The “C” Word.

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I talk about cancer ALL the time because it’s the culture I’m embedded in, but I rarely talk about how it makes me feel.  And really, as I type this, I don’t know that I want to tell you how I feel about my job.  For the most part, I have it together.  But sometimes I do feel a little buried beneath the weight of what I do.  I’m obligated to a lot of people, and I’m last on my own list.  Most importantly, I have someone’s life in the palm of my hands, and I pray every day before work that I’m guided to make decisions that are in the best interest of my patients.  But that’s a tall order.  While my faith in God is fierce, sometimes I question what’s happening around me.  Was an unexplainable outcome the thing that was the best for them?  Why did A, B, or C happen?  Did I make a mistake? Did my prayer request fall on deaf ears?  I’ve been doing a lot of thinking.

Obviously, I’m happily obligated to my patient.  A patient once told me that a cancer diagnosis means you’re just going to be plucked from your regular life, but everything carries on without you no matter what’s happening with you exactly.  You go to the doctor with a generalized complaint.  Maybe you have the flu, or mono, or anything other than cancer.  You’re rushed to an oncologist, who rushes you to an inpatient unit and you’ve never even been hospitalized before.  All of a sudden you meet me, a perfect stranger who is about to get ten kinds of fresh with you.  And while I’m doing things I have to do, you feel incensed and violated.  And I don’t blame you.  I’m inspecting every inch of your body checking for wounds and bruises, putting the bed alarm on so you don’t fall in unfamiliar surroundings despite the fact that you can clearly get around just fine, counting your urine, asking when you pooped last, requesting you to recall your entire medical history with a room full of family members.  And that’s just the simple stuff.  I’m bringing you paper after paper, explaining central lines, blood transfusions and all the complications, the full body scans I’ve scheduled, talking about chemo, and hair loss, and nausea, and NADIR, and sex, and that you’re going to be with me for the next month.  WHAAAAT!?!?!  What is right.  What the hell is going on?  You haven’t heard one word I’ve said since someone told you that you have cancer.  And who could blame you?  Cue the chaos, turmoil, and preemptive mourning… and we haven’t even DONE anything yet.  It’s day one down a long row to hoe.  And here I am acting like I know what you’re going through, trying to reassure you and move you along this entirely terrifying course of action.  Have you ever really considered what all that must be like?  I can’t even swallow pills, what the heck would I do in a hospital?  I don’t even remember which girls I worked with last night much less my ONE prescription.  Checking myself and thinking about what the patient goes through always brings me back down to earth.

Over the last few years, I guess I thought maybe I would get used to cancer.  I certainly talk about it at work like it’s just one more thing.  On my floor, it is the common denominator in my patients.  But even if I see it day in and day out and can regurgitate information on everything oncology until I am blue in the face, I am not desensitized to how much cancer can rock somebody’s world.  Yeah, it’s medicine, nursing and the disease process and all.  But it’s NOT just that.  Deep down, I know cancer isn’t just one of those things.  It’s scary and awful and it takes people on a ride like no other.

Of course, I feel obligated to the wellness of the family dynamic as it defines my patient’s support system.  I spend weeks and months on end sometimes, getting to know the patient and their family.  I see people in what they would probably prefer to be private moments.  I help them bathe and use the bathroom when they were hoping parts of their body could remain a mystery, I cry with them when they get bad news, I cry with them when they get good news, I referee tense family moments when the patient’s goals don’t match the ones their family members set forth.  You, the patient, don’t know what it’s like to be the person caring for a loved one with cancer.  They are stressed out, they feel out of control, and they feel useless because they cannot help you.  You, the loved one, don’t know what its like to be a patient.  They are scared, in pain, disappointed in themselves and their inability to function like they normally would, and everyone says cliché things that don’t make anything any better.  Sometimes it rips people apart.  Sometimes it brings people together.  Cancer changes everything.  As a nurse, I’m supposed to distance myself from you to some degree so that I can maintain my emotional stability when things get hairy.  How do I do that when I’m so intertwined in everything my patient goes through?  As a nurse, I feel like I’m on the up and down roller coaster right alongside them.  So if you’re reading this, and you ever find yourself in the bed or at the beside with your loved one, believe wholeheartedly when the nurse tells you she loves you and wants to help you with whatever you need.  Don’t dub it as some disingenuous remark to smooth a rough situation.  You have no idea the amount of time she spends thinking of you, the years of struggle she spent learning her craft, the uphill battle she fights to make sure your needs are met.  She’s the eyes and ears of the doctor, and she advocates for you when you can’t do it for yourself.  And more importantly, trust that she is working tirelessly for you.  Trust her.  Don’t ever refer to her as just a nurse.

I’m obligated to the strength and wellness of my team.  Its hard sometimes to keep a grasp of reality.  In the hospital, you see the sickest of the sick and there’s a fine line between “doing alright” and “crashing” when you think about people with literally NO immune system.  We have to remember to support each other so we can be successful providers and that ain’t always easy.  I look around at my coworkers and all of their skills and know when chaos ensues, everyone will come together like a well-oiled machine to save our patient.  And I look at newer nurses, and wonder how they see me.  Can they rely on me to support them and make them confident in their work?  Are they going to be alright when the shit hits the fan?  Am I emotionally available to provide some comfort when everything is just too much?  Do they trust me to have their backs?  The team is critical, its the only way to care for each other and your patients.  How do you make sure it’s bulletproof when your goals for your patients aren’t always met?  Sometimes, everything works out and I get to watch people that I’ve become incredibly attached to go on to have wonderful lives with renewed purpose and positivity.  And sometimes, the battle is lost.  In those times, it’s hard to remember there are thousands of patients that do well in outpatient settings and never have to meet me.  It’s a very special population of patients.  From the day I started, all fresh and scared of everything, until now, with the addition of some spiffy certifications and some experience tucked under my belt…I still look at my patients and think there’s nobody more deserving of my time.  And I know I’m in the right place.  You should feel that way about the people you serve.

My unit is a lot like a family, and I think that’s because we’re shaped in the light of the family-centered care we provide.  In the last couple of weeks, cancer struck one of our own.  The unit as a whole has been shaken.  In my time there, we’ve never had a current coworker have to deal with this.  So what do you do when then unthinkable hits too close to home?  You rally behind her in support.  My friend is fearless, and she’s survived cancer once already.  She’s a fighter, and she’s not about to entertain any negativity.  And we’ve embraced it with open arms.  Get ready guys, the next post will be all about our Boob Voyage Party!  Stay tuned!

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One response »

  1. Pingback: The “C” Word. | jenlking's blog

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