I started my young adult life wanting to help people, so naturally, I went into nursing. However, in my “older and mature” life I was forced to leave that life and I am now slowly entering the world of writing. Although I no longer practice nursing and I miss some days, and I believe that you can take the girl out of nursing but you can’t take the nurse out of the girl. Most of my career was spent as a visiting nurse or community health nurse. This article relates to my first few months on this job that I loved.
I admitted my first patient who wouldn’t listen to anything I was trying to teach her, three months, not bad huh? I’ll call this patient Betty. Betty was in her late seventies. She had Congestive Heart Failure (CHF), among many other diagnoses. She, of course, lived alone and in a huge home. She would never answer the phone and rarely came to the door. She was going to be my first real challenge.
Betty was on diuretics (fluid pills) that would take the fluid from around her heart and flush it out her body through her kidneys…which meant she had to go to the bathroom more often than the average person, Betty hated taking these pills. “I have to pee all the time; I don’t want to take them anymore.” At first, she told me she was forgetting to take them but I caught on real fast. I then set her up for what we call a “pre-fill,” I put all her medications in a prefill box that had the times and the days that they would have to be taken, thinking this would make it easier for Betty. Nope. She just would forget to take them, or did she?
Whenever we do a pre-fill, we do it for three days only at first to see how a patient will do with them, well Betty didn’t take any of her meds and I taught her the consequences of not taking them and set her up for another three days. When I came back I checked the box, she still hadn’t taken any of the pills, this time she told me that she took them straight from the bottles and she didn’t like the prefill box.
I was very frustrated with Betty, to say the least…I too was very naive, but I was really worried about her too. She didn’t have any neighbors that could help her, none of her family lived nearby either. I went to my manager, who had many more years in this job than I did, for advice and she shelled out these words of wisdom, “Marilyn sometimes we just have to let a patient fall before we can help them back up again.”
I looked at her and said, “what does that mean?’ she looked at me and again stated another cliché`, “you can lead a horse to water but you can’t make them drink.”
“Oh…so what am I supposed to do? Let this woman just fail because I can’t figure out what to do.”
“Yes! You will learn that we can’t force anybody to do what they don’t want to do, we just have to be there to pick up the broken pieces.”
“I see,” I said without an ounce of satisfaction. I will never forget these pearls of wisdom because she was absolutely right, I can’t force anyone to do what they didn’t want to do, I had no right to make this woman of sound mind take medicine that she didn’t want to. I had to go through this rite of passage whether I wanted to or not. You just can’t fix them all because that’s your plan.
I did not give up on Betty though; I came up with another idea. I would let her take her pills from the bottle if she promised to answer the door so we could visit, she agreed. So I put all the pills back in the bottles and I set it up so we would see her for the next three consecutive days, Friday thru Sunday. In fact, my boss saw her on Sunday and reported that she was doing fine and taking her pills from the bottles and that we could skip a couple of days and I could see her on Wednesday.
Wednesday came and I was very busy. I went to see Betty in the late morning and I knocked on the door for more than five minutes, but to no avail, she did not answer. I then went from window to window and the back door banging on them all as I went and yelled: “Come on Betty please answer the door.” After twenty minutes of bruising my knuckles and a couple of phone calls later, I left thinking that she must still be asleep after all it was early. I decided to go down the street to visit another patient and I would come back to her. She really was putting a dent in my day.
This story is too much craziness for a one-time sharing, come back next week and find out what happens to Betty. You won't believe what happens next.
