The Cost of Caring
Suddenly there it was—a lack of compassion. Or was it?
She was only 29-years-old when the phone rang with news no one wants to hear. She didn't believe it at first, and neither did her family. Then it became reality-more doctor appointments and finally surgery scheduled for a double mastectomy. She had ductal carcinoma, highly aggressive, but caught early. The funny part was she felt something was wrong long before others believed her. Her doctors informed her young women her age do not get breast cancer. She made a joke of it and said, "I guess they were wrong."
The day she went in for surgery, I and her family were present to hug and love her. She made a request of me: tell her the truth when she came out of anesthesia. Being her aunt and a nurse, I knew the rhythm of the operating room and recovery thereafter. My family and I watched the board to see the colors change and knew where she was in the surgical process. As the clock went around and around again, her holding time in the recovery room became an outlier. My family was worried (and, frankly, so was I) that she was not moving up to her inpatient room. We could not go back and see her and later learned room availability caused the hold-up. When a room freed up hours later, we finally got to see her for the first time.
As she came through the door, we were waiting. She acknowledged her husband, parents and then turned to me and said, "Did they get it all?" I was the truth teller, and she knew I would hold my promise to her. "Yes, sweetie. They got it all." Heavy emotion hung in the air as her words and my words drifted together. Suddenly a voice, crisp and matter-of-fact said, "Come along folks. We cannot stand here in the hallway forever. I have to get back to my other patients."
There it was, the moment when a perception of compassion was lost forever, replaced instead with feelings of anger and judgment by me and my family.
The question I had to answer to myself was the why behind the action of the nurse. It is clear that in today's healthcare environment we move throughout the day in a rhythmic way, addressing the tasks. Was she so deeply connected to the next "to-do" that she failed to see the human suffering before her? Was this the fifth patient today who had a life threatening diagnosis and surgery, and she just couldn't be present to the raw emotions anymore? The nursing profession is doing a better job of trying to understand compassion fatigue. Could self-care be missing and she just didn't have it in her to be empathetic one more time? In essence, her cup was empty?
I will never know the "why" of the nurse and her actions that day. I don't know if it matters. I do know it propelled me into greater understanding of how emotionally tired nurses are across the country today. In the coming months, I will share with you some of my learnings and what you can do to help yourself be a healthy nurse with the ability to be resilient.
How real is compassion fatigue in your life, and what do you do to fill your cup?