Don’t Judge a Book by its Cover

When I first started my nursing career, I worked on a busy telemetry unit.  I loved the hustle and bustle of the unit as most nights were spent responding to beeping IV drips, telemetry alarms detecting heart rhythm irregularities and complaints of chest pain.  A nightmare for some nurses, I enjoyed the pace and time went quickly.  Every night I fell into bed exhausted, but knowing that I had helped my patients.

During a particularly busy and long stretch of nights, a certain patient that I’ll call Darla was on our unit.  Darla had been admitted for headaches.  The medical unit was overflowing with patients, which is how she ended up on the telemetry unit.

Darla constantly pushed the call light, begging for pain medication.  Eventually her nurses began to tire of her and considered her a “med-seeker.”

Who hasn’t encountered a “med-seeker?”  You know the type, right?  Always in pain, always wanting pain medication, perhaps even knowing what type of pain medication they want, allergic to certain pain medications so that they can ask for certain medications, maybe even asking for their medications on the hour?

If I remember correctly, this description mostly applied to Darla.

As a migraine-sufferer, I was a bit more tolerant than some of the other nursing staff.  Her doctors weren’t sure what was causing Darla’s headaches (or if she was, indeed, seeking medications), but I tried to exercise empathy because I knew what it was like to suffer from headaches from days on end.

I came onto shift one night and learned in report that she had undergone a lumbar puncture which hadn’t gone particularly well – the physician performing the LP had a difficult time obtaining the cerebrospinal fluid, but had ultimately been successful. However, this meant that in addition to Darla’s aching head, she had a sore back.

And as anyone in the medical field knows, a side effect of lumbar punctures is a headache.

That night, Darla was on the call light more than usual for pain medication.  This made for a long night, considering the fact that I also was charge nurse and had to deal with another patient who was having chest pain and had to be sent emergently to the cath lab.

When I left work that morning at 0730, I breathed a sigh of relief.  I was off work for two days.  Two whole days of freedom.  I had never been so happy to be away from work – or at least it felt like it.

When I returned to work two days later, Darla was still a patient – and once again she was assigned to me.  I was shocked to see her still on the census.  But when I received report from the afternoon shift nurse, I was even more shocked.

The results of the lumbar puncture had come back within the past several hours.  It had revealed that Darla had a rare fungal infection in her cerebrospinal fluid.  The fungal infection was causing her intense headaches.  Even more shocking was that Darla was being transferred to a higher acuity hospital the following morning, as this hospital had an infectious disease doctor who had experience treating that particular fungal infection.

“I can’t believe it!” the nurse said.  “She didn’t have any other symptoms.  Here we are, all judging her for the past week!”

“I know,” I replied.  And I felt so guilty.  I had started off taking care of Darla, practicing empathy because I knew all too well what it is like to feel poorly and live with a headache; but in the end, I got just as frustrated and judged her as well.

Lucky for me Darla didn’t know that I was frustrated with her.  Several months later, I received a thank you card addressed to “Nurse Krysti” delivered to my unit.  There was a very simply message inside thanking me for my excellent care and for believing her when not many others did.  She also mentioned that she was “doing better.”

My fellow nurses, the bottom line is this… we do not know what our patients are going through on a daily basis.  Even on days when you are frustrated with your patients, try to remember that they are also scared and going through things that brought them to you.

Krystina Ostermeyer

Krystina Ostermeyer is an RN. She has worked in a variety of practice settings, from a telemetry and stepdown unit, to an allergy and immunotherapy clinic, to most recently, a diabetes education office. She recently earned her certified diabetes educator (CDE) credentials and works with people with diabetes through all stages of life, from pediatrics to geriatrics. When she isn't working, she enjoys freelance writing. She also enjoys traveling with her husband and 2 year old son, walking, reading, cooking, spending time with friends and family, and enjoys craft beers and dark chocolate.

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