patient stories

Once They Think You’re Important

One of my favorite patients from my time as an inpatient nurse was Roberto. A middle-aged, self-described “skinny” truck driver, Roberto had a rare quality of being humble without being self-depreciating. The son of an immigrant family from Argentina, he was fluent in both Spanish and English.  His Spanish background was apparent in how he spoke English. He articulated with a lyrical cadence which became even more apparent when he flipped to spot-on impressions of American English during his stories.

Oh, man, did Roberto have stories to tell me. After years of traveling the United States as a truck driver, he could make even a small town in rural Arizona sound like the most magical place on Earth. “The best way to see the world is from the road,” he would say.  His descriptions of the rolling hills of Kentucky, the futuristic-looking cities of Texas, the majestic trees of Northern California, the beautiful wilderness of Wyoming tantalized me. Wisconsin, my home state, happened to be one of his least favorite places. “You can never predict the weather here,” he quipped.

Roberto did not expect to be cooped up in a hospital bed during a majestic Wisconsin summer. A back injury on the road left him needing surgery. He was slowly on the mend, thousands of miles from his home in North Carolina.  Roberto was subtly anxious about his upcoming discharge. It wasn’t apparent when various staff were in the room during the day, but as they all left, his fears sank in. A slow night outside his room, I was happy to sit and listen to his perspective on the rest of the country. I was starting to seriously consider travel nursing at the time, but I was afraid of the unknown. Hearing from someone who had driven through an area was hugely comforting.

Years on the road with plenty of time to think had given Roberto a keen insight into people. “99% of truck drivers don’t like people,” he explained. “All that time alone, thinking, they’ve forgotten how to like people.”

Roberto described other people who’ve forgotten how to like people. His example was a security guard who harassed him until he realized Roberto had a high level of clearance into the building. “He asked me, “Why didn’t you say anything?” I told him, “You never asked.” It’s funny how people change once they think you’re important,” he said with a small smile.

After our conversation wrapped up and I continued with my nightly duties, I reflected on his words.

It is funny how people changed once they thought you were important or had some use for them. I smiled as I thought of all the patients I’ve had who would never trust a thing I said to them and just needed a person in a white coat to say the exact same thing to them. I thought of all the customers who used to treat me so poorly when I worked in food service and retail. Would they treat me any differently if they knew my role now?

As Roberto said about truck drivers, I think about 99% of people don’t like people or have forgotten how to like people. It’s easy to like people who like you. It’s easy to get along with patients who are gracious and kind themselves. It’s easy to treat people at or above your station in life with respect. But what about everyone else? What about the people who don’t like you? Or the patients who are difficult, mean, and treat you poorly? Or the people who are supposedly “below” you?

It’s the second half that shows our true colors, and it’s the second half that challenges me to no end. It’s easy for me to go on and on about how I love my nursing career when I have awesome patients who constantly compliment me on everything I’m doing for them. It’s great going home from a shift where a patient or family member bonds with you so much that they hug you at the end of it. It’s fantastic when the rest of the staff treats me with respect and that what I say and do makes a difference. That’s wonderful, but that’s not always reality.

It’s difficult coming home from a shift where a patient cusses you out every time you’re in the room or makes such sexist comments that it makes your skin crawl or never says “thank you” once but barks orders at you for 12 hours. It’s difficult wanting to come back to work when you know the rest of the staff is rude and makes you feel like an idiot. It’s the most difficult when you give everything you have, do the absolute best that you can, and it still doesn’t make a difference. It’s those difficult days that really make me question if being a nurse is the right thing for me.

But that’s the thing – it’s not about me. Every low-paying, unglamorous service industry job from a cashier at a garden store to a student manager at a college cafeteria taught me it’s about the customer. Now, despite the most recent moves in the health care industry, I will talk until I’m blue about how patients are NOT customers.

Regardless of what you call them, customers and patients are not always right. Whoever came up with that mantra should hear some of the things people try to tell me are true. “No, I didn’t drink anything tonight,” they say. Yeah, then how do you explain your admission blood alcohol level of 0.31? I think. “I fell on it,” they say. Yeah, then how do you explain how that thing got into your abdomen/anus so perfectly? I think.

People lie. People will treat you horribly. People will make you question who you are and if you’re even capable of doing the job you’re doing. The thing I’ve learned about people is we treat people better than how we ourselves expect to be treated.

Yes, you read that right: we treat people better than how we ourselves expect to be treated. Even that jerk who thinks he’s the best thing since sliced bread is trying to cover up the fact that he secretly doesn’t think he’s all that. Even that nasty lady who is so full of herself is trying to forget that she secretly doesn’t think she’s all that great.

The absolute worst and most difficult patients I have are usually the ones who have had a rough life. They are demanding, take everything from me that they can get, are distrusting, take as much “free” stuff as they can, leave a mess, and rarely say thank you. They test every ounce of my patience, but I gain more patience the more I think about their lives. Outside the walls of the hospital, they are probably taken advantage of more than I have ever been in my life, and that would make most people distrusting, demanding, and cold. For them, being cruel is no longer a choice; it’s a survival mechanism.

Thinking about the security guard who harassed sweet Roberto, he most likely learned to treat people “below” him like crap because his superiors never treated him with respect. In his low role as security guard, he most likely thought he deserved to be treated rudely, so he treated Roberto a little better than how he himself expected to be treated. That security guard probably didn’t harass Roberto as much as he had been himself.

So, every time I’m about to walk into that room, the room of the difficult patient that I’d much rather avoid than enter, I take a deep breath. I tell myself: The people who make you feel like a worthless piece of dirt need you. They need you to show them respect, because if they’re treating you like dirt, they think of themselves as even less than dirt. I picture how difficult it would be to be in their place, and I enter.

I wish I could say I was the best bedside nurse in the world, but I lose my patience all the time. It was and is so difficult to be fully present and committed to a job that drains so much out of you. Still, I know when I’m there, really there, it makes a difference. I’ve seen rude, mean, demanding, draining patients slowly come around when they feel respected.

Not all of them will and not all of them do, but those are the patients, the patients who are craving respect in the worst ways, the difficult ones, the ones who make you feel an ounce of their perceived worthlessness, who need you the most.

As Maya Angelou once said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

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