O, You Beauty You

Dragon navigating the deep

She's a new nurse. She plops herself in front of me at the nurse's station, exasperated.  "I don't know what to do with this patient.  He refuses to take any medications, he has verbally abused every case worker who has walked in there, 

 calling them a fat cow, spitting at staff.  He won't deal with me.  What would you do?" I feel a host of things in the moment. I first see her.  She's beautiful; young, open, wanting to do good. I feel how brave she is.  Admitting not knowing, something I myself avoided as a new nurse. Than I feel my age.  She's reminded me, I'm older than her, she thinks I know something she doesn't.  I sit squarely in front of her.  I ask her to tell me what she knows about the patient.  She tells me the social part of his history being, his son called the medics after he found the patient not being able to get off the floor of his home for three days.  He was covered in his own excrement, having smeared it over walls and floors and brow beaten his wife into not calling for medical help earlier. I say, "So outside his primary medical diagnosis, we know a few other things. He's got a mental illness, he's got little control over his situation and he's terrified.  What do you, as a nurse want to do, what's a priority?"  "I want him to take his medication."  This reply reminds me of our indoctrination in the medical system.  We nurses have a job.  In the pursuit of doing our job, we forget our calling. We adhere and attach to the control inherent in the act of caretaking and become distanced to our own humanity and that of others. I say, "Put on your compassion hat.  He requires you make a relationship with him. He won't cooperate without that, and you will need the boundary setting on your end, he's big into manipulating.  He needs some control back.  You might want to address his terror."  She looks at me.  It's a different angle.  She pops up out of the chair, like only a hopeful 20-something can, and heads off to his room.  I give her a few minutes before I go stand at the patient's door to eavesdrop, interested in seeing what she creates. From my partially hidden viewpoint, I find her squatting at the bedside, eye level with him in the bed. Wow, I think, she IS brave to do that with a known spitter and shit-slinger. I can hear her being in her heart. She's calm and real with him and I hear him being responsive to this.  Well done I think, as I move back to the nurse's station. She returns ecstatic.  "He won't take the medication now, but has agreed to take it in an hour."  Good job, I tell her.  

In an hour she comes to me deflated. "He only took one pill out of the six he is supposed to take.  God, I can't believe it. I failed."  Hurdles.  I ask her which pill he took and she says what amounts to the most needed pill out of the six.  I tell her congratulations.  She connected with somebody almost impossible to connect to and he was able to move an inch by taking the major medication he needs. He's still terrified of losing control, that's a long term challenge she started to help him meet.  It's not overnight or instantaneous. It's one engagement at a time, one pill at a time. She didn't fail.  She began making relationship.