaxants. “Is he going to be okay?” I asked.

Robert shrugged. “Was he on any other drugs?” he asked.

I explained that there was a rumor that Justin was on drugs, but I wasn't sure.

“So you're telling me,” said Robert, “as a member of his family, you're not sure what drugs he's on?”

I was stunned. What kind of question is that? I thought.

“I'm not very close to him,” I told him.

“Well, this is what happens when you take drugs—you end up in the hospital hooked up to all sorts of monitors and a machine that's breathing for you. How stupid. Didn't he know that you can't mix those things together?”

I wanted to tell him how selfish and unprofessional he was for even mentioning such a thing when my cousin was just on the other side of the door, grasping at whatever was left of his life. Instead, I turned away, opened the door, and went into Justin's room. I was relieved that Robert didn't follow me. My gaze was drawn to the heart monitor on the wall, softly beeping at regular intervals. The room was cold, with a strong scent of bleach. Just as I'd imagined, Justin had multiple tubes coming out of his inert body. I sat, tears streaming down my face.

Soon my mom and aunt entered the room with Robert. I stood up to hug them. With uncertainty, my aunt asked, “What's going to happen next? Will he wake up?” I knew she was really asking if Justin was going to die.

“It's unclear what his prognosis is just yet,” said Robert. “However, if he does get better, with cases like this they tend to go home, get back on drugs, and bounce right back into the hospital.”

My mom, who is quite forward, responded that Justin wasn't perfect, but he deserved to be treated with respect. “If this is going to be a challenge for you,” she said, “please let us know so we can request another nurse to work with us.” After a long silence, Robert apologized and excused himself from the room.

My dinner break had come to an end and I had to return to work. The rest of that shift, all I could think about was how angry I was with Justin's nurse. How could a nurse be so heartless as to insult a patient in such a vulnerable state? There seems to be a dangerous epidemic of clinicians blaming patients for their health issues. As a nursing student, I saw more and more of this attitude. The health care profession seems to have evolved a culture of accusation and attack against patients, a group we should be empowering and protecting. One day, I hope to see a change in the way we view health and illness; otherwise, situations like the one I experienced will continue to occur.

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