Watching Patients Decline
In this rehab setting, I have the opportunity to get to know my patients fairly well. Most of them stay in the rehab program for two weeks, and with three hours of therapy a day- you get to know the person, build relationships. In these instances, you get a sense of accomplishment and overall happiness that these patients improve in function, are (mostly) discharged home with a clean slate in front of them.
Sometimes, though, things aren't all that wonderful. Sometimes patients don't get better. Sometimes, they keep getting worse. They walk less. They comprehend little. Doctors try different medications, hoping it will help. Everyone hopes it's just a fluke, but in your heart you know this patient is slipping, and it's the circle of life.
Circle of life? How am I supposed to explain to my heart that my patient is dying, and there isn't anything you can do? It is really, really hard.
There are all these categories I am evaluated on during my clinical internships. Documentation, professionalism, safety, blah blah blah. There is one category, "Stress Management". Where is the category of emotional growth? Of letting go? Of dealing with death? How do you keep a safe emotional distance, but still leave space to connect?
Maybe there should be a category called "Dealing With the Important Stuff".