Thursday, June 10, 2010

Hospital Experience #4: Nurse Dreadful


This is my fourth post about my recent hospital experience - having a cardiac catheter ablation at Ochsner Hospital to correct a heart arrhythmia. My previous three posts are (1) an explanation of the background leading to my hospital experience, (2) a description of the hospital experience itself, and (3) my reflections on my panic in the procedure room.

In my previous post, I mentioned that I could see some very small steps of growth in compassion within myself, particularly toward my doctor and the medical team during the cardiac catheter ablation procedure. This post will show that I still have a long way to go compassion-wise. I am certainly not there with Nurse Dreadful. Nurse Dreadful is the name I will give to the first nurse I encountered at Ochsner Hospital on the morning of the cardiac catheter ablation. I will begin with what happened, and then reflect on the experience.

POST-SCRIPT: I am writing this Post-Script after completing this post. Having just finished writing the post, I am struck by the power of writing to call forth deeper insights. I started this post with no compassion in my heart for Nurse Dreadful. The very process of writing took me from a place of no compassion for her to the beginnings of compassion, as you will see.

WHAT HAPPENED - FROM MY PERSPECTIVE

When I arrived at the Short Stay Cardiac Unit of Ochsner Hospital for the cardiac catheter ablation, I was shown to my hospital room, where I would undergo initial preparation for the procedure. I was instructed to remove all my clothing and put on a hospital gown. I decided to remove my upper clothing, put on the hospital gown, and keep my slacks and underpants on until the nurse actually came in to start doing things, at which point I could quickly slip them off.

After about twenty minutes, Nurse Dreadful appeared. As soon as she spoke, I could tell that I didn't like her. She was very matter-of-fact and stand-offish, and she lacked a kind and caring manner. (Every other nurse I dealt with that day had a kind and caring manner.)

Here's what Nurse Dreadful said: "You'll need to take off everything. You have to be naked as a jaybird."

Here is what I heard: "I don't have to respect you. I can use expressions that remind you of your nakedness in our hospital - such as 'naked as a jaybird.' I don't have to use polite expressions with you, such as 'We're going to start getting you ready for your procedure now. Would you remove the rest of your clothing, please.' "

Later I asked about getting two extra pillows. (It really helps me sleep at night if I have a pillow on either side of me as well as at my head, and at this point, I believed that I would be spending the night. My previous post "Hospital Experience #2: The Experience Itself" explains why I was able to go home on the same day.)

Here's what Nurse Dreadful said: "We have eighteen patients to take care of today. We don't have any extra pillows right now. I might be able to find some later, but I don't know." Merry, a wonderful friend who was accompanying me throughout hospital day, jumped in at this point to explain that my request for pillows wasn't just a whim or preference. Merry said: "She needs the pillows because she has sleep apnea and uses a C-PAP machine at night. The pillows help to keep her in a good position for using the machine. That's why she needs them." [This is indeed the case.] Nurse Dreadful said: "Well, I'll see."

Here is what I heard: "You certainly are a bother to us. It's a burden to have to take care of you on a day when we have seventeen other patients, who are more important than you. And now you make even more work for us with your demand for extra pillows. Well, I'll try to satisfy your demand, you inconsiderate and unimportant person."

Boy, I didn't like Nurse Dreadful! She proceeded to ask me the usual array of hospital questions - very matter-of-fact the whole time. Then she got ready to draw blood from a vein in my arm and to put in an IV port through which sedatives would be administered to me in the procedure room. Another nurse, whom I'll call Nurse Kindness, also came into the room at this point.

Nurse Dreadful wasn't able to find a suitable vein for drawing blood or installing the IV port. She kept sticking different veins, which I didn't like at all. Merry came over to hold my hand while Nurse Dreadful kept sticking me, and Nurse Kindness said encouraging things. Blood just would not come out of my veins. Of course, I was getting more and more tense, which wasn't helping, either. Blood can be drawn more easily from a relaxed arm.

Finally, Nurse Dreadful and I had this interchange, with me being quite irritated.

ME: Haven't you found a vein yet?

NURSE DREADFUL: No. Your veins are jumping.

ME: I am NOT jumping. This has never happened before.

NURSE DREADFUL: Ma'am, I have been doing this for many years.

ME [feeling that I might need to rely on her care later and probably shouldn't get her too irritated]: I'm sorry. I didn't mean to suggest that this is your fault. In fact, I know that it's my fault for not relaxing. I just meant that this hasn't happened to me before. [I figured I had better say something placating so that she wouldn't try to take revenge on me later. Someone like Nurse Dreadful probably has all kinds of ways of making a patient endure discomfort.]

At this, Nurse Dreadful left the room, and Nurse Kindness took over. Well, guess what. Nurse Kindness was able to find a vein for the IV port and to draw blood on her first try.

MY THOUGHTS ABOUT WHAT HAPPENED

I find it very difficult to feel compassion for Nurse Dreadful. Actually, I don't feel compassion for her at all. In fact, I even find myself enjoying a revenge fantasy - what I might have said to her instead of my final placating words. I imagine the conversation with a vengeful final line from me, like this:

ME: Haven't you found a vein yet?

NURSE DREADFUL: No. Your veins are jumping.

ME: I am NOT jumping. This has never happened before.

NURSE DREADFUL: Ma'am, I have been doing this for many years.

ME: And after all those years, you STILL haven't learned how to do this right???!!!

So, you can see a lack of compassion and a depth of hostility on my part toward Nurse Dreadful. I realize that she may normally be a much more pleasant person who was temporarily thrown off-kilter by a bad day. I realize that she may have been dealing with pain or stress or loss in her life that might do me in if it happened to me. I realize that she may be unaware of how negatively her words, spoken with good intentions, are coming across to patients (or at least to me) - like "naked as a jaybird." I realize that she may be unaware of how brusque and uncaring her matter-of-fact manner can seem.

I also realize that Merry saw Nurse Dreadful differently. When I complained to Merry about Nurse Dreadful, which I certainly did as soon as Merry and I were alone in the room again, Merry said, "She certainly wasn't a good match for you," and "She does take a matter-of-fact approach." But Nurse Dreadful didn't strike Merry as quite so "dreadful." I realize that my perspective was colored by my anxiety.

I do think, however, that there is some truth to the way I perceived Nurse Dreadful and that Nurse Dreadful should be made aware of what at least some patients will hear through her choice of words and her manner. When Nurse Dreadful says, "You have to be naked as a jaybird," at least some patients will hear, "I don't have to respect you." When Nurse Dreadful says, "We have eighteen patients to take care of today," at least some patients will hear, "You are a bother." When Nurse Dreadful speaks in a strictly matter-of-fact manner, at least some patients will interpret this as uncaring.

Nurse Dreadful may be a skilled and competent nurse who would be great if she would improve her bedside manner. Or she may be a skilled and competent nurse who does usually communicate kindness and caring - but I just caught her on a bad day.

I wonder - what is Nurse Dreadful like as a person outside of her role as nurse? Who are the important people in her life? Which books and movies does she like? Which activities does she enjoy? Does she go to a church or synagogue or mosque or temple - perhaps sing in the choir, have a meditation practice, volunteer in a soup kitchen? What is she like if you sit down and talk with her over a cup of tea?

How did Nurse Dreadful perceive me? I complained to Merry about her. Did she later complain to someone about the hostile patient (me) that she had to deal with?

Nurse Dreadful and I clashed in the hospital. What was going on at a soul level? What can my encounter with Nurse Dreadful teach me?

I have a feeling that I will explore those final questions in a future post.

3 comments:

  1. I really like how you worked through to a positive framework re. this disagreeable encounter. I like to learn from negative experiences and try to do better, but it helps to reflect the way you have to come to better approaches int he future.

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  2. Thanks, Kathy. I find that writing is a wonderful way of reflecting. It often amazes me how the process of writing about something will change my perspective. My writing in this post and the next gave me a completely different view of this encounter.

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  3. I would love to read , more of your stories!

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