By Jo Ellen Welborn, MSN, RN
Sometimes routine encounters can remind us of the rich life experience that resides within many older patients. One cold winter while working the night shift, I was making bedtime rounds when I came to a room in which two elderly gentlemen slept. I left the lights off and worked using the light coming in the door from the hall and the street lights shining through the window. I checked on the first patient, addressed his needs, and he settled back in to sleep. I moved on to the other patient, “Sam,” and tried not to wake him as I evaluated the IV infusion and observed his breathing. He turned over and began talking softly. At first, I thought he might be confused because he seemed to pick up the threads of a conversation in progress. He started to tell me a story from his youth about the harsh winter of 1917-18, on the plains of Oklahoma.
Sam was a handsome, white-haired gentleman in his 80s who had grown up in rural Oklahoma on a farm. His face was kind, but bore the imprints of a long life of hard work. Sam began telling me about the winter of 1917-18, when the Spanish influenza outbreak devastated communities all over the world, including his small community. He was 15 years old and had dropped out of school in the third grade to help support the family.
Most people were cared for at home by family, especially in rural areas. Sam told me how he spent the mornings driving the local doctor from farm to farm to make house calls. Automobiles were scarce, but the area’s only doctor had one. By Sam driving the car, the doctor could doze off between farms and houses. Sam spent the afternoons digging graves in the frozen ground of the local cemetery. What a somber and heavy task for someone so young.
One night on his way home, Sam noticed that a neighbor’s house had no smoke coming from the chimney. Sam went to the house to investigate and discovered that every member of the family had died except one — the baby. He wrapped the baby up and took her home. His mother cared for the baby until relatives could be located. Sam’s eyes had a far-away look in them that told me he was back in the winter of 1918 recalling an experience that changed him forever. He provided me with a snapshot of life on the prairie, and a viewpoint of how difficult and harsh life could be.
I retrieved an extra blanket for him, partly to provide added warmth and partly to shelter him from that cold night 70 years before. I thanked him quietly and wished him goodnight. I drove home after my shift with the car heater on full blast, thinking about that cold lonely walk for Sam, trying to keep that poor baby from freezing.
I often think of Sam as a teenager trying to endure a devastating epidemic. The expertise of healthcare was so limited then. There was little that could be done to ease the suffering. I wonder, would I be able to respond to a devastating epidemic? Would I be able to offer comfort? Would I be able to move forward or would I fall into despair?
When older patients share their life experiences, I feel I have been given a gift. There is something richer about an experience that has been lived, processed, recalled and kept that gives it added luster and depth. In his way, Sam honored the memory of those who shared that experience — those who endured
and those who could not.
Sam reminded me that each elderly patient I see was once a strong and vibrant youth with the hopes of a lifetime stretching before him or her. He reminded me that my elderly patients are a rich mosaic of a long life with all of its joys and sorrows. Sometimes I will be privileged to get glimpses into these lives as I seek to learn how to better listen to them and to resist the common attitude to treat elderly patients like they are wrinkled or incompetent children. I see how poorly that respects the person lying in the bed. I hope the next elderly patient will be met by a nurse whose eyes and heart are open, and provides an honest acknowledgment of the complete person, wrinkles and all. Thank you, Sam.
Jo Ellen Welborn, MSN, RN, is a professor in the ADN program at Weatherford (Texas) College.
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