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Someone's Son

Carder, Jami RN

AJN, American Journal of Nursing: October 2017 - Volume 117 - Issue 10 - p 72
doi: 10.1097/01.NAJ.0000525884.43091.10
Reflections

It's easy to judge patients for their choices, harder to see them as individuals.

It's easy to judge patients for their choices, harder to see them as individuals.

Jami Carder is an RN case manager at the Visiting Nurse Association of Cape Cod, Dennis, MA. Contact author: jami.carder2012@gmail.com. Reflections is coordinated by Madeleine Mysko, MA, RN: mmysko@comcast.net. Illustration by Eric Collins / ecol-art.com.

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.

Unfortunately, it was easy to become jaded. After days of nonstop work, it was frustrating to feel that any time was being “wasted.” Awaiting new admits, we would hope for something manageable. More often than not, it wasn't. Whenever I saw “ETOH,” I knew I would probably not get lunch that day. Detoxing is dangerous and exhausting, for both patient and nurse. The patient would be confused, hallucinating, and at risk for seizures, requiring continuous monitoring. It wasn't uncommon to be vomited on, spit on, scratched, hit. I remember complaining, at such times, about not being able to take care of my other patients who were “really sick.” It bothered me that these people who “chose” to drink were taking up my time, while the person in the next room dying of cancer had to wait for me.

I once cared for an alcoholic who wasn't quite detoxing, but was almost as difficult. He had cirrhosis and multiple infections, with deep yellow jaundiced skin. He didn't seem to care much about changing his lifestyle in order to heal. I remember how dirty he looked, especially his hair. He was angry and refused showers, so never got a real shampoo. Part of me was grateful he was refusing, as it gave me more time for other tasks. He was constantly sweating and scratching his skin, leaving dried blood under his fingernails. He was rude. Not horribly, but enough to put up a wall between us. I had to put on a gown, gloves, and mask before entering his room. If I needed something, I had to remove them all, wash thoroughly, get what I needed, then put everything on again. When you have five patients who need you at once, this becomes frustrating.

A few weeks in, he began dying. His demeanor changed once he found out. He let go of his anger. He softened. I softened, too. I learned his sister had overdosed and died in this same hospital a few years back. He was the last child left, and felt guilty thinking of his mother.

It turns out, I knew his mother. Or rather, I saw her every morning—she lived near the hospital in a tiny home nestled between medical buildings. She'd water the roses along her picket fence each morning as we rushed by, giving us a smile and wave. We all enjoyed that moment of sweetness before we faced whatever tragedies were lined up for us.

The patient became unresponsive as he entered his last days. I learned that his mother would be coming to say goodbye. I was about to do a hundred other things, but stopped. This was her son. I had sons. I imagined this man at their age, holding onto his mother's skirt in that yard as she watered her flowers, his sister playing nearby. I wondered what had happened to them… what changed them. I realized how judgmental I'd been, thinking he “chose” that path. I had no idea at all. His mother was probably remembering the last time she walked across the street to say goodbye to her dying child. Tears stung my eyes. I gathered my supplies, put on my gown, mask, and gloves. I wasn't going to let this woman see a dirty yellow man—she was going to see her son.

I washed his hair. This was a man I had disregarded because of choices I thought he had made. I felt ashamed as I ran the comb through his soft, black hair, probably as his own mother combed it, years ago. She would be here shortly, holding his hand for the last time, wishing for things to be different. I scrubbed his nails, soaking them in soapy water, clearing every bit of blood and dirt. I gently rubbed in lotion, bringing the softness back. I folded the sheet over him neatly, tucking pillows under him just right. I tidied his room, hiding supplies, throwing away trash.

I no longer saw a dirty, time-consuming patient. I saw someone's child. I saw my child. I realized every child starts out the same, and some have bad things happen to them while others don't. Some can compensate for those bad things, and others just can't. None of us know the paths they will take, or why they will take them.

I never did get lunch that day. As my shift finally ended, I passed his room and saw his mother sitting by his bedside, holding his hand. The vision of him and his sister in the yard came back, tears stinging again. She ran her fingers through his hair and I cried.

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