To all, whose names I’ve not got, right here by my cot,

I’m quite grateful as well, for how you helped me feel swell,
And sorry I can’t give you a personal chant.

So this will have to make do, for I’d give you your due.
From the start of my arrival, you ensured my survival.

Registered me with care,
Despite the ongoing repair,
Making you do, more than your share.

Asked me the same questions (again and again),
Slowly getting more info, while helping me grin.
Diagnosed me with care, not willing to err.

Wheeled me to room 248, with a gentle, slow gait.
Observed me all night, until all was right.

You all did your part, but I hope to depart.
Never to be seen, again in this scene.

Written by Emily

Reflection

Practicing in healthcare is not always as glamorous as what it is made out to be. Diagnosing conditions, giving the best treatment and getting patients healthy again is the general idea that most people (health practitioners) strive for. However between all that we often face challenges, intrinsic and extrinsic.

Do we always give the best service we can knowing that a certain outcome is inevitable? Do we answer questions based on what we think might please the patient so we can have a better outcome in sessions, or should we shoot a straight arrow and make them aware of the reality? These are some of the intrinsic challenges I have come across at my time during clinical rotations. I’ve sometimes found myself being overly optimistic to mask my fear of being labelled as incompetent or getting a bad review.

In this instance, I have been working with a patient who has been struggling with health problems for the longest time and it has come to a point where death has been a shadow at her bedside. The above poem evoked a feeling of nostalgia, disappointment and de motivation not only in myself, yet my patient as well, which I have later come to realize. She has been in the same room for some time, getting familiar with new faces only to see them part before she does, which she can relate to in the opening sentence of the poem (Emily, n.d.). She had multiple encounters with death due to uncontrolled diabetes, hypertension, gangrene, high cholesterol which eventually lead to an above knee amputation along with taking the second and fourth digits of her one hand. Upon our first encounter she neglected exercises and was uncooperative as if she had already accepted her fate – This could been influenced by the many health problems, those of the past. newly diagnosed and this was merely her way of accepting everything. Being in a situation such a hers, to be emotionally distraught is expected. It could be related to the stages of grief identified by (Kubler-Ross & Kessler, 2014). She was susceptible to infection, this was her battle as she went head-to-head with septic shock on 2 occasions and rose victorious.

After a few more encounters, she became light hearted, excited for treatment sessions which evoked a lot more positivity from me. It was at this moment in time that I realized she could relate to parts 4 & 5 of the poem as well as the final stage of grief, acceptance (Kubler-Ross & Kessler, 2014).

My dilemma arose with the discovery of bed sores, an infection of the affected leg and later diagnosed with Peripheral Vascular Disease of the unaffected leg. She doesn’t have much support in her home environment and mobility was clearly an issue. She was placed on suction of the affected leg for 2 weeks and little improvement has been made. After my second visit she agreed to treatment however knowing the current prognosis and her social situation, I felt I should be more selective of what I do in treatment sessions as a way to buy time to get help and support for her social situation. It may not be within my scope to control what happens after discharge however one cannot help to empathize with her current situation. With that being said, reviewing her current health condition, I found myself at a crossroad where one option was to delay treatment to get post-hospitalization help or to perform efficiently to ensure no other secondary complications can occur before discharge.

After consulting with other students and my clinician I’ve come to understand that there are certain things that fall beyond the scope of my control and that one could also be too empathetic, and this could have been the curtain that clouded my judgement. Balancing the empathy and sympathy towards our patients is a challenge that not many realize they are facing, a challenge with many facets that may present itself in many forms.

Reference

Emily. (n.d.). Hospital poem #9: Full Cast. Retrieved from Hello + Poetry: https://hellopoetry.com/poem/3088842/hospital-poem-9-full-cast/

Kubler-Ross, E., & Kessler, D. (2014). On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss. London: Simon & Schuster UK Ltd.