"That B*tch is back." | The Moment that Eased my Soul When Nothing Else Worked

“Oh no, she’s so mean… that b*tch is back.” – per night shift report.

What does this even mean?

To be fair, starting a 12-hour Emergency nursing shift with this energy is a direct statement for shaky grounds.  Especially when there is a full workup ordered that has been untouched (full work up translation: blood work, urine tests, & imaging diagnostics as indicated).

I worried, then I looked at the name and recognized this individual as a patient I had less than 72 hours ago, admitted to the hospital for continuing care.  The nurse was right! – “She’s back.” But why?

Mind you, the night shift gave me a sympathetic warning that they had just cleaned up a large bowel movement before I got there.  This was the reason no labs were drawn, and the workup was not started. 

When you have been in the healthcare industry for this long, you no longer think of the tasks.  You transition to thinking of the air of your shift and how smooth things will unfold based on the personalities of your patient, family members, physicians, and team members.  (aka connection)

Unfortunately, I automatically asked another nurse for assistance, rather than stating I needed help; I stated, “she’s mean so I just wanted to be sure I had support to do this.”

Listen First,

drop the assumptions 

But at that moment, I checked myself, stopped to go meet the patient first, remembering her lack of bubbliness I encountered during my last shift.  However, my internal voice expressed that today was a new day and every one of us deserves a chance to be new again.

I went in with all my supplies ready for use, introduced myself and mentally prepared for the unknown.

P.S.  The patient gave me wholehearted verbal consent to share this story.

PMH (Past Medical History) Update: 

Typical plaques seen in spinal and brain CT of patient with multiple sclerosis. (From Herring W. [2016]. Learning radiology, [3rd ed.]. St. Louis: Saunders.)

This patient had a known history of Multiple Sclerosis (MS).  MS is a chronic neurological disease that will typically result in the worsening function of voluntary muscles, meaning lifelong with no cure.  Some forms may be more aggressive and shortening one’s lifespan, whereas, in this scenario, the patient had learned to function without the use of both legs and very limited use of both upper extremities.

Tip #1: LISTEN FIRST

The first thing I did when I returned to the room was, set my pile of supplies on a tray and I sat down on a moving stool at the patient’s eye level and asked, “How can I help you today?”  The patient proceeded to describe the reason for return to the ED and expressed apologies for coming back into the hospital.  I explained all the procedures that needed to be done from a nursing standpoint and asked the patient what the patient would like to have done first. 

If you are a nurse, actor, psychiatrist, salesperson, physical trainer, 30 under 30 entrepreneurs, elementary school teacher and more… the most powerful gesture you can provide to your potential client/student etc. is to listen.  It does not matter how many years of experience or degrees an expert has under their belt.  In the end, it is about the needs this human right in front of your eyes is able to express openly and vulnerable towards you – the expert. 

Tip #2: DROP THE ASSUMPTIONS

As I proceeded to complete multiple uncomfortable tasks, the patient responded with so much gratitude and we had a beautiful conversation about how this patient was able to live with MS on his/her own.  What were his/her thoughts when presented with the diagnosis.  This patient lived for years unable to move waist down and did not say a single word to complain about his/her journey. 

This b*tch was not back.  He/she was nowhere within range of this remark made up of judgment and assumptions.

I have been an ED nurse for 8 years and this was the first time I cried as I put in the intravenous catheter into his/her left hand.  Obviously, I tried to look down and hide it, but this was not necessary.  In turn, she allowed me to express my feelings.  I told her, at times I find it extremely difficult to remove the events, unique people, illnesses, struggles, and tragedies I see at my work and not take these polaroids home with me.  I persistently wonder, how people cannot recognize how valuable life truly is.

When I see lay people complain of minuscule challenges, it blows my mind every single day.  As a result, I sometimes isolate myself because I see adversity in a different way.  I want to see light in people when I look in their eyes during a one on one conversation.  I want so badly to see people make peace with the most challenging events in their life.   I want so badly for people not to be scared and to value their self-worth.  I want so much…

Tip #3: LOVE WHAT YOU HAVE TO OFFER

As we continued the day, this patient told me, “You really need to go to Disneyland, get on space mountain and just scream.”

This made me laugh and realize once again, I am so passionately in love with what I do and the opportunity to develop unique polaroid moments with my patients and their families.  The overbearing concern I had for my patient was unnecessary.  As I was attempting to help feed him/her, the patient expressed that he/she was okay and thanked me for my efforts.  Rather than see these events as a hardship with no recovery, this patient taught me that I needed to return to a space of permission and honor.  My openness to love what I had to offer in turn gave my patient permission to feel and express elements of life special to this specific disease.

What is it that you love?

What do you have to offer?

My soul was complete.  There was no exchange in the world that could replace the amount of insight and consciousness I gained from this patient.  From human to human I will never forget his/her words, “man plans my steps, but god plans my way.”

Some of us may not see eye to eye with a higher being.  This is okay.  But at this moment, this is what made sense to my soul and brought me great clarity for ~ every move I make in life as a human here with the rest of you, the lessons learned will always be worthwhile.

Tip #4: COMMIT TO CONTINUITY

Lastly, the "aha" moments that create a brief impact on our personal self.  In one of my favorite texts written by Singer entitled The Untethered Soul, he mentions

“Your will is supreme overall.”

— Michael A. Singer

This reminds me of the will to continue and the will to demonstrate accountability.  The soul is most at ease when good deeds are mastered through repition and refined over and over again until the psyche is not longer overthinking.  If it is a sound position in nursing, fashion, real estate, fitness, nutrition, finance, and more that you pursue, stay on top of your A game.  Grow through what you go through.