Can Nurses Care Too Much? - Well Blog - NYTimes.com - About

In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.

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In medical oncology our patients stay in the hospital often for weeks or even months.

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In medical oncology our patients stay in the hospital often for weeks or even months.

Highlighted by killacam1

In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.

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medical oncology

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oncology

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In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.

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In medical oncology our patients stay in the hospital often for weeks or even months.

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medical oncology

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or because they need more chemo, or because they’ve relapsed

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chemo

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We get to know them, their families, even their friends.

Highlighted by corygearlds739

We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.

Highlighted by jlbowie15

We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them.

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We get to know them

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And because we know them so well, in such an intense and intimate setting, we end up caring about them.

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And because we know them so well, in such an intense and intimate setting, we end up caring about them.

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we end up caring about them.

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we end up caring about them.

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we end up caring about them.

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we end up caring about them.

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we end up caring about them.

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a patient I had gotten to know well,

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I had been his nurse off and on since his initial diagnosis the previous spring, and had cared for him more recently after an autologous stem cell transplant.

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I had been his nurse off and on since his initial diagnosis the previous spring, and had cared for him more recently after an autologous stem cell transplant.

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rural Pennsylvania for years

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autologous stem cell transplant

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autologous stem cell transplant

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autologous

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autologous stem cell transplant

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is scary and ominous.

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is scary and ominous.

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“If he dies I don’t know what I’m going to do,” I confided to the dayshift nurse. She looked at me, then looked down at her papers and nodded.

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“If he dies I don’t know what I’m going to do,”

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“If he dies I don’t know what I’m going to do,”

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“If he dies I don’t know what I’m going to do,”

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“If he dies I don’t know what I’m going to do,”

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If he dies I don’t know what I’m going to do,

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This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.

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This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

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This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.

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This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.

Highlighted by corygearlds739

a no-win situation where compassion routinely gets hijacked by grief.

Highlighted by tellio

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief

Highlighted by asmira

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief

Highlighted by jamie11

a no-win situation where compassion routinely gets hijacked by grief

Highlighted by klj4123

no-win situation

Highlighted by ausome

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

Highlighted by killacam1

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death

Highlighted by maryhuynh107

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.

Highlighted by ahadden

a no-win situation where compassion routinely gets hijacked by grief.

Highlighted by tabathaphelps

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.

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, but we’re the ones who are always there.

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On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.

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if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.

Highlighted by tabathaphelps

f you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.

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ut if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.

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if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.

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person caring for you in your last days, hours, and minutes will be a nurse

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will be a nurse

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but we’re the ones who are always there

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but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

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we’re the ones who are always there.

Highlighted by bradleyvenable

The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

Highlighted by asmira

e watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

Highlighted by corygearlds739

We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

Highlighted by jlbowie15

We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

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something just seemed off.

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When I did my initial assessment of the patient that afternoon, something just seemed off

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I asked him to follow my finger with his eyes and to push up and down against my hands while I pushed back. These are basic tests of neurological function

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These are basic tests of neurological function

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She had remained calm and kind throughout his many hospitalizations, but I could hear the worry in her voice.

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I called the doctor. She was leaving the hospital for the day when she got my page, but she came back and examined the patient. His ammonia levels were rising due to his failing liver, something that can cause “mental status changes.” He was getting large doses of heparin, a blood thinner, because of his clot. Could the heparin have caused a bleed inside his head? The doctor’s exam, like mine, showed some deterioration in neurological function. She ordered a CT of the patient’s head and she prescribed a treatment to bring down his ammonia levels.

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I called the doctor. She was leaving the hospital for the day when she got my page, but she came back and examined the patient. His ammonia levels were rising due to his failing liver, something that can cause “mental status changes.” He was getting large doses of heparin, a blood thinner, because of his clot. Could the heparin have caused a bleed inside his head? The doctor’s exam, like mine, showed some deterioration in neurological function. She ordered a CT of the patient’s head and she prescribed a treatment to bring down his ammonia levels

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ammonia levels were rising due to his failing liver

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heparin, a blood thinner,

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Could the heparin have caused a bleed inside his head?

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She ordered a CT

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So am I gonna live or am I gonna die?

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“So am I gonna live or am I gonna die?” he asked me.

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“So am I gonna live or am I gonna die?” he asked me.

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Why did this patient matter so much to me?

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“I don’t know,” I told him, turning away to put the used syringe in the sharps container. My voice seemed small and tinny. “I wish I could look in a crystal ball and find out, but I can’t,”

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“I wish I could look in a crystal ball and find out, but I can’t,” I said, forcing myself to turn back around and look at him.

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“I wish I could look in a crystal ball and find out, but I can’t,” I said, forcing myself to turn back around and look at him.

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Why did this patient matter so much to me? This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me.

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Why did this patient matter so much to me

Highlighted by jlbowie15

Why did this patient matter so much to me? This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me. One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car. The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.

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who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me

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Why did this patient matter so much to me?

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This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me.

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This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me.

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. One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car.

Highlighted by tonimarvel

One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car.

Highlighted by cackylee

One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car.

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The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.

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The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.

Highlighted by maryclaire411

The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.

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The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world.

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The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.

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“He’s got a fever!” I said, as if it was the first fever in the history of the world

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I had several days off following that shift and I called work on my third day at home to ask about him. “C.M.O.,” our secretary told me, and I swore into the phone

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Now, though, he was struggling.

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I called work on my third day at home to ask about him.

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I called work on my third day at home to ask about him. “C.M.O.,” our secretary told me, and I swore into the phone. C.M.O. means “comfort measures only”: they were withdrawing care.

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C.M.O. means “comfort measures only”

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C.M.O. means “comfort measures only”: they were withdrawing care.

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C.M.O. means “comfort measures only”: they were withdrawing care

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cerebral bleed

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Without even thinking about it I decided to go to the hospital where I knew his family would be gathered.

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It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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The lounge to the N.I.C.U. was filled with his family members, all sad, some crying. I saw his wife, who hugged me. She asked me if I wanted to see him, but I said no, since he wouldn’t have known me. Instead, we talked about the two of them, about trying to pick up her life, about making sure that he wasn’t suffering. When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

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The lounge to the N.I.C.U. was filled with his family members, all sad, some crying. I saw his wife, who hugged me. She asked me if I wanted to see him, but I said no, since he wouldn’t have known me. Instead, we talked about the two of them, about trying to pick up her life, about making sure that he wasn’t suffering. When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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but I said no

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When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

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When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day

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When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

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When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

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When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.”

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I love you

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He died later that day

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It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

Highlighted by anepicchance

It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

Highlighted by kennethdurlin

It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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You girls get too attached,

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A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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she’s right, of course.

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Can Nurses Care Too Much? - Well Blog - NYTimes.com

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on 2009-02-06 by tellio

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