Helplessness

One of the things I find the most difficult about nursing and medicine is the feeling of helplessness. Today I was working (as a nurse!) and had some pretty sick patients. I went into Ben’s room sometime in the morning to find him half-way between his bed and wheelchair, about to fall on the floor. I ran over to help him and was shocked to find he weighed as much as a little child. I helped him back into bed.
“What’s wrong, honey?”
He stared up at me with dull eyes sunken into his emaciated face and didn’t answer.
“What’s the matter? How are you feeling?”
“What do you think?” He gasped between labored breaths.
Later I found him slumped over in his chair and I squatted down next to him, trying to see if I could rouse him. Had he had a stroke? I put a hand across his shoulder and felt every single bone across his back and shoulders protruding out. He was literally nothing but skin and bones. He was dying. I adjusted his oxygen mask and turned it up a little, smoothed down his shirt. I counted his irregular pulse and ragged breathing, and I wrapped a blood pressure cuff around his skinny arm. I couldn’t get a reading; it was so thready and weak and his arm was nothing but paper-thin skin stretched over his fragile bones.
“What should I do?” I asked the charge nurse.
“Do you think he had a TIA?” She asked me. (A mini-stroke.)
“Maybe….. I think he’s just wasting away.” I said.
“The doctor will be back soon.” She said. “You can get him to take a look at him.”
The only thing was, I knew what the doctor was going to do. Nothing. What could he do? Maybe some protein shakes, but Ben wasn’t eating. Maybe some pills to keep him from being agitated, but that wasn’t really his problem. He was dying, that was the problem.
Another patient that morning, Richard, had a dose of morphine due and I went to bring it to him. He was completely stuporous and I couldn’t rouse him no matter how hard I tried.
“Is he usually like this?” I asked another nurse.
She sighed. “Sometimes….. He’s up and down.”
Morphine has the effect of depressing respiratory function- in the case of giving it to a completely stuporous patient- you have to make sure the benefits (pain control and decreasing agitation) outweigh the possible risks (respiratory depression leading to death).
“I’m not giving him his morphine.” I said. “You let me know if he gets agitated and I’ll decide then.”
I wasn’t feeling well all shift and when I came off and reported to the incoming staff I felt pretty low about the whole thing. I drove home in my car thinking about Ben dying and not being able to do a single thing for him. No matter what I did, I was just prolonging his inevitable suffering. The same with Richard; nearly comatose, hardly breathing- what could I do for him?
By far the biggest thing, though, that makes me feel helpless, is my sister Hannah. Since I came back from Antigua she has been having trouble swallowing periodically, leading to choking episodes. It kills me to see her getting worse. I would do anything for her, there’s not even a question in my mind. But what can I do?
The only thing I can do is love her. Be her sister, pray with her when I tuck her in bed at night, listen to how her day at school went, be patient with her. Love her.
And that’s the only thing I can do for patients like Richard and Ben and so many others. I can give them their medications and try to treat them, but in the long run, it is the love I give them that matters.
Richard can’t respond but I like to think he can hear me when I talk to him gently as I dress him. Ben stares at me with hollow eyes but I rub his gaunt shoulders as I give him oxygen and I point out that the sun is shining outside the window and it is a beautiful day.