Saying goodbye to a favourite patient provides some valuable lessons for our student nurse blogger
Never in my life would I ever have expected it to be possible to care too much.
If anything, people don’t care enough. But this week two situations in placement made me think twice about boundaries.
When I returned to the ward after my rest days, I quickly discovered that one of our most animated patients was no longer with us. The poor soul has fallen and broken his hip and was currently residing in the surgical unit.
I was absolutely devastated for him - he had been improving rapidly within our assessment unit. More than that, I was upset for his family. This gentleman had previous had a stay in an acute ward prior to admission with us. While there he was labelled as unmanageable and his family were concerned that history would repeat itself.
My mentor and I had the opportunity to visit our patient in the surgical unit in order to access suitability for returning to the ward. On arriving there we found him asleep in a side room. I’m ashamed to say that at this point all I could think about was when he was last spoken to, whether he had been fed that afternoon and whether his carers were aware thathe needs constant interaction.
Of course, I knew deep down that he would have been receiving the same level of care in that ward as he had previously, but I couldn’t help but think that nobody knew this patient better than our team - and therefore nobody could care for him as well.
Fortunately my mentor decided that we could care for him back in the ward, and shortly afterwards he arrived back to a familiar welcome and his old room. He has of course been treated like a king, and his relatives are happy with his progress.
On reflection, I knew deep down that he was in safe hands, but I almost couldn’t trust another ward to look after ‘my’ patient. These nurses are experts in their field, with years and years more experience than me. So why couldn’t I let go?
Why couldn’t I entrust this patient into their care? Was I criticising them in my head because I care too much, or because I felt guilty for not being there when the accident took place?
The second scenario involved one of our long-term patients. The day had come for him to finally go into long-term care, his room was packed and the taxi was booked. I could see that although he didn’t have insight into what was happening, he looked apprehensive.
I was asked to accompany the patient to his new home and tried to be as positive and reassuring as possible when travelling to the destination. On arrival at the nursing home, I had to gasp. It looked so beautiful - an old country manor house set in the middle of nowhere.
Unfortunately I never did learn the old lesson about not judging a book by its cover. Being met by the matron at the door, I immediately sensed a poor work ethos. The care staff all appeared unhappy and tired. We were shown to his third floor room via a lift from the 1930s. The room smelt damp, the furniture worn. I could see the distress in his eyes.
There I was again, only seeing the negatives, assuming on first impression that my patient, whom I had given countless cups of tea and shaved every morning, could not be happy here.
He sat on the chair in his room and a carer was asked to make him a cup of tea. ‘Milk and two sugars’ I called, ‘and he only likes it half full’.
It took a tremendous amount of professionalism to walk away from the situation and back to the taxi. On saying goodbye I had to restrain myself from whispering ‘any problems at all, you give us a call’.
It was time for him to have a permanent home. It was time for me to realise that his comfort and well-being were number one priority, and that I couldn’t hold onto him for selfish reasons.
Being a student nurse did I simply care to much? Did I feel guilty that we had let them go? Is it natural to believe that no other team can provide holistic care as well as you and your colleagues?
I think in this case that it simply highlighted that although I have been living, sleeping and breathing nursing for over two years, I still have so much to learn.
I have to learn that it is ok to leave these precious patients in other professionals’ hands. I have to believe these people were also born to nurse, and that they will treat each and every one of them like their own mother.
More than anything, I have to learn to not assume no-one can provide care like I do. I need to show confidence in my fellow colleagues. Even when the furnishing isn’t nice and the smiles aren’t always there, I need to assume EVERYONE cares.