Sunday, March 23, 2014

A New Nurse

It’s not easy to get an IV into my veins. As the experienced nurse at Dana-Farber said last week, my arms looked “used.” As the gateway to almost all of my medications, they certainly have been used, and the nerve damage from a year of infusions has left the top surface of them numb.

A few weeks ago, my mom and I got talking about a hypothetical that was somewhat based on experience. We were pondering which nurse we would prefer if we had to choose between two IV nurses. The first nurse, Nurse A, is a total expert and can get an IV into the arm with ease; just one poke, and it’s done. No hassle, no small talk, no comfort if you’re feeling scared. Nurse A is all business.

Nurse B is a newbie, and she smiles a lot. She struggles to get an IV into tired veins, but she tries so hard, wants so much to help, and wants so badly to not hurt anyone’s arm. The skill does not come naturally to her, at least, not yet, but she cares. Genuinely cares.

Which nurse would you choose?

My mom insists that no one should have to choose; that Nurse A’s skill should always be combined with Nurse B’s kindness and empathy. I agree, but I force her back to the hypothetical. “It’s not even a choice in my mind,” my mom explains, and she chooses Nurse A. “Get the damn IV in,” she jokes, in all seriousness. I knew she’d choose that one.

I don’t need to think about it, either, because without question, I’d choose Nurse B. Sure, I’ll endure a bit of needle-digging and I’ll leave with a few bruises on my arms, but I don’t mind the physical discomfort. It’s the mental stuff I suck at so I want someone who can spot all that mental baggage I carry. I want someone who tries, in his or her own way, to help me through it. I want someone who leaves work still thinking about the people he or she cared for there.

After my less-than-impressive early interactions in the radiology department at Dana-Farber last week, it was finally time for the CT scan. A young woman, probably in her late twenties, came to retrieve “Tara S.” My heart jumped into my throat. I gulped, and left Brian and my mom behind to venture into the testing area.

From the moment I met her, I liked the nurse who prepared me for my scan. She noticed things, like that I was shaking and on the verge of tears, and she so clearly wanted to help ease my pain. When she asked me to take off my bra, explaining that underwire could interfere with the scan, she immediately went to lower the shades to the window that looked into our room (I hadn’t even noticed people were behind that glass). The shades were broken but the nurse insisted on getting them to work so I could have some privacy. I waited while she tugged at the string. “Oh, don’t worry, half this place has already seen my boobs,” I joked quietly, appreciative that she respected me the way that she did.

When I lied down on the table, clothes and shoes on, the nurse explained that she was new so another nurse would be helping her. I have come to love new nurses. I’ve found that they often seem to try harder to do well than more experienced ones do. (I’ve always been one to judge people largely based on effort.) As the new nurse prepped the IV gear, she explained that they would run contrast into the IV at one point during the test. “You’ll feel a warm flush and you’ll probably feel like you peed on the bed even though you didn’t.” Lovely, and ultimately, very true.

She then explained what would happen during the test. The table would move me in and out of the thin tunnel a few times and a voice inside would tell me when to hold my breath. It sounded very simple, but still, tears fell onto my pillow. The nurse reiterated that the test would not be as scary as I thought. “It’s not the test I’m afraid of,” I explained. “It’s the results.”

In truth, I was so scared that my spirit was barely contained within my body, the former perhaps trying to escape from the latter for having betrayed it. Everything around me became snapshots, clear images captured in time; almost everything in the background completely blurred out.

The nurse looked at me. She saw the terror, and she wanted so sincerely to make it better. At one point, I’m pretty sure she almost started crying, too, which made me want to hug her and tell her I would be OK, even though I thought that was a lie. She rubbed my arm and told me that her mom was breast cancer survivor of several years. That she can only imagine how scary this must be; that I’ll get through it. She told me that I was brave. That last part made me laugh out a, “Yeah, right.” I had never felt less brave in my entire life.

It all sounds simple now, what the nurse said to me. But the power of her kindness was indescribable. She took the weight of the world and made it lighter.

Soon it was time to get the IV into my arm. The new nurse went to fetch her mentor, a more experienced nurse, and they each stood on either side of me. The new nurse attempted to insert the IV. She dug around in my stubborn vein for a while, apologizing for causing me pain. “It’s nothing,” I explained. “I really don’t mind.”

Eventually, both nurses realized that the IV wasn't going to flush correctly and we’d have to try again. I couldn’t even really see her, but I could tell the new nurse was disappointed in her apparent failure. She apologized some more. I tried to convince her that I didn’t mind at all. “It took five times at my last infusion,” I explained. But neither of the nurses saw that as an excuse. They clearly didn’t want to stick me five times. 

The expert nurse—a woman equally as kind and comforting as her mentee—started to assemble the materials to insert the IV on my other arm. I knew that she would get it in on the first try; she had that sort of calmness and confidence. But I had another idea.

“She can try again,” I told the mentor nurse, referring to the new nurse. They both froze, confused. “I know she can do it, let’s have her try again.”

What happened next was so awesome, probably because I think that education is the key to all progress in the world. I watched the experienced nurse teach the new one. The woman on my left explained to the woman on my right how deep she enters the vein with the needle before she “threads the catheter” (only one quarter in). She asked the new nurse to describe what she felt as she tried to hook into my vein. For a minute, it wasn’t about me. It was about teaching and learning; an expert passing on her wisdom to someone who so badly wanted to learn it. Despite the fear that had, minutes prior (and minutes later), overwhelmed me, I was able to escape into those few moments and see the real beauty in them.

We all celebrated quietly when the new nurse got the IV into my arm on the second try. I was so proud of her, and she was proud of herself, too, which made it even better.

The test came next, and both nurses continued to guide me through it like angels who had swooped down to earth to rescue me from what really had become the scariest time in this whole ordeal.

I could see the experienced nurse’s name stitched into a patch on her white coat. I locked her name into my memory so I could thank her one day. The new nurse’s badge was flipped backwards, however, so I couldn’t see her name. Once my legs stopped shaking violently (no doubt, at the thought that a radiologist was somewhere viewing the inside of my chest that was riddled with tumors), I asked the new nurse her name.

“It’s Kristen,” she answered. I smiled to myself, and knew that I would never forget it. 

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