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Commit to Sit

Dear diary,

The holidays have come and gone. The past two years of being a nurse have changed the way I look at the holiday season. Mostly because hospitals are always open and so, working a holiday is part of the job. It makes you appreciate the times when every holiday was a guaranteed off-day. I lucked out and didn’t have to work Thanksgiving or Christmas, but when I did, I remember not only feeling the envy creep in, but I felt for my patients. Like us, patients are stuck in a sub-ideal place on days that are centered around joy, family, and traditions. I bet a hospital bed didn’t compare to baking Christmas cookies, or carving a turkey. I’ll bet getting poked for blood tests didn’t compare to falling into a food coma or watching family members unwrap a gift you nearly ruined the surprise of months ago because you were that excited to gift it (nice little run-on sentence for you).

On my floor, we have been honing in on an initiative known as “Commit to Sit.” I’m not exactly sure if it’s an established initiative, but we have enjoyed highlighting nurses who were caught in the act. It is something we should do automatically. When we have time, sitting and talking to our patients is an amazing tool not only for building a rapport, but also getting to know them. I have found that knowing the little quirks about my patient or what topic makes them light up, helps me provide better care.

Nursing isn’t just administering medications, collecting blood tests, and charting. No, nursing also works to support a patient holistically. We look to treat the needs of the mind, body, and soul. Becoming ill is inevitable. None of us are immune to every possible contractable or inheritable disease. Because we know this, when caring for a patient, we work to ensure their care isn’t solely around trying to relieve them of the effects of whatever brought them in. When we work this way, we remind them that they are more than their diagnosis. They are less likely to feel like a burden or like they are just another patient. We remind them that they are still a mother, a father, a fireman, a lawyer, a sister, a grandparent, a teacher, etc. They are still who they are, so that’s who we treat.

It’s been a part of the practice for a long, long time. I’ve learned that a significant part of a patient’s ability to progress and heal is directly related to their morale. A high morale helps yield more positive outcomes. Addressing their holistic needs ensures their spirits are up enough to want to remain compliant with the plan of care. Sometimes the complication isn’t the actual diagnosis, but a patient’s unwillingness to allow care to be provided. Establishing trust and cultivating an environment of comfort is the key.

When time allows it, I am very intentional about spending time with my patients. One by one, I will sit and chat. I start with easy questions such as, “where are you from?” or “what did/do you do for work?” I do it in small doses as to not overwhelm them. Who knows, they might be wondering who the heck this random nurse is asking twenty questions, and why? From there, once I feel we’ve built a foundation, I’ll have them recall the good things in their lives and pretty much open the floor for anything they have on their mind. I sometimes can’t believe how transparent my patients become. It doesn’t take them long to have a completely different outlook on their hospital course. They feel more inclined to allow us to do what we need to do because they feel seen, heard, and human. Trust isn’t given, it’s earned.

I once sat with a patient, we can call her Jane. Jane is another frequent flyer and she is a challenging one, mostly because of how demanding she is. I was assigned to her one shift and we know each other from previous admissions. I was not really prepared for her shenanigans today, so I decided I’d set the tone early. I would go in with kindness, but also assertiveness. As I walked in, I remember noticing something was off. Jane was off. She was lethargic and slumped over. Physically, she was alive (don’t worry), but her spirit seemed spent. She hardly acknowledged my entering her room and her silence was unfamiliar. I prepared her medications, gave them, and left. The same process occurred a few more times as the day went on and there was no change in Jane. Finally, I went in and sat down. She looked up and I asked,”what’s going on with you?” At first, she acted as if I was interrupting her pouting, but eventually, she gave in and talked. Jane was sick, sure, but Jane was also hiding from the problems that existed outside of the hospital walls.

She has a very complicated family dynamic at home. She’s got lots of kids, grandkids, a husband that never visits, family drama and an unfortunate illness. The illness gets treated here, sure, but it’s chronic, meaning long-term. She has it, will always have it, and all we do for her, here, is treat any exacerbations she might be experiencing. Once we’ve done that, she gets to home, but what if home isn’t a place of rest? What if home is a constant reminder of how out of control life has become and the only way to escape it is to get admitted to a hospital? We’re no 5-star hotel, but we know Jane well and we know exactly how she wants to be cared for.

That’s just it, isn’t it? Don’t we gravitate towards what feels safe; what feels comfortable and familiar? It’s in those places we’ve developed a rhythm that works for us and we don’t dare try and change the pace. No, changing the pace means changing everything you’ve worked tirelessly to establish, right? It means becoming vulnerable all over again and for some, that means the door for disappointment, hurt, fear, and uncertainty opens again. We welcome new beginnings the same way we’d welcome a stranger into our home: with slight hesitancy.

For Jane, I wanted her to accept where she was now, and to believe that it was not where the story of her life would cease to be written any further. I wanted her to know that as long as she had breath in her lungs and hope in her heart, then life had all of the pieces it needed to ebb and flow into a beautiful, new rhythm. So, I told her just that. We had a lovely discussion, and I got up, and went about the rest of my shift. She was discharged a day later, which was exciting because she always tries to find a way to delay her leaving. I’d checked in before clocking out and she seemed to be in good spirits. She expressed her being “ready.” What that meant for her, I’m not sure, but I like to think that she’d been “ready” the entire time. All it took was for someone to sit with her, to look beyond her illness and speak light into her situation.

I learned so much from my experience with Jane. I learned that committing to sit goes beyond my workplace. There are people in my life that need to be seen as a whole person and invested in as such. Maybe the same is true for you, too? Maybe there are people in your life that need you to be more present; to help them feel like someone gives a damn about what’s going on in their world. We need people. We need accountability. We need someone to say, “hey, I see you, hear you, and believe there’s still more for you.” That interaction might just be the spark they need to ignite a willingness to change their rhythm.

Commit to sit.

-RN

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