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My Favorite Patient & What She Taught Me

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During my time working in the hospital setting, a young woman, Cindy, who had fought Chron's disease most of 29 years was admitted to our floor post abdominal surgery for colon cancer. Her doctors repeatedly tried to remove the cancer from her colon and to reattach the healthy parts of the organ. Unfortunately, Cindy did not respond well to the multiple surgeries, medications and treatments. She developed sepsis several times as well as fistulas and tracts all over her abdomen.

Cindy was a mystery to the medical staff and it seemed as if there was no hope. The fistula tracts along the surgical incision never healed and there was so much fluid coming from them that the ET (enteralstomal therapist) nurse developed a closed suction system to help save the intact skin. I and other nurses had to empty the container of fluid at the end of each shift. There was never less than a liter each time. How could this happen to someone so young with her whole life ahead of her? None of us could understand.
Cindy wasn't very trusting of anyone and could be belligerent, which sometimes made it very difficult to take care of her. I guess people can become that way after spending their lives in and out of hospitals. The residents and interns were intimidated by Cindy and often would stand by her bed talking about her as if she were a specimen and spoke as if she were not even in the room. One night Cindy actually threw one of the residents out of her room and told him never to come back. As sick as she was, Cindy could hold her ground; it was also the only control she had of her situation.

Yet once I got to know Cindy and earn her trust she became one of my favorite patients. I admit that at first I was often intimidated by Cindy because of my own insecurities as a new nurse. It was also difficult to cope with someone close to my own age who was dying. I tried to imagine how it would feel to be at the mercy of everyone around me and to be so sick and weak. I think that deep down Cindy knew she would never leave the hospital.

Eventually, all of the nurses became close to Cindy. She was our patient for close to a year and she spent her 30th birthday with us. The more time that went by, the more her disease took over. Cindy's mom visited her each day, and while the two knew Cindy was losing her fight, they never acknowledged the fact that Cindy was dying. Instead, they would talk about Cindy getting discharged and the two of them taking a trip together.

I happened to be taking care of Cindy the day she died. The doctor ordered doses of morphine to keep her comfortable, which I administered. All of the nurses were in and out of her room throughout the shift. We all had become friends and needed to say good bye. I was standing on one side of Cindy's bed with her mother on the other side when Cindy bolted up and said she wished she had a gun. She lay back down and within minutes her respirations grew shallower. We watched and waited with such heaviness in our hearts.
Cindy drew her last breath surrounded by her mother and her friends. We were all relieved that she would no longer suffer, but it was very sad to lose someone so young. I will never forget Cindy. I learned a lot about myself as a nurse while caring for her. Because of Cindy I never take my good health for granted and now realize that what I do as a nurse really does have an impact.

Lesley Klein, RN, BSN, is from Los Angeles, Ca.

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