I woke up today after dreaming about being scolded by the family of a patient and requesting me not to attend to his call bells and asks somebody else to do anything related to his condition. Even though the rest of the patients in the room were consoling me I was super depressed, and I woke up even before the alarm went off at 0430h. Of course, I can't really see the patient's face and the relative's, but I guess this showed the stress in me (funny as it is since I am not doing anything meaningful and serious). Then I was trying to dig from my memory the possible source of stress and I thought of this patient. And I am not allowed to say anything about his condition because I am not sure of the boundaries of "patient confidentiality", but I would say that initially I thought he was a very difficult patient, always with that smile on his face that just seem weird to me. And since I am reflecting and saying this was an initial impression, my opinion of him has changed through the days, especially after knowing his case history. Then I realise, the smile on his face is actually so hard to come by and I thought him to be optimistic to live the way he is living. Even though he scared me when I answered him that he cannot take painkillers without the doctor's review yet, even though his reaction is more than I expected when I said he is still on sips of water and nothing else; even though he said that he was not aiming at me, but I couldn't help but feel that I am partially responsible. I really understand after he said it, why is it that he has to wait for the doctor who takes eons to answer when he is shaking in pain? Why can't he drink water to cool down when he is having fever? But we as nurses (and me being a student) couldn't do anything more than calling on the doctor and try to ask him/her to come down earlier to see him, or review his condition faster, because we can't do anything "invasive" without doctors' orders (that is why I want to be APN, to be able to give basic interventions to the patient without seeking approval all the time, or at least until the doctors come around to the ward).
And then came along another thing that I need to reflect on. Yes I know we are supposed to do reflection every week and to be submitted in for the CI and the school, but this is something that I think I'll be counseled on if I write it in so. Even though I have been trying to convince myself that basic nursing care is as important as the staff nurses' job, I guess innately I believe much more in myself that I can do all those things that are deem "advanced" for us. That I think, I went beyond my capability. That I totally forgotten "not to harm", that I got too ambitious, that I put myself before the patient. In trying to achieve the skills, I am putting too much emphasis on the "I" and not thinking about the patients anymore. I lost sight of what is important in the path of nursing - caring for the patient. Not for myself, not for proving, not for anything else. I vaguely remember someone said on some occasion regarding something that doing any action is a once off thing, so we should do the best we could every time we do anything to avoid regretting it afterwards. Regret is haunting me now. And because I am off for the next two days, I won't know first hand if my actions cause any traumatic after-effects on the already frail body, but I am praying. For the patient for his well-being, for myself so that my conscience may be cleared.
And I really need to change out of the selfish mode. If I were to think of myself all the time, do I even suit nursing? I need to believe that there is no shame nor any downgrading for doing basic care for the patients, nor any less important in that. There are people who remain as EN for a reason even with the lower pay, and I need to adopt their mindsets. Remember my ambition to be able to care for the patient at the bedside, and that is if I take pride in doing the junior works and not chase after the "high end" jobs just because I want to feel in power.
For U, not I.