End of Shift: Lessons from Nana, my first patient

By Danielle Airaghi, BSN, RN, CARN I remember I first wanted to be a nurse when I became a quasi-nurse at age 15. By my sophomore year in high school, I had perfected safe lifting and ambulating techniques, wound care and medication management. These things are easy to master when you're highly motivated by your patient. In this case, my patient was my grandmother. She taught me the most important lessons about being a nurse that I could ever learn -- to have patience and compassion, no matter who your patient is. Nana was a nurse many years before becoming my patient. I had always known her to be strong and intelligent. She was my best friend when I was a child, a constant fixture in my life. When she had her first heart attack, her cardiologist told her she would need a quadruple heart bypass. This was not an easy procedure for an 84-year-old to bounce back from. She had the surgery, but the physicians were forced to use cadaver vessels after not finding suitable transplants in her legs. They told Nana this procedure would extend her life by only a year. She came home after a few weeks in a skilled nursing facility and returned to her own bed. Nana hired in-home nursing care, but only so we wouldn't worry about her during the day. We knew it wasn't working when I returned from school and found the nurse sleeping on the couch on more than one occasion. Nana said she'd be fine on her own. We'd set her up in the morning with all the food and necessities for the day, and with a phone within reach. That year, I came straight home from school every day to care for my special patient. I cared for the incisions and staples in her legs from the attempted vein retrieval and her chest incision. I talked to her about her day and made sure she had taken her medications. I helped her to the bathroom and checked her daily weights. I washed her clothes, cooked her meals and combed her hair, as she had once done for me. I cleaned her incisions as she had once washed my scraped knees. Some nights, she would get scared. She never explained to me about what, but I realize now she was facing her own mortality and it frightened her. She would ask me to come stay in her room on those nights, and I would fall asleep to the sound of her little battery-powered radio forecasting the weather for the next day. Nana was leaning on me as I had once relied on her. I listened to her fears and tried my best to comfort her. I had no way of comprehending the enormous weight she was carrying. I didn't have to understand; just having someone to listen to made her feel better. Nana, my first patient, taught me the importance of being present as a nurse. To be emotionally present is the most powerful skill a nurse can possess. Every nurse needs to have -- or learn -- the ability to truly care and empathize with every patient, no matter who they are. Nurses need to be open to listening to anything patients and families need to say, to share the emotional burden they're carrying just by listening to them. I learned this lesson at age 15. You don't need a higher degree to be an excellent nurse, just a higher sense of caring. Danielle Airaghi, BSN, RN, CARN, is a staff nurse at Virginia Hospital Center in Sterling. To comment, email [email protected].