Sense Memories – Healthcare as a Mutual Process

I’ve written about the loss of my father from my mom’s perspective elsewhere – but I’ve never blogged about it from my perspective, as it relates to my work as a nurse.

I am a nurse wherever I go, whatever I do now. The instinct to care is on auto-pilot – a practice I’ve built and developed over an eighteen year career as a nurse assistant and registered nurse in healthcare. Sometimes it is difficult to maintain the level of caring I desire to provide because our health care delivery system bombards us with tasks, commits us to processes, culture wars distract us, and design doesn’t allow us to spend the time we would like with our patients. We often don’t even acknowledge our need for support to recharge our empathy circuits. We are dealing with loss of different levels (physical, emotional, mental, spiritual) with people repeatedly on a daily basis, yet it never seemed appropriate to share my own personal loss of my father.

The message has always been to create clear boundaries in our personal and professional lives. We still debate this on social media. I question whether that is truly possible to do so. I question whether it is even healthy to do so. We are our experiences. Just as a humbling patient situation may affect our personal lives (we’ve all had those shifts when we came home and hugged our significant others just a little tighter), our personal experiences affect how we provide care. Yes, appropriate boundaries are important – privacy respected from both sides. My point is personal development and professional development may occur simultaneously, so it’s crucial for nurses to reflect rather than burnout. This practice of reflection isn’t as mainstream in nursing as infection control, for instance, but it should be for the health of all.

My father’s unexpected death a few years ago is what helped me better understand patients’ and caregivers’ experiences in their own loss. I was present while I assisted hospice patients and their families in my mid-twenties, but until I experienced what those families went through by losing my own loved one did I further possess clarity of the range of emotions related to grief. Nurses learn disease process, nursing process, care guidelines & skills in education. We attend our clinicals to practice those objectives as a beginning foundation, but the true growth of a nurse comes in the experiences – even our own experiences outside the shift.

Some of us may come to the profession with personal loss we’ve experienced in our lives. Others may not. I attended nursing school directly from high school. Although we discussed death and dying in our nursing curriculum, it’s not quite something that can be simulated until it happens in our own lives. It’s not something that can be felt until it happens. Felt – what does it feel like to grieve? What does it feel like to have diabetes? What does it feel like to spend a week in the hospital? What does it feel like when the cancer has metastasized? What does it feel like to receive dialysis? We can never know, as clinicians, all of these experiences. Patients do know. Another nurse might know. A physician might also know.

So here’s the greater lesson – healthcare at its best is a mutual process – between everyone. Everyone. We are all in this human experiment together, but each of our experiences of health and illness and loss and wellness may vary. So the sooner we can understand and appreciate the mutual process of care between patient and clinician, nurse and nurse, nurse and physician, patient and insurance billing representative – the better we can provide care. We learn from each other. We grow from each other. Our knowledge may vary but our life experiences are what connect us. Allow me to rephrase: our knowledge doesn’t connect us, our experiences do.

Any nurse can provide knowledge to a patient and do it by rote, but if a nurse is invested in what the patient may be experiencing while educating about a disease or treatment – therein lies the connection.

When I heard the news that my father died, one of my early thoughts was: “I know. I know now. I understand.” I now can relate to the heaviness in the diaphragm when experiencing grief. And the drifting thoughts of a parent I’ll never see again. And even though I have accepted my father’s death – I am prepared that when I’m serendipitously listening to “Car Talk” on NPR one Saturday afternoon as a young woman tells a story of how she wrecked her father’s car as a college student, all she has to say is “Dad!” and her father who has just been called into the radio show responds, “Yes?” that tears may still well up in my eyes. Grief is an ongoing journey.

The quicker we experience care as a mutual event (not just a bunch of data, not just a list of DRG codes, not as a series of people identified as hospital room numbers) – the better care we can create.

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