the::people::around::me

Henri Cartier-Bresson, La Villette, Paris 1929

New-nurse-in-the-hood describes herself this way:

Baby nurse in the ED surrounded by nursing homes in the worst part of a big city. Consequentially, I get sworn at A LOT, and I'm growing up fast.

I've been meaning to recommend her, but as you know, I'm not blogging much of late. It was on my list.

Then the girl went and wrote this, impinging on my doggone hiatus. She calls it Compassion Deficit:

I think everyone has their type of patient that they just can't get over the feeling of wanting to kick. I've been a little surprised at myself lately at who it's been. I've always known that I can't deal with the entitled patients. I know why, and I've learned how to deal with them. But lately another sort of pet peeve- I hate to even call it that, because it's a little stronger than that- has crept over me for our addicts.

This may seem like a given to a lot of nurses, especially those that work in ER. But it sort of bothers me. I've always sort of felt deep inside that the reason I always end up with so many high drama psych patients is that God knows I know how to deal with them. I always thought that I would feel sort of a kinship or at least a deep empathy for addicts because of my own past. I was never a substance abuser, but I've dealt my whole life with a lot of unhealthy tendencies. When I was about 13 or 14, I started cutting myself. A couple years later, I also started dieting to a ridiculous degree even though I was already underweight. When I slipped up, I would make myself throw up. I didn't tell anyone. For a long time. When my family found out, and I realized how much it hurt them to see me this way, I worked very hard to stop. I had my setbacks, and I still have the tendency to do these things. I always will. The thoughts still run through my head, but I have it in me to stop myself because I think about how it hurts the people around me.

I think this is where I struggle. I hurt for our depressed patients. I hurt for the type of people who rely on some self destructive behavior to escape all the bad things they feel. But I hurt even more for their families.

I took care of a lady with liver failure and esophageal varices the other day. I remembered her face. I knew why she was here. Drank herself sick again. This time, though, her son was with her. I knew I would have remembered him. He was a big cherubic looking kid. Really quiet. Really young, about 21. He never asked us for a thing. He sat there and stroked his mom's hair and held her hand while we tried to start an IV on her scarred-up shit veins. I don't think she even really acknowledged his presence. She did demand Dilaudid from us while he sat outside the room and cried. He asked one of the nurses how much it would cost to get his mother a liver transplant. That was enough to make me cry, too.

And my patient last night. Came in via EMS for approximately the 50th time this year. Took 9 Vicodin at once for whatever bullshit pain complaint she made up at that particular moment. Her tooth...nope. Maybe her back. And/or neuropathy. Wherever the pain was, she wasn't trying to kill herself or get high. She was just trying to make the pain better. In fact, the pain was still there, could she get some more pain medicine? Yeah. No. So her husband came back. Apparently this was a pretty regular little routine for them. By the way, she'd also been popping Xanax all day like they were sweet tarts. She does this and passes out, he says, so he just calls the ambulance as soon as she does it. Take her meds away, we tell him. Nope. Can't do it. Supposedly if he takes her meds she throws boiling water on him. Why he stayed with her I have no clue. But he did. The whole night he hugged and kissed her while she drooled. He cleaned and changed her when she peed on herself. This is my wife, he said. I married her because I love her. The EMTs who ran on her knew her by name. They said he would run down the block and use the pay phone to call 911 because she got so irate and abusive when he did it, so he would call from outside the house and pretend it wasn't him. I felt so awful for him. He clearly loved his wife so much, and there was absolutely nothing he could do for her.

I looked into both of these people's faces trying to find what it was that made these people love them. I could not figure it out for the life of me. Who had they been? And what happened? I can understand trying and failing. But I cannot understand looking into the eyes of your loved one and seeing the desperation I saw in both of these men and not wanting to change at all. The selfishness in them made me sick. It didn't change the way I cared for them but it just felt... bad. Like there was an anger in me for them that I really felt uncomfortable with. Chances are that these women will both kill themselves with their behavior one of these days. An awful part of me felt like it would be better for their loved ones if they went ahead and did it.

Is this normal? Am I putting too much on them? And is it even fair for me to compare my problems with theirs? This job sneaks up on me so bad some days.

[Click HERE to read more amazing blog entries over at New Nurse, in the Hood.]