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06 Feb 09

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

well.blogs.nytimes.com/...can-nurses-care-too-much - Preview

Nurse Care

Too Much?
In medical oncology our patients stay in the hospital often for weeks or even months.
8 more annotations...
- We get to know them, their families, even their friends.
- “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.
- This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief.
- ut if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse.
- 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.
- 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.
- 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.
- 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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