Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation
Just a few times in my life, I have been witness to real artistry. And during those rare times, I am usually caught quite off-guard. An ordinary moment somehow slows down and the good we can do in the world and for one another becomes so beautifully possible and necessary. This week I experienced such moments within our healthcare system – dysfunctional and difficult as that system is to maneuver, there are still moments of human compassion and professional artistry that provide lessons for other times of crisis in life and in our nation’s current economic and social condition.
Being a patient in the ICU after surgery must be traumatic well beyond the physical reasons that landed one there. There is an almost constant and startling amount of discordant noises and activity – alarms are going off everywhere, it seems. Medical personnel move in and out of the area. Loved ones try to comfort but pain and illness make that difficult; the signs of worry on their faces cannot be questioned from the fog of medicated semi-awareness. Any amount of restful sleep is nearly impossible yet the body cries out for some comfort.
Such has been the scene for my husband six times over the past few years, and so it was this week as he came through another risky surgery aimed at averting an even more disastrous medical crisis. And such was the scene for me as his primary caregiver outside the hospital. It never gets easier for either of us. This surgery and ICU experience was especially difficult on many levels but maybe most because we were totally alone to face it. The children are spread out all over the nation, too busy in their own lives or hurting from their own financial struggles, so no one came to be with us.
As my husband’s alarm kept sounding – due to a low heart rate (bradycardia) and very low blood pressures – he would ask, “What’s that? What’s my blood pressure? What does it say now?” At home before his surgery we had sometimes seen very low readings, but never this low. Sometimes I answered honestly when he asked about the alarms, but as the numbers became more erratic and later as they slipped lower and lower, I would answer less directly and try to deflect his attention. Nurses would slip into the room to quiet the alarm before another minute or two would pass and the alarm would begin again. Soon enough, two nurses stayed in the room, they silenced the alarms and stood watching the monitors and ready to administer needed care.
They began administering pressor drugs to raise my husband’s blood pressure, and as his pressures would rise up a bit, he would start complaining of a terrible headache. The nurses would then give him intravenous pain medication for his headache, and he would drift off to sleep for a few moments. Blood pressures and heart rate still too low, and more pressor drugs, more headache, more pain medications. During these hours of ICU attention, I was mostly quiet except for a few words of comfort for my husband or to let the nurses know something he could not or had not that might help. The numbers I was seeing on my husband’s monitors I had only seen a couple of other times in my life when people I loved were near death and did indeed die. I knew part of what my husband needed from me was reassurance and calm, even if inside I was terrified.
At some point during those hours, my husband said he was hurting from being flat on his back since the surgery many hours earlier. The nurses told him they’d be happy to help him turn to one side, though all the drains, tubes and wires seemed like huge obstacles to any movement. Quickly and smoothly, one nurse gave my husband a gentle roll to one side as the other stood ready to hold him on the other side. He’s not an overweight person, but he is tall. One of the nurses straightened out all the wires and tubes as the other rolled a fresh bed pad to go under my husband’s back. Then in one swift and well-practiced maneuver, one nurse reached behind and grabbed some powder and sprinkled the bed pad as the other nurse held my husband before they reversed their holds and he was gently resting on his side with fresh linens underneath. In less than three minutes, the patient was more comfortable, the linens were changed and the nurses were back to the monitors.
Over the next few hours, I watched and listened as they worked to stabilize my husband. They knew that I knew how serious this was – and they also knew that I was most comforted and best able to comfort my husband when I knew they were acting at every moment to keep him safe. It wasn’t until the immediate crisis had abated that I noticed one of these amazing nurses was very pregnant. I asked her when her baby was due, and Grace answered (yes, Grace was her name), “August 6th is my due date.” Imagine working in this sort of high intensity, highly physical and demanding setting when she is less than six weeks away from having her first child.
Over the next couple of days, I saw equally challenging situations addressed with artful professionalism as patients and their loved ones cycled through this busy, urban neurosurgical unit. While my gratitude certainly related to my own husband’s continued recovery, my admiration for bedside nurses as the lifesaving, life affirming glue that holds an ever more fractured healthcare system together for us all grew exponentially. I knew in those moments that even if the outcome had been less good, all that could have been done for my husband was done by these registered nurses.
I felt as though I had watched a symphony of sorts or seen a great painting or read a masterful poem. And I knew once again that trusting the judgment of nurses is a good thing, a wise thing and a sound way to go. Their training to assess and respond appropriately for the good of their patients should serve as a model for what we look for in other situations of crisis – their motivations are as clear and unfettered by self-interest as any I know of.
If I tried to compare what I witnessed this week to what I see from the vast majority of our elected officials in terms of their willingness to dig in and do what is right to heal our nation, I saw a stark difference in not only compassion but also in common sense and viable solutions.
The artistry I saw in the healthcare system this week occurred aside from the payment difficulties millions of us face when we try to access appropriate care. Many know my position on that – I’m with the nurses in demanding a system that provides a progressively financed, single standard of high quality care for all. But the nurses of National Nurses United have also launched their Main Street Contract campaign to demand that the healing of our economic trauma include the appropriate mechanisms to repair the damage. As for me, I’m with the nurses. Our politicians would do well to make the same decision. And our nation would be the better for it.
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