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We all have a story. A story about our childhood, a story about how we met our spouse, a story about why we chose to work in healthcare. Our patients have stories too. Stories about their youth, stories about their family, stories about their illness. These stories, when told, elicit emotions and those emotions are what make us human and allow us to connect to others in a way only humans can. This human connection is at the heart of nursing. Knowing our patients and considering their story when planning and delivering their care is what sets nursing apart from all other disciplines in healthcare. Nurses care for the whole person, not just physical symptoms. I would argue that it is hard to really care for a person if you don’t know their story and you will most likely miss something important. I spent the first half of my nursing career as a bedside ER nurse in a large, busy trauma center. As in most ER’s across the country, ours had a steady supply of very regular patients. Some like to refer to these patients as “frequent fliers”, or patients that come to the ER often – some daily – seeking care for concerns that generally don’t fall into the emergent category. These patients are usually dreaded by most ED staff and thus their attitude towards these patients often reflects that dread. I was no different – until I met Trina. Trina was a 27-year-old who regularly visited our ED three to four times a week. Her complaint usually started with abdominal pain that spread to other parts of her body when we found nothing wrong with the previous location. The pain would always become more severe with the suggestion of discharging her home resulting in extremely long visits. Week after week this would be the drill with Trina. On one particular day Trina came in with her usual complaints and I drew the short straw – literally. That’s how we decided who would take care of her when she came in. After the usual battery of labs and x-ray’s with no abnormal findings, I went in to let her know we would be discharging her from the ER and she, as predicted, had a sudden burst of back pain and refused to leave. Normally I would have gone through the usual process of having security help her out, but the ER was unusually quiet, and we didn’t need to immediately fill the bed, so instead I sat down on the bedside stool and asked, “Trina, why do you always do this?” An unprofessional question for me to ask, but after weeks and weeks of having her in our ER I felt it was time to call her out. Trina stopped moaning about her back pain, put her face in her hands and began sobbing. I wasn’t sure what to do as this was a side of Trina I had never experienced. After a few long seconds she finally looked at me and said, “I can’t go home. When I’m home I feel him and it’s too much.” Having no idea what she was talking about I asked her, “who do you feel?” Trina spent the next 50 minutes telling me her story. Three years prior Trina married the man of her dreams and tragically he was killed in a freak accident just over a year ago – and just four and a half months after they found out they were expecting their first baby. Six weeks after her husband’s funeral, she lost the baby. Trina had lost her parents when she was twelve and was raised by her great aunt who was now plagued by dementia and no longer recognized her. Trina’s only escape from her overwhelming grief was the chaos of our emergency department. She came to our ED week after week looking for care, support and human connection – and we gave her the label of “frequent flier” and only offered compassion-less care as the result of a short straw. I was ashamed. So ashamed I couldn’t make eye contact with
her. I couldn’t believe that I had become so callous that I never thought to
ask about more than just her physical complaints. I and every other nurse in my
department never took the time to care for her as a person, a
whole person. After helping to untangle some of what she was going through we were able to get her connected with some resources and make some other helpful referrals. Over time, we saw Trina less and less. The last time she came into our ER it was for a mild allergic reaction from a bee sting. After a few years I heard that she was able to move out of the house she shared with her late husband and begin to rebuild her life. I have had a few moments in my career that I can say
radically changed me – as a person and a nurse. This was one of them. We all have a story. Our stories make us who we are as
people, and those stories matter to us because we care for people. If you don’t
know your patient’s story you might be doing a great job of providing a series
of tasks– but you are not actually caring for them. Trina’s story is an awful one, and I will forever regret not seeing and caring for her as a whole person long before I did. I am hopeful that wherever Trina is today she is thriving. I also hope that somehow, she might know that because of her story I have dedicated my life to making sure that patients are more than a derogatory label, clinical symptom or diagnosis. Regardless of their physical presentation, patients are all people who have a story – and that story deserves to be heard.
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