If someone asks me, "What was the most frustrating moment for you as a nurse after so many years?"?
I would say, it was the moment when I was struck by a patient.
If someone asks me, "What is the moment that hurts the most?"?
My answer is still that moment.
01 Pain ravages: Calmness and dignity shattered by severe pain
Chen, 78 years old, had bone metastasis of liver cancer. Before his retirement, he was the director of a bureau in the city. According to his family, he was accustomed to being in charge all his life. When he spoke at meetings, he never used notes and his speech was clear and decisive. However, the pain of bone metastasis is relentless. It doesn't care who you are, how much you talk, or how many people you manage. When it comes, it's the same for everyone. In the last two weeks, Chen's pain relief regimen had been increased to a high dose, but the breakthrough pain still came as suddenly as it arrived. That afternoon, I went to turn him over and caught him in the throes of pain. His hand suddenly grabbed my wrist with astonishing strength, while his other hand pushed and hit my shoulder in a haphazard manner. His eyes were red with anger, and he was shouting in a hoarse and broken voice. His wife was crying beside him, trying to pry his hand open while saying, "Chen, wake up! This is the nurse! Let go! You've always been the most reasonable person in your life. What are you doing?" He didn't let go. He didn't recognize us anymore. The pain had transformed him into a different person. The person who had always been reasonable was forced by the pain to lose all sense of reason.
02 Empathic understanding: Uncontrolled irritability is all a silent cry for help
After about ten minutes, the medication took effect. He gradually calmed down, and his eyes gradually became clearer. He first looked at the ceiling, then looked down at the hand he had clenched around me, and then looked at his wife's red and swollen eyes. Then he understood everything. The ward was quiet for a while. He didn't cry. A person who had given presentations and chaired meetings all his life had long been accustomed to not crying in front of others. But he turned his face away, not towards the window, and his shoulders trembled slightly. After a long time, he turned around and said in a very soft voice, "Little comrade, did I hit you just now?" "Little comrade," he called me little comrade. This was how cadres in his era addressed people, politely but with a sense of distance. I said, "Old Chen, you were in pain, it doesn't count." He waved his hand. I was too familiar with that gesture, it was the one he used when in power to indicate that others didn't need to explain. He said, "You don't need to excuse me. In my life, Chen X, I have never had a problem of principle in my work, and I have never wronged anyone in my life. I am old and old, and I hit the person who takes care of me..." He couldn't finish, and pressed the heel of his palm against his forehead. That position used to be a neatly combed pompadour, but now it was a sparse white hair after chemotherapy.
03 Gentle Care: Upholding Patient Dignity with a Nursing Heart
That day, I pulled up a chair and sat down beside his bed. I didn't speak immediately. I knew that for a person who had been a leader all his life, the hardest thing to accept at this moment wasn't the pain itself, but the loss of control - he had controlled the situation all his life, but in the end, he couldn't even control his own hands. After waiting for a while, I said, "Mr. Chen, let me tell you two things. 'The first thing.' I rolled up my sleeve and showed him the mark on my wrist. 'Look, it's nothing serious. If you really wanted to hit me, my wrist would have been broken long ago. You were pushing, not hitting.' The nurse had been there all along. If you don't believe me, ask the nurse. The nurse nodded. 'The second thing. Do you know why I didn't dodge just now? It's not because I'm not afraid of pain, but because I saw your eyes. Your eyes were screaming for help, but your mouth couldn't speak.' I paused and said, 'You weren't pushing me. You were pushing away the thing that was making you so painful that you couldn't live.' He suddenly raised his head to look at me, his lips trembling several times, and finally just said, 'You little comrade, why are you speaking like this...' He didn't finish. But I knew what he wanted to say.
The next day, I discussed with my sisters in the department, and we made a small card for Mr. Chen and hung it by his bedside. The card read: "Mr. Chen, retired cadre. If the pain makes me lose control, please call me 'Mr. Chen', and I may come back. I have always abided by the rules in my life and don't want to lose my composure in my later years. Please." When writing this card, I had sought his opinion.
He looked at it for a long time and finally said one word: "Okay." His wife later told me that it was the first time since he got sick that he was willing to let others help him. From then on, every time the pain eased, he would nod to us. Not to apologize, but to nod. Just like how he used to indicate "it's okay" to his subordinates during meetings, crisply and decisively. The morning he passed away, his consciousness was already not very clear. I went to do morning care for him, and he suddenly opened his eyes and looked at me, and very slowly, he nodded. That was the last greeting he gave me.
Chen Lao has been gone for over a year, and the imprint on his wrist has long faded away, but this incident has always remained in my heart.
We often say that narrative nursing involves listening and empathy, but Mr. Chen taught me that there is another kind of narrative, which is to preserve the dignity that a patient has held onto throughout their life.
For a retired cadre, what is more terrifying than pain is losing control. Having controlled one's life, one ultimately cannot control one's body; having been reasonable all one's life, one is finally driven to lose one's composure by pain.
The collapse of dignity can sometimes be even more agonizing than cancer pain. We don't need to forgive from a position of superiority; we simply need to squat down and help him pick up the scattered pieces of his dignity.
It wasn't the real Chen Lao who hit me. It was he who silently nodded and apologized after he came to his senses.
Love is an empowerment. For Chen Lao, the best empowerment is not an excuse, but a sentence: "I know that's not you. We all remember what you were like throughout your life."
Article/Speech: Gao Qiao
Editor: Zhang Huana
First instance: Huang Guifang
Second instance: Jiang Bei