My patient’s name is Joe, or so he says, and I am his nurse. His chart states his name as Zbigniew Zwiezynskow and under place of residence, there is merely a sad trio of letters: NFA — “no fixed address.” He’s in his mid-forties, admitted last night to the Intensive Care Unit, the ICU, with pneumonia. He’s feverish, delirious, and so violent that he may try to kill me if I decide to release him from the restraints we’ve placed on his arms and legs. Medically, his condition is improving — no small thing here in the ICU, where all of the patients have life-threatening, catastrophic illnesses. We’re full; each of our twenty-two beds is occupied. Attached to every patient are monitors, machines, and equipment and in every room there are sickening odours and horrific sights, but I hardly notice these things any more. I have learned how to go beyond it all, to see through it, push it gently aside and go straight to the person lying there in the bed.
Today, all day, Joe is my patient. His heartbeats, urine output, breaths, cough, skin, dirty fingernails, and wild, greasy hair are all my concern. I will enter his world and for the next twelve hours, minute by minute, I will dwell with him there.
It’s taken me such a long time to get here.
The sheer math astounds me. Since becoming a nurse in 1983, I have put in thousands of twelve-hour shifts at many different hospitals. I have worked with thousands of nurses and hundreds of doctors and other professionals. I have taken care of tens of thousands of patients ranging in age from eight to 104 who have had a multitude of diseases, illnesses, and injuries, and have administered to them a sea of intravenous fluids, rivers of syrups, suspensions, injectable medications, and at least a million pills, capsules, and tablets. Researchers study large populations, searching for patterns and trends, but the only way I know how to practise as a nurse is one patient at a time, seeing each individual in my care through illness, loss, pain, grief, or the prospect of death. For me, each time, the numbers all come down to one. As a nurse, there is the patient I am caring for and together, we proceed, one on one, side by side.
It wasn’t always like this. Even though I was practically born a nurse, with strong instincts to help others, I was raw and unskilled; I had to be made into one. But long before it became my livelihood, taking care of others was my way of life. You could say I practised as an amateur for many years before going professional. My mother was my first patient and I cannot recall a time when I did not know it was my job to be her nurse. I was six years old when she first became ill, but as my father always said, I was very mature for my age.