The elderly man hobbled into my office using his walker, his loving wife right beside him. He had the sweetest smile - as innocent as a child's.
When they were both seated I took his vital signs asked him certain questions regarding his health. The final question was "Do you have any pain?" He continued to smile and quietly answered, "No Nurse Donna, I am fine."
My nursing intuition told me otherwise. His wife spoke up and said that he did in fact have pain. His back had been hurting him "for a while now, and he didn't fall or anything."
I explained the pain scale, and then asked him the severity of his pain. He softly replied, "A one; maybe a two."
I proceeded to ask him questions such as location, if there was any radiation, etc. He answered quietly every time.
He told me he didn't like to complain, "Especially when there are so many people worse off than me." I assured him that he could freely express his feelings, and he simply replied, "Thanks, but I'm OK."
He saw the physician next, who ordered an MRI of his back.
The MRI showed multiple lesions which the radiologist felt certain was metastasis. He was admitted to the hospital oncology unit for a few days where they did a biopsy and released him home pending the pathology report which would determine the next course of action.
I called him at home once he was discharged, and he said again in his humble way, "I am still in some pain, but it is better than it was. The pain medicine helps. Aren't I lucky to have some relief?"
I told him I would see him at his upcoming office visit and to call in the meantime if he needed anything at all.
"I will," he replied. "And thank you so very much for calling."
As I hung up the phone I realized that this sweet, innocent man had reminded me of a few of the most important lessons I had learned many years ago in nursing school:
Sometimes a patient's body language speaks louder than his words.
Take the time to ask questions, and really listen to the patient's answers.
And, most important of all, never forget to let the patient know how much you care.
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