By William M. Keane Jr.

Everyone has a bad day at work. As one would guess, a bad day for some may seem insignificant to another. For a nurse like me, bad days seem to carry a lot more weight given we deal with people who are ill.

Since starting this career, I decided to work for perfection; meaning I would not miss a box on my paperwork, focus on my patient and never miss a day of work. An unattainable goal, but I felt trying to achieve it would maintain my focus.

A Day to Remember

Well this day, a patient threw me curve ball.

He was coming to our procedure unit for the revision of a stent. When I entered the room, his eyes revealed an empty stare. It was not a stare to deceive an opponent in poker; it was one that left me cold with dread. This stare froze my blood solid. This patient wanted to speak with me; what he said left me at a loss words.

The patient slumped back on the gurney with a sigh. "I have stage 4 stomach cancer and this procedure is my last option. Either it works or it's over."

I did not know the diagnosis and statement for this patient's health in the short term. Did the patient have weeks, months, or days? I did not know and it took all my self-control to hold back that question.

I gently closed the door to the room and sat down. I harkened back to my school days of discussing therapeutic communication with the patient. However, another voice inside me kept me quiet and I just sat and listened.

Charting New Territory

As the patient vented, I quickly realized anything I said would be trivial and perhaps insulting. The patient wanted to be heard; to release the frustration he had built up.

The more I listened, the more I realized this patient had heard in the past few weeks from a host of doctors from numerous specialties each with their own agenda. Perhaps this patient could not get a word in edgewise. The thought of losing control or say in one's life scared this patient as much as the diagnosis.

When he finished and seemingly looked to me for a reply or to participate in the conversation I told the truth. I did not know what to say; this patient was the first to really open up his feelings and emotions to me. I took a moment and said this was new territory for me; I had never had a patient in this situation.

I asked if he would like me to respond or just listen. The patient asked me to just listen.

Sometimes Just Listen

Sitting in a chair beside the bed, I waited for the conversation to continue. The silence choked me and my inside voice screamed for conversation or any noise to remove this suffocating silence. Thank goodness my mouth did not open. This was the patient's moment and to hell with how uncomfortable I felt.

We sat quietly, the patient comfortable with the silence and me fighting to stay quiet. With minutes passing, I hoped my facial expressions did not reveal the inner turmoil within.

Unfortunately, my shift ended and I said goodbye to the patient. The patient thanked me for just sitting and allowing him to vent. I walked out of the room after shaking hands and wondered silently if I helped this person in any way or did I just make a difficult situation worse.

Even after extensive reflection, I still do not know.

William M. Keane Jr., Havertown, PA, can be reached at wkeane2@comcast.net.