So so soooo sorry for my absence! There's something about spring turning into summer and a body turning pregnant that has kept me away from the type-written word. In actuality, I've started journaling, and sometimes you just don't feel like writing the same thing twice, ya know?? More on that soon. Anyway! I've been thinking on this one a little bit. Nothing baby or pregnant or anything, just nursing stuff to chew on. Thanks for still reading, I do love having this space :)
Way back in nursing school we were introduced to the concept of Lateral, or "Horizontal" Violence. This term references the
well-documented phenomenon of nurses psychologically injuring one another, either physically, verbally or behaviorally. As a young woman graduating from a private Christian college with very little work experience, I didn't actually believe this could exist, at first...
Then I became a nurse. And sadly this concept came to life. Over the past six years I have witnessed nurses belittling one another (in front of staff and patients), nurses undermining others behind their backs, nurses conspiring to get another nurse fired: in short, nurses just treating other nurses poorly. I have theories about why this happens - Maybe it's job dissatisfaction. Maybe it's the stress of working in healthcare. Or maybe it's because many nurses feel trod on, and the only power they can wield is over one another. In truth, I don't know.
I only bring this up because last week I had the wonderful experience of being the recipient of what I shall now call "Horizontal Compassion". Let me paint the picture.
It was my fourth shift out of six in a week, so I could tell that my personal stores were beginning to run a little low. And for the love, don't you know pregnancy makes you more emotional and stuff?! I now work on an Oncology floor, which means not only providing medical care to potentially dying individuals and their families, but being aware of their emotional needs as well.
For the previous three shifts I had worked with a patient who was suddenly struck with an extremely aggressive cancer that had numbered her years to a few measly weeks. She was lovely, relatively young, and surrounded by the most caring and supportive family I have seen in years. Her room was adorned with flowers, there was always someone sleeping by her bed at night, her every need was anticipated. Despite the fact that she had stage 4 cancer, she was a woman rich in love and friendship. And each night she was sleepless.
One night she struggled with pain - no medication would touch it, no position in bed was quite right, there was nothing to be done but comfort her. The next night the struggle was nausea and bloating - every anti emetic was given, every trick in the book attempted to relieve her stomach distention, walks were taken in the wee hours of the morning. The third night was constipation - stool softeners, suppositories, enemas and hemorrhoids. So far, I had 36 hours logged with this patient and after so much perceived failure to simply give her a restful night's sleep, well, you get how I was maybe getting close to quitting.
By night four, I thought we had her all set. Everything that had been a struggle up til then had been resolved! No more uncontrollable pain, no more heaving nausea, no more stopped up bowels. Finally, we should see some sleep! No...this was not to be. At midnight I was called into her room for an urgent matter: she told me with dismay that she had dry mouth. I assured her that this was normal, brought the usual supply of oral swabs and mouth rinses, and thought that should take care of it. At 12:30am I was called back into her room where she insisted that nothing was helping, and what ought she to do?? At this point, I suggest that maybe her mouth would be less dry if she were able to sleep with it closed. So in an attempt to keep from mouth breathing, she decided to reposition to sleep on her side. Not a good plan. This set off her pain, which set off her nausea, which brought her to tears. With her sister comforting her and me struggling to keep my composure, I excused myself from the room.
As I passed the nurse's station, my face must have read clear as day because the charge nurse looked up from his computer and said, "Do you need a shoulder?" to which I replied, "I need a muffin" and rounded the corner to give myself a time-out in the break room. This is the point when I would usually just spend a few minutes in frustrated silence and then make some off-hand remark to the next nurse that asked if I was ok, because saying that you're struggling is just not usually well received in the healthcare world. However, this is when my surprise moment happened.
The charge nurse entered the break room right behind me and asked what happened. As I hesitatingly relayed the situation I had just walked out of, he nodded and listened. And listened. And I soon found myself talking not just about that night, but the last few shifts, and the pressure I had felt growing in that room, and how the buildup of her needs and my helplessness to meet them had been slowly chipping away at my emotional reserves until I literally had nothing left to give...and he listened. And listened. And then, miracle of miracle, he began to affirm me.
He shared a few of his experiences working in psychiatric nursing. He talked about the toll that caring for the mental and emotional needs of patients can take on nurses if they don't feel free to debrief in a healthy way. And he told me it was ok that I was at my limit - that in order to take care of people, we need to first take care of ourselves. This. Was. HUGE.
Oftentimes, in nursing, you feel like you always need to "have it". You need to be ready with the answers, have limitless patience, deflect all careless words from patients and families who don't know how to process the health reality they are now in. You stand at the front lines between patients and their providers, walking with them through every minute of your shift, attempting to ease their way. It is taxing work, both on your mind and your soul. Because for 12 hours your needs take a backseat. And to have another nurse acknowledge that, when the issue wasn't clinical and the problem wasn't medical, was priceless.
And you know what's amazing? After maybe 15 minutes, I went back out onto the floor feeling like a weight had been lifted off my back. Nothing had changed in my patient's condition or needs, but I somehow felt loads better! All because my frustration had been validated. Such a simple gift.
I was able to care for this woman and her family for a handful more shifts until she passed away last week, surrounded by those she loved. I consider that a privilege. And I truly believe I would have requested not to have her as a patient again if it hadn't been for that nurse taking a moment to see me where I was at, and to show compassion. So I would like to raise a challenge to you, especially those nurses out there. Who do you see around you that's struggling? Who looks like they could use a moment to exhale? Sometimes I know my first instinct is to look away, because we are so very busy and we just don't have time for that right? I disagree - because our patients need EACH of us. And by building one another up, we are actually working toward meeting our patients' need to be cared for by a nurse who "has it" when it counts. It just takes a moment.
