I grabbed my nursing diagnosis textbook and eagerly headed to what some called “the no-frills” trauma hospital. My teacher's lecture about “problem statements, interventions and related factors” was still fresh in my mind as I entered S.W’s room, but when I took one look at his gaunt face, the fragile shelter of my care plan fell apart. Nervously, I introduced myself and mentioned that I was assigned to be his nurse. S.W. glanced at me and quietly said, “Ok.” His body was so thin and his bones so brittle that I thought they would snap when he hobbled to the bathroom. The slightest exertion would send his heart rate racing. I gently pressed my stethoscope to his chest until I captured a fluttering sound that reminded me of a caged bird beating its wings.
To assess S.W.’s neurological status, I asked questions like: “What is your name?” Where are you from?” and “What time is it?” S.W. was alert and oriented to person and place, but he had lost time. The perpetual glare of the hospital’s fluorescent lights had melted the boxes on his calendar, and the days collapsed and disappeared into one big blur of doctors, nurses, and medical treatments. He confided, “You know, I’ve been in the hospital for so long that I sometimes don’t know if it’s day or night.”
Yet, S.W. was thankful, even for the hospital food with its unappealing odor. When I asked S.W. the percentage of the meal he had consumed, he enthusiastically replied, “I ate it all. I love macaroni and cheese!” As I reached to take away his dinner tray, he insisted that I leave and cover the top of an opened can of Ensure “so that a bug wouldn’t crawl into it.” I thought of the irony of his fear about a little bug when he knew he was dying. I felt a pang of sadness when he eventually closed his eyes to sleep. He had meticulously combed his hair, attempting to look presentable for visitors, but they never came.
When I entered nursing school, AIDS was a diagnosis and a statistic. My brief encounter with S.W was like being struck by a forceful blow, and I still haven’t fully recovered from it, even after 20 years of patient care.
Patricia Cannon has been a Registered Nurse at UCSF since 2001. She has worked in cardiac critical care, neuro intensive care, hemeoncology, school nursing, and currently, in research. In the early days of the pandemic, she was redeployed to the CATCH team which stands for the Covid, Assessment, Treatment, Coordination Hub. This pilot was launched to help patients get much needed procedures and surgeries. Her passion is her faith, photography, and the written word in all its forms. Her poetry has appeared in several magazines and books.