Nurses care for patients. That is our primary and overriding duty. But in order to care for our patients, we also need to take care of ourselves.
During my Death & Dying lecture in Fundamentals, one of the key lessons we learned is that in order to effectively help patients and their family deal with such issues, we need to have our own issues with the subject resolved. The rationale being that one who has unresolved issues with the topic of death and dying won’t be able to properly offer the help and care the patient will need at such juncture. It makes perfect sense, actually. The greater truth is, however, that this same lesson applies to pretty much every type of care we offer our patients.
This is a lesson that was driven home today for me in my skills lab when we learned how to insert a nasogastric tube. An NG Tube is a type of catheter inserted into the stomach through the nasal passage. It is used to decompress (get stuff out) the stomach, as well as for feeding and delivery of meds in some cases. In most cases, it is a treatment done for only a few days, except in rare cases. My mom was one of those rare cases.
Mom developed a duodenal tumor that shut down her gastrointestinal tract cold. In early February of 2009, I had to take her to the ER when she started feeling unwell. By the time we got there, she began to vomit violently and continuously, some eight times in a one-hour period with no signs of stopping. By the time she was finally taken into the treatment room, she was almost unconscious from all the fluid lost. She was immediately given an IV for rehydration, and when they detected very little bowel sounds, the doctor ordered an NG Tube be placed to decompress her stomach.
Imagine for a moment having a 15-inch plastic tube stuck into your nose and down your throat. Now imagine that while having an almost uncontrollable urge to vomit because you have three-days’ worth of food, liquids, and body fluids stuck in your stomach.
I saw the nurse put the NG Tube in Mom and it wasn’t pretty, even though we all knew it was for her benefit. It did its job, though. For the next 100 or so days of hospitalization over the following six months, Mom would not be without an NG Tube for more than 10-20 days. Towards the end it stayed in permanently; she took it to hospice home care and had it on the night she died.
I have unresolved issues with NG Tubes. Every time I see one a shiver runs down my spine as I recall that moment when it was inserted into her as an emergency procedure, and I remember how long she had it. I knew today we would be learning this skill and I steeled myself as best as I could before even leaving the house. The moment the professor pulled out the equipment, I lost my resolve. I withdrew, physically and emotionally. I hid in the back of the room. I fought back tears. I did not want my classmates or professors to see me this way. When I couldn’t take it any more, when the mannequin looked like Mom to my eyes, when I felt the world collapsing around me, I got out of the skills lab and hid in the bathroom.
I am a nurse student, and part of my training is going through situations like this so that I can face my own demons, fight them, vanquish them, and in the process gain the wisdom necessary to serve others who will be where I was back in 2009, or today for that matter. Putting in an NG Tube is a skill I need to be able to perform to pass this class, so you can bet that I will go back to the lab during practice hours and learn how to properly do it. And for that I need to resolve my personal issues, because ultimately there’s nothing I want more than to be a nurse.