Nursing Hands

by Sandra Garofalo, RN

I often hear people speak very highly of my profession, saying that nurses are “angels” and “heroes”. I would never say that these compliments are undeserving but if I look at myself honestly, I’m not sure I can describe myself that way. I like to think that I care for all my patients with an equal amount of compassion, refraining from harsh judgment, but I must admit that at times I find it a challenge to do so.

Years ago when I was a fairly new nurse I took a call about a patient that was coming to us from the Emergency Department during a night shift. I sighed when I heard the patient’s name. It was a man I knew well. He was a homeless man, a known drug user, who would come to us about once a month or so. The presentation  was usually the same. This man would do a large amount of drugs, his blood pressure would sky rocket, and he would come to the emergency room. He would be admitted to the hospital and we would keep him inpatient until a bed opened up in a homeless shelter. We cannot discharge a patient to the street. That meant that he would be with us for up to a week or more and he would spend most of his time asking for narcotic pain medicine and extra food. There never seemed to be enough of either. This was a man who knew the system and he manipulated it well. I was frustrated before the patient even came onto the unit because I knew what my night would be like. His call light would be ringing for the rest of my shift. He would ask for as much pain medicine as he could get and when he hit his limits he would demand I call the doctor to order more. This is not why I became a nurse. I didn’t want to spend my hours being a drug pusher and a waitress.

I was standing at the elevator when he came up to the floor. His eyes met mine. “Are you my nurse?” He grumbled. “I sure am, you and me tonight,” I mustered in false cheerfulness. He cursed under his breath, and then quickly settled into his routine. Call light, food, pain medicine, nausea medicine, food, pain medicine. He complained about my efforts to monitor his blood pressure and even tried to refuse the medicine to control it. I was growing more bitter with every ring of that call light, and finally I went into his room, ready to square off with this man. “Where is all this pain you are having?” I demanded, “You are here for hypertensive crisis. High blood pressure doesn’t cause intense pain.” He looked down, “It’s my feet. My feet are killing me.”

At the time I lived in a very old city in the South. Some of the roads there are still made of old stone, put in before the Civil War. The city is below sea level and most of the streets flood with the rain. The homeless people there carry a damp, rotting smell from these streets which seems to seep from their pores, and this man had that unmistakable odor. I looked at his feet. He had on hospital socks from the ER, which I pulled off to reveal feet so caked with filth that they seemed not to belong to a human being.  They were also swollen and sore. I was disgusted.

This man would not receive a bath until morning because there are only a few nurse’s aides on the night shift, but I could not abide having these filthy feet on my unit another moment. I put on a double pair of gloves, filled a tub with hot, soapy water and began to scrub. I would love to make a wonderful analogy and liken this moment to that of the New Testament story of Jesus washing the feet of his disciples, but there was no love or compassion in what I was doing. No nursing angel or hero was present that night. I scoured and scrubbed at his skin, appalled by his condition.

As I worked I thought of my first year of nursing school, when I had been taught to give bed baths. I remember my instructor spoke to us about how a bath was a good time to connect with a patient. Many people, especially the elderly and chronically ill, go for long periods of time and never feel the kindness of human touch, she pointed out. They only know prodding, poking and being lifted or moved. She encouraged us to remove our gloves and touch our patients whenever possible, but I remember thinking, “I’m not ever taking off my gloves, especially not during a bath.”

Now, here I was, with this man that I didn’t want to touch even with two pairs of gloves on. However, the thought kept coming to me, a soft voice, “Just take off your gloves.”  I pushed the thought away. I had given many baths since nursing school and this had never before crossed my mind. What was I thinking? But in spite of my efforts, I could not lock the thought out. After washing his feet the best that I could I walked over to the sink and filled the tub with fresh, hot water to warm up a bottle of lotion, and pulled up a chair to the foot of the bed. I wasn’t really thinking any more, just listening to that voice: “Take off  your gloves . . . the kindness of human touch.” I pulled off my gloves and rubbed the warm lotion onto his feet, slowly, gently, and firmly, being careful in the most swollen places. We were both completely silent for a very long time.

As I cleaned up and started to leave the room, he stopped me. “You know, before I was a junkie, I was nurse. I was a nurse in this hospital for twenty years. I would have never taken off my gloves to touch those feet.” He paused and looked down again. “Thank you.”

That moment changed me. It changed my heart and the way I looked at my patients. I saw that it was not my job to judge this man or anyone else. This experience came during a time in my life when I did not believe in God, but now I can see that God was with me that night. That still, small voice I heard was the Holy Spirit guiding me. It humbles me that even though this man and I were both far from God, he had not forgotten either of us. That man was a child of God and so was I.

Years later I would learn a story in The Book of Mormon about a good king who taught his people to love God, and to show gratitude for that love by sharing it with everyone around them. He said:

16 And also, ye yourselves will succor those that stand in need of your succor; ye will administer of your substance unto him that standeth in need; and ye will not suffer that the beggar putteth up his petition to you in vain, and turn him out to perish.

17 Perhaps thou shalt say: The man has brought upon himself his misery; therefore I will stay my hand, and will not give unto him of my food, nor impart unto him of my substance that he may not suffer, for his punishments are just—

18 But I say unto you, O man, whosoever doeth this the same hath great cause to repent; and except he repenteth of that which he hath done he perisheth forever, and hath no interest in the kingdom of God.

19 For behold, are we not all beggars? Do we not all depend upon the same Being, even God, for all the substance which we have, for both food and raiment, and for gold, and for silver, and for all the riches which we have of every kind? (Mosiah 4:16-19 in The Book of Mormon)

Health care workers often see how people bring suffering upon themselves by their own weakness and error, but that does not justify us in giving them any less care or compassion. I still often struggle to find these qualities within myself, although I believe medical work can be done with kindness, compassion and love, even for the most difficult patients. Prostitute, drug addict, angry old man, risky teenager, stubborn child, demented woman, Christian, atheist, black, white, gay, straight. . .they all need us, and they all need our compassion. Love is the essence of our profession, and the essence of our religion.

True divinity is the ability to love those who do not deserve it, and to serve them without judgment or hesitation. Jesus Christ treated everyone with love, compassion and forgiveness. He gave physical and spiritual healing without hesitation or discrimination. Jesus wants us to follow his perfect example of divine love.  Isn’t that what our patients need the most? Isn’t that what the world needs the most?

Sandra Garofalo is a member of The Church of Jesus Christ of Latter-day Saints and is a registered nurse.

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