A Common Language
By Darren Smith, BSN, RN
There was nothing unusual about one Tuesday night in the winter of 2016. I had received my nursing assignment, began doing patient assessments, and prioritizing my course of action for the shift. I thought I would be spending most of my shift with Mr. S, as he was, no doubt, my sickest Veteran. This was his first admission to our hospital. He was sick and at risk of getting much worse that night. I went in and introduced myself to Mr. S and his wife. His blood pressure was low, his heart rate was high and irregular, and his legs were swollen, red, and sore.
I pulled up a chair to sit and talk, no to LISTEN, to Mr. and Mrs. S. I knew the medical plan. I knew the medications that would be ordered and administered throughout the night, as I had done this many, many times. However, Mr. S had never been in this situation before. His parents had died of cardiac issues before they were 60 years old and Mr. S was in his early 70s at this time.
He told me that he didn’t really understand the medication that was going into him. The admitting doctors had used long medical words and acronyms that he didn’t understand. He said he had to “pee all the time” and that “these damn cords and stickers have to stay on, and if one of them comes off, someone immediately comes in and puts them back on.”
As I sat listening and looking into his eyes, I heard what he was saying. I heard fear in his voice and saw it in his eyes. I asked him what he did for a living. This was a technique I had used before – seeking to find a common language that I could use to translate his medical condition into a subject that he could understand. He told me that he was a retired airplane mechanic, and later owned a lawn care company. YES! I immediately thought of a way that I could speak to him in a language that he could understand. It was like my eyes, ears, and voice were opened and steady for the first time. Words, thoughts, and phrases that didn’t come from me, were given to me without any preconceived pep talk. I began to use words that he understood, with references that were familiar within his specialty.
Looking back on this experience today, I do not know where those words came from. I feel I was being used as a voice from somewhere otherworldly to provide this message. I now believe this was a power greater than myself speaking through me to Mr. S. I feel that I was sent to translate, that I was being used as a beacon of hope in an otherwise dark time.
I held his hand, looked into his eyes, and explained what was going on with him. At first, he seemed surprised that I was holding his hand and then I saw a tear run down his face. He looked at me and thanked me for talking to him in that way. I went to leave the room, and Mrs. S stood up and gave me a big hug and thanked me for taking the time to talk to them. I thought nothing of it. I had done this type of translation hundreds of times.
Why was this night and this conversation different? Why was I now recognizing the impact of the words that I had spoken? I saw the complete picture of what was happening to the man in the bed.
I sat outside of his room for the rest of that night because Mr. S was on the verge of needing to be transferred for more intensive care. I hovered, looking in on him as I had when I was a new parent, opening the blinds every 10 minutes to watch him breathing. Around midnight, I went in and told him that if anything happened, if he needed me, I would be right outside of the room. I told him that I would do everything I could to make sure that he made it through the night.
The next morning, when the medicine team came to see Mr. and Mrs. S, Mr. S told the doctors what his medical diagnosis was and what was happening with him, in terms that HE understood. As I listened from the doorway with a grin on my face, I had a feeling inside of me that I had made a great connection, and I took a risk that had paid off. Far too often I have felt like I should stay in my lane, that I am “just a nurse.” I will never again second guess that gut feeling to show vulnerability. It doesn’t happen with every Veteran I care for, but I saw the benefit right then and there. At the time, I couldn’t explain what this moment was, I just knew that I would never forget this night.
Over the course of the next nine years, I continued to see Mr. and Mrs. S sporadically. They ended up moving not far from me, and one day I stopped in to see them. They were so happy to see me and told me that I had saved Mr. S’s life that night. I was humbled.
One day last winter, I received a voicemail from Mr. S’s granddaughter to tell me that my friend had passed away. I was sad to hear this, about this man who changed the way I look at the person in the bed. I feel like I saw all of him, not just a diagnosis, not just another congestive heart failure patient in bed.
Darren Smith, BSN, RN
I went to the viewing to say goodbye to the man that opened my eyes up to allow myself to see and show the vulnerability that can change how I see people. I took a chance to open myself up and consider how I would like someone to treat my loved ones. How I would want to be seen as a man, not just some sick guy in a bed. His family thanked me repeatedly, telling me that I had given them 9 more years with their husband, dad, and grandpa. I told them I was the one that was blessed to know my dear friend Mr. S, and that I learned from him.
This experience gave me hope. I had allowed myself to go against the grain and make a personal connection. I was so worried that I had shown too much of my own humanity, of my own fears. By allowing myself to be vulnerable, I made a spiritual connection and was allowed to be a bridge in some omnipotent scheme that was beyond my mortal comprehension. Somewhere early in my nursing career, I was told to not become so emotionally invested in the care of my patients, and that this form of compassion, I guess an agape type of love, was wrong. I now feel sorry for whomever feels that way. This experience still motivates and drives me to be the best I can as a fellow traveler on this Earth. Mr. S’s granddaughter told me that she had become a nurse, and she hoped to be as good as me someday. I told her that her papa helped to make me that nurse, and I am the one who was better because of knowing him.
This night happened almost 10 years ago. I have taken care of hundreds of Veterans since then. I cannot explain why or how it happened. I have made so many connections in that time… connections that changed me again and again. I think back on my friend and other shared sacred moments that have been a part of my nursing career and I wonder, how can one man be so blessed? What have I done to make me worthy of these moments when time stands still, where words flow from me as if they were written by the Master Himself? How have these opportunities shown up when I least expected them?
I am not sure if any of those sacred stories, those spiritual experiences, would have ever happened if two men had not allowed themselves to show their vulnerability, enabling both to grow. Thank you, my dear friend. I love you. I miss you. I am a better man for knowing you.