August 8, 2020

Morning Vitals: Losing a Patient Should Never Be Easy

During the past several weeks, I’ve seen several patients I’ve gotten to know during serial hospitalizations. I’ve cared for them during what has been or will likely be their final hospitalizations. Needless to say, it hasn’t been easy. Actually, after some reflection I can honestly say that I hope it never becomes easy. I’ll tell you why.

As a nurse who provides wound and ostomy care, I’m a member of a team focused on caring for people with what often turn out to be chronic, if not permanent or terminal, conditions. Many of our patients have chronic wounds. Others have one or two ostomies, which can be very difficult to manage. Other patients require both wound and ostomy care.

At the root of both nursing and Christian ministry is the knowledge that those who are dying stand in the greatest need of life.

Risk factors for skin breakdown are compounded in some patient populations. Aside from non-modifiable risk factors, very often patients at the greatest risk for skin breakdown are also least able to address modifiable risk factors successfully.

There are many possible indications for ostomy creation. There are also many aspects of ostomy care that are complex enough that they lend themselves to being described more effectively as art than as science.

Combine the severity of certain wounds with the complexity of ostomy care, and it’s no wonder there are patients we get to know well. In fact, nearing the end of some patients’ hospitalizations, I find myself at times having to resist the impulse to say “I’ll see you next time.” That’s a poignant realization.

Despite all of the patient care and the strain that accompanies it, there are the inevitable deaths to contend with. Sometimes I see them approaching from a distance. Other times, the deterioration and loss of life are sudden, even counter-intuitive.

Having said all of this, why wouldn’t I want things to be easier? In short, it’s because my nursing practice is influenced by my faith and the career mission it yields. My success as a nurse isn’t determined by the proportion of wounds healed or ostomies managed effectively.

As a Christian in nursing, I choose to embrace the gut-wrenching, heart-rending reality of life against death at the bedside in health care.

During nursing school, I came to the realization that in some strange way I tend to gravitate toward death. I already knew at the time that the motives that had led me to nursing were similar to those that had given me the desire to attend seminary.

At the root of both nursing and Christian ministry is the knowledge that those who are dying stand in the greatest need of life. As a Christian in nursing, I choose to embrace the gut-wrenching, heart-rending reality of life against death at the bedside in health care.

If this is your position as well, please know that there is someone else out there with a similar mission. I would love to hear from you to get to know you in this world and the next. Please drop me a note in the comments below.

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