Fledgling Nurse, Part 6: Melvin as a Superpower

So, I have had patients that needed to vent before, patients that were so caught up in what their current circumstances.  Being in the hospital is a traumatic thing, where the "normal" is broken.  And being "fine" one day and requiring to call someone to help you go to the bathroom the next does not always sit well with a lot of people.  A lot of people tend to feel very much out of control in these spaces and subconsciously try to reestablish control by making demands or picking a small fight.

Not everyone has the vocabulary to dig into what they're feeling in those spaces.  I am very intentional when I meet a patient to ask them what I may call them and often whether they would like their door open or shut--in other words, I start off by checking for consent and permission while also honoring their space and giving them a modicum of control.  I think it helps.  Giving the patient a degree of choice and autonomy in the first few moments of our interaction is what I would want at least.  

Later in conversation with the patient, while helping them to the bathroom, performing my morning assessment, or documenting all of their morning medications, I tend to see if I can get a conversation going, to understand a bit more about their situation and where they're at.  If I have caught the patient in a space where they A) trust me enough to be honest, B) are emotionally overwhelmed enough that it doesn't matter, C) seek to manipulate me in some capacity (unconsciously or otherwise), or D) some combination thereof, I might be able to tap in to how they are coping emotionally as well.  I try to make specific invitations to these places, actually.  

Every now and again, though, I get a patient that tells me that I don't understand what it's like to actually be in the hospital.  And they cannot see small tightening of my lips under my mask as I have an involuntary, rueful smile.  Then, I tell the patient, that, sure, I cannot understand exactly what they might be going through, but I have some idea, at least.  At that point, I may add in that I have had a chronic illness since I was twelve and have a permanent colostomy that I call Melvin, with a long hospitalization fresh enough that I still remember a lot of those same general feelings.  It's only ever a sentence or two, unless they start to ask about details, because I put the conversation focus right back on them--it is a vessel to validate their feelings, to acknowledge some frustrations that are real yet hitherto unnamed.  I establish my credibility and authority not only as a nurse but now as a human being that has also been in a similar space.  I might mention how inconvenient it is to twist around for the toilet paper in the bathroom, particularly if one is sore and achy or recently had abdominal surgery.  I might mention that the first time one can shower by themselves again is a glorious achievement, as is the first time farting after a surgery.  But I always come back to their current experience.  I show them briefly my authority to empathize, and then it is back to a new, deeper understanding between us.  

And often the conversation is free to dig into the real concerns that they want to talk about.  I listen, paraphrase back, add in my own ways of describing similar feelings, and continue to listen while tidying up the room a bit or occasionally doing some quick charting to allow myself to linger a moment longer.  Other times, it's clear I need to put down some distractions and either touch their shoulder gently or take their hand, offer a tissue.  

I don't always have as much time as I would like for these holy, human moments.  It does make them all the more precious.  

It's odd to think how having a chronic illness and an ostomy can become its own superpower.  Frankly, to some people living with an ostomy is the worst-case scenario, that they cannot "imagine having to do that!" (which people have said to my face, that my life embodies their hell, which is...not exactly uplifting).  And yet.  Here I am.  Certainly with scars and trauma that I wear perhaps too well some days, but I am here.  I went to nursing school and swim laps and am happily married and have a dog and proceed to keep living, even with an ostomy and, in fact, because of my ostomy.  A patient's demeanor can change dramatically when I choose to reveal this vulnerability, this small piece of truth, occasionally putting a couple of other things into perspective for them, too:  their current distress is real and difficult to process; there are also quite possibly ways to accept it and people who have whose experience can be learned from.  

That's with patients, though.  I'm not shy about telling my peers about my ostomy either.  And, honestly, it is such a relief to be around people that I don't have to go into a full lesson about what an ostomy is--there is a base, mechanical understanding immediately there.  I know that if I have a bag blow-out in a shift that I could have hands that would know how to act and help in the immediate physical places (grabbing my supplies, getting new scrubs, checking in on a patient, etc.) and a number that I would trust to support me in the emotional ones.  Inevitably there will be a day where I need that kind of help, and I feel a community present in these spaces.  

Melvin's presence has a way of helping me, too:  I have less trouble asking for help when it comes to Melvin.  It is something so un-normal for most people that there are few assumptions made about what I do and don't need in those spaces, so I can set the timbre.  I tell people frankly that I need to vent the bag or that the loud, wet sound they heard was "just my ostomy," to normalize it a bit more, sometimes for myself.  Melvin also gives me an excuse to go to the bathroom--I can tend to Melvin with little internal discussion when I had successfully ignored my bladder for the last several hours, which means that it is also a good time to pause for some water and otherwise take a few mindful breaths while I'm at it.  

Just a normal bathroom, for our version of normal

Melvin makes me pause, both to my frustration and relief.  Melvin humanizes me to both my patients and my peers.  Melvin does not define me, but it definitely does frame my experience significantly to the degree that I cannot separate myself from my disability.  Living with an ostomy means that I always have to be checking in with my body in certain ways and have contingency plans for different situations, which can turn into experience I share with patients all over again and reasons to further self-advocacy.  It is a continuous journey of self-acceptance, grief, and resilience, overlapping corners with other challenges and the needs of the moment.  And the only visible marker of all these things hides under my shirt.