The Last Day of Spring Vacation

Somehow, a month has gone by since I last posted. Oops. There was the week before the last week before break, when we were tested on our catheter-placing ability, and then there was the week before break, when we were tested on the respiratory system and taking a health history and doing a physical assessment of the skin, eyes, ears, nose, throat and probably some other things I forgot, and then it was spring break and time to get out of town. So, it's been busy.

For spring break, Ross and I went back to New Orleans courtesy of our tax refund. It was a good trip. We got to see folks we used to work with and I checked in with a few of the homeowners whose houses we rebuilt. One of them in particular was good to visit because when I talk about the things in New Orleans I saw that made me want to be a nurse, I'm often talking about her. I'm still not exactly sure what her specific health problems are, though I'm fairly sure she had a stroke and at least one heart operation not long before I met her. She is extremely medicated and has trouble staying awake or sleeping when she's supposed to. She once took out all 13 of her prescriptions from her purse and dumped them on the coffee table in front of us and said, basically, that she had no idea what they were all for. I can tell that in her former life, she was a feisty and capable woman and it irritates me that she is so clearly not in charge of her own health or informed about her treatments. I say that knowing that there are a lot of things that make it difficult to communicate with patients and to form a really collaborative and trusting relationship with them. But I didn't get the feeling that most people working with her had even tried.

She was very excited when I told her, before I left New Orleans, that I was going to nursing school. She sent me a Christmas card saying that she wanted me to deliver her next baby. My lack of qualifications for that particular task aside, I doubt this woman has been fertile in 30 years. This time when I visited (along with Tommy, who took over lots of my job responsibilities when I left and is now a bonafide old lady whisperer), she had been feeling sick and was in bed and all curled up when her grandson let me in. It was a surprise visit, so I suppose I should have been worried about accidentally giving her a heart attack. But she was fine. Her little head popped right up out of bed and she gave me a big hug. She was actually looking pretty good. Since I've gotten to know her, she has started freely telling me about her health, so this time I got a full update on her recent vaginal discharge and her lack of bowel movements. This is the kind of thing that makes me think that if someone wanted to really have an open and thorough dialogue with this woman about her health and how to improve it, she would be all for it. She is totally happy to talk about it - she wants me to know about her vaginal discharge. She actually called after Tommy and I had left to tell us that in the intervening half hour, she had both vomited and had a bowel movement. So I got to leave New Orleans knowing that her digestive system had been thoroughly emptied.

Anyway, I just kind of keep coming back to the idea that a person's own health and health care shouldn't be a mystery. Just because it's complicated doesn't mean it can't be explained if you just take the time to do it. I know that everything in health care now is about efficiency and that nurses and doctors are probably spending less time than ever with their patients. In the end, though, I would guess that whatever gains you get in "efficiency" are off-set by more medical errors and the patient confusion and lack of compliance that result when people don't feel empowered and invested in their own care. For now, all of this is mostly speculation. But each day I'm learning more and it is exciting, if daunting, to think that someday soon I'll know enough that I'll actually get to try this out for myself.