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https://www.infirmiere-canadienne.com/blogs/ic-contenu/2016/03/07/la-compassion-du-bout-des-doigts

Stephanie Keddy breaks through the barriers of isolation precautions

Mar 07, 2016, By: Stephanie Keddy, RN, BSN

“I need to go to the bathroom,” she said. I was covering for this patient’s nurse while she was on break. I washed my hands and walked to the isolation precaution rack to put on the yellow gown. I donned a mask with a visor that covered my mouth and nose and shielded my eyes, washed my hands, and pulled on gloves. Theoretically, I was now protected from catching the illness this patient might have.

“I’m not contagious,” she said, assessing me.

I nodded in agreement and shrugged my shoulders. “Those are the rules — just in case.”

“I know. I’ve been through this before, so I understand why you have to. But I can tell, I don’t have contagious pneumonia,” she offered.

I pulled the flimsy aluminum walker around in front of her, to facilitate the transition to the bathroom. The oxygen prongs were pressed up into her nose, the tubing bisecting her cheeks and wrapping over her ears, reconnecting below her chin. Her breathing was rapid and laboured.

Following behind the walker, I kept the oxygen tubing and a Foley bag from becoming tangled as she spun back to sit on the toilet.

“Do you need a minute?” I inquired, more for my own sake than hers. She nodded. I slid the door closed and walked away from the bathroom, peeling off the sticky gloves, then washed my hands, pulled off the gown, mask and visor, and washed again.

Before long, the rapid beeping of the bathroom-assist call bell snapped me out of my night-shift stupor. Deep breath and big sigh. Hands to wash. Gown, mask and visor, gloves to put back on.

We made our way back to the bed, where she plopped herself down. Her breathing was more laboured. With every exhale, she pressed her lips tightly together and blew as if trying to cool down hot soup. Eyes downcast, eyebrows knit together, she concentrated on slowing her breathing.

She rocked backward and sprawled across the bed, then slowly swung each leg up. I raised the head of the bed, and we waited for her breathing to settle. Breathlessness, so often paired with helplessness, is never easy to watch. My heart ached as I looked at her through my shiny visor.

She looked up with eyes full of sadness and gratitude. “Thank you.”

I muttered “no problem” as I turned to exit though the curtain; then her stoic features crumbled and she began to cry.

I reached for the box of tissues on the side table and placed it in her lap, stepping back to my original position. I watched and waited for her to speak.

“I’m sorry. I hate needing help. I have always helped everyone else. My kids. My husband…he was like a kid; he never helped with anything. My mom...when she got sick, I looked after her until she died. This isn’t me. This isn’t what I wanted. I look back and think about everything that has happened in my life. The bad things: as a child I was sexually abused, and my dad would bring home mistresses while my mom was away. And the good things: I used to be a dancer. I taught my granddaughter how to dance and put her through lessons. I used to be thin and beautiful, would you believe it? I still have so much to say. I want to tell people my story. I’m not ready to die. But I can’t live like this. This is no way to be. I can’t believe I’m sitting here crying. I’m sorry. This isn’t like me; it’s the first time I’ve cried.”

I stood there, heart racing, wanting to rip off the mask so she would be able to see my whole face. Desperately trying to come up with the right response, I noticed I was already holding her hand — an automatic unconscious effort to offer comfort. I had been rubbing my gloved thumb back and forth over her knuckles and the back of her hand while she talked.

I asked about her daughters and granddaughters. Did any of them live nearby? Could they visit so she could share her stories? I told her it is OK to be upset. Sometimes a good cry is exactly what we need.

Against my better judgment, I stole a glance at the clock while she was looking away. Already 05:55. She caught me. They always do.

“You have more important things to do. I know how busy you are,” she said, picking up on my thoughts.

I told her, “Everything else can wait; this is where I need to be right now.” I squeezed her hand. She squeezed back.

In that moment, I understood what it means to be fully present as a nurse and that listening with compassion can be the best care we can give. I had learned this in school but had not truly accepted it. I vowed to remember this lesson always.

Dabbing away her tears with a balled-up tissue, she looked up at me. “Thank you…You know what the best part of talking to you has been?”

I shook my head.

“The way you have been holding my hand.”

Stephanie Keddy, RN, BSN, works in heart health services at the Royal Jubilee Hospital in Victoria.