You may have noticed this term rabble-rouser in my blog title sub heading….. Or maybe you did not. Probably the latter. I am fairly self-deprecating by nature and do not want to seem overly confident that anyone is even reading this, but one can hope. “I’m not worthy, I’m not worthy,” as quoted by Wayne and Garth, circa 1992-ish is my natural mantra. I can’t seem to stop. It’s too comfortable. But I am a work in progress. So rebel rouser? What the heck is that?
Rabble-rouser is defined as:
A speaker who stirs up the passions of the masses; a demagogue.
I have heard this term before and used it, Amm…. Well, never. But it stuck with me forever after hearing it on a Seinfeld episode and I have been dying to use it ever since. And, it kind of fits. So here I am, going to make an attempt to rabble-rouse. A soft attempt. As this is, in fact, my claim. We are going to ease into this, however, as I want you all to come back.
There are so many issues that are ethically challenging to choose from in the medical profession. I think that we can agree, will be something that is never ending. I was quite taken recently with a fairly controversial article while browsing the allnurses.com website the other day titled, My Burnout Story. The link is below.
If you are in this profession long enough; the word burnout, may at some point, resignate with you. I know that it has for me. This article spoke to me. It conveyed such honesty, that it was hard not to become moved by her experiences and her feelings towards them. She signs the article with the words, Another Broken Healer. I relate….. I know……
The nurse’s candor was something that is not very common in today’s medical world where the mantra is cover your butt first. Her words seem desperate and lonely. She worked in the ICU. She writes that she was dealing with another patient death and it appeared from her words that she has dealt with many. She reached her breaking point. Death is one of the many facets that we have to deal with in this all encompassing role that we have chosen. I can say today that I do not think you are ever quite prepared for the first or the last, and also, all of the in-betweens. It’s a unique experience that I would argue cannot be taught in a classroom or conveyed in a text book. You have to experience it…. Be present…. Be there.
I remember the first time I was with a patient that died. I stayed in the room and stroked his head consistently as I prayed in my mind over him. Something that I still do to this day when I am with anyone who is passing, patient or family. I feel such a strong and intense need to touch them as though somehow they need this, and that it will help put them at ease in the process. He lay there shallowly breathing and unconscious. The ventilator had been removed quite a while ago. Respirations were decreasing. He had no family or friends by his side, just me. While he took his last breath I remember that I felt his energy. I always feel the energy. It was powerful and something I cannot put into words. I realize to say “I liked it” would sound wrong, but I did. I liked being a part of the change, the transition; the end or the beginning…. The experience was and is intense.
I have been with many people who have passed since then and my feelings are the same. But I know what to expect now and that sometimes has made it a bit easier. The energy is still there. I still feel it, but you can become tired of it, or become tired from it; either which, I’m not sure. The feeling can be exhausting. Even if you do not know this person. It’s a life… It’s your patient.
You then have the variables…. Were they young, suffering, or tortured,? Did they die suddenly? Are they leaving behind small children? Are they a child? The list is endless. But what about the variable that is us? What about the question you may now ask yourself, “Was I somehow responsible?”
This is what the nurse speaks to in this article, and I must say I greatly appreciate it. She claims to “know” that she had some responsibility in some of her patients’ deaths. If we all rationalize enough, I think that many of us in one instance or another can say the same. The what if’s… The should of could of’s… The replaying of a situation over and over and thinking of what you could have done differently.
“What if I called the Dr. earlier?” you think. Or, “Why didn’t I see the change in status quick enough?” These are things we can torture ourselves with. Anyone in this field can. Some just torture themselves differently than others. Some suffer in silence. Some repress… And maybe there are some who don’t suffer. Maybe they can cope. I don’t know. Because to talk about it would be taboo. It would be like some admission of guilt although there has not been a crime. So we don’t. We carry on.
We are not perfect. Medicine is not a perfect science. It’s a science invented and performed by flawed humans with an imperfect skill set. I can say this over and over, but it sometimes is just not enough to ease the pain or to stop the “What if’s” from playing over and over in our heads. The stress and anxiety can be unbearable at times. The author talks of looking at a medication five or six times to make sure you are not making an error. I recall many nights obsessing about things that I thought that I had forgotten to do when I left my shift. To keep going in this job sometimes you have to, I think, just try and let go. At least on some level. We take an oath to practice safely and with the best intentions, and at the end of the day, we have to believe that we did just that. We have to believe in the system of checks and balances. We have to allow it to rest in someone else’s hands and leave when our shift ends. We have to realize we are not the masters of the universe.
Sometimes it is all too much. Sometimes you have to let go, move past it, live and learn. And sometimes you just get up and quit, like this nurse did. Sometimes that is the only way because sometimes you just can’t take anymore. But more often, you just keep going, because this is what we do.