It's Okay to Care.

Lesson #6: If you're compassionate, don't restrain yourself from spilling all that you are.

Before I ever stepped foot into a hospital in the role of a student nurse, I had a preconceived idea of how I would react in certain situations.  I believed I knew myself well enough to predict my emotional response to death, even though it is not something I've been surrounded by or exposed to very many times in my life. 

When I started my nursing journey, I prided myself on keeping my personal views, opinions, and emotions to myself.  Especially my emotions.  I've always been a "sap" but I started school with the idea that I would condition myself to keep emotions regarding patients out of sight.  I thought in doing so, I would portray a "professional nurse" image.

Fast forward a year.

I showed up to clinical and was assigned to the ICU.  Oddly, my patient was awake, alert and oriented X3.  He was going back and forth about whether or not he was going to get an internal jugular tube (central line) that afternoon.  After chatting for 2 hours over breakfast (pancakes and sausage) about life, his past, his family and his medical condition, he decided to sign the consent forms and follow through with the procedure.

We wheeled down to the lab, prepped, suited up in the appropriate medical attire, and I was able to stand in on the procedure.  I stood at the head of the table, where I could see him under the sterile blue sheet.  We continued chatting as the procedure began...

I had no idea the mans hand I held that morning was going to code on the table later that afternoon and I was not at all prepared the way I had planned in my head.

My first code was a roller coaster ride full of emotions.  Everything I had conditioned myself to believe, immediately went out the window.

I replayed the conversations we had that morning about his wife and children and how the scariest thing he had ever experienced was during war.  I replayed  his words when he said how he really didn't want to do the procedure because it would only prolong his life, making himself a burden to his family even longer.  I recalled his laugh when I accidentally spilled his juice all over the table and how he told me what a great job I did when my instructor checked me off on his IV push.  All I could think about was his voice,  (that I heard just 15 minutes earlier) and how he wasn't breathing now.

The room was chaotic, I couldn't focus on one single person because there was so much going on.  The voices all blurred together and in my mind, this was going to be the end of his life.  I could only focus on the monitor and the nurse doing compressions.  It took every ounce of my being not to cry.  I started sweating, it felt like a million degrees.  I stood in the corner, zoned out.  One minute felt like eternity, but after an hour, he was stable again.  Unconscious and intubated, but "stable."  (He died later that week)

I will never, ever forget that day.

I know they say it gets easier and easier each time you're exposed to the death of a patient, and that may be true. However, I don't ever want to be so disconnected from my patients that I cannot feel the emotions associated with grief and loss or share their joy in the happier moments.  I want to be able to have enough control over my emotions to not buckle under pressure but not so much control that I lose the genuine ability to sympathize/empathize with the people I care for. 

It was silly for me to believe that I could take a passion and put reigns on it, or that I would want to dull something about myself that makes me who I am.  I no longer believe that the "tough" nurses are the most admirable, nor do I believe that being emotionally invested in your patients health and well-being is a weakness. In fact, I think it's what makes the best nurses.