monday night, she was smiling.

after i gave her enema, she smiled. after i gave her a heparin shot, she smiled. after i repositioned her, even in obvious pain, she smiled.

i think it was not because she was elated with the things i did to her. it was just because there was nothing else to do. she only spoke hindi, and i have no clue what she was talking about when she did talk.

so, she smiled.

i had to call her daughter in the middle of the night when she refused the second enema. after talking to her daughter for a few minutes, she passed the phone back to me, nodded and motioned me to go on. then, that smile.

granted that the sad result of her EGD came back that night, and the hateful tumor was labeled malignant, but still. she was not one of those patients who reeked of death. she was weak, yes. but dying? that did not even cross my mind when i left tuesday morning.

when i came back tuesday night, i was a little surprised that her name was not on my patient list, but i was not concerned. i thought they either moved her to a basic unit, or worse, to ICU.

then, they told me she died.

i wanted to cry. out of shock, out of empathy to her very enthusiastic daughter who filled me in with every little details of her mom’s life in the few minutes that we chatted. the sense of sadness that overtook me was the kind that daughters share when they lose their mom.

i wanted a moment. a minute or two maybe, just to be sad, because that was how it was, sad.

unfortunately, my job didn’t give me the luxury of that moment. to make matters worse, there was the annoying irony. a couple of my coworkers who sensed i did not take the news very well tried to dismiss the idea of grieving, even for a moment, by saying “come on May, she was better off going anyway.”

granted that was true, was it wrong to grieve anyway?

well, not that it was wrong. it was just that there was no time. literally. four patients waited for me, all needing my undivided attention. there was blood pressure to be stabilized, a confused patient to be kept safe, a psychotic patient to be watched, an unresponsive patient whose children were in the corner of the room, crying in frustration and fear had to be monitored. clearly, the last thing all these people needed was a teary eyed nurse, crying for a patient who was not even there anymore.

so i bit my lip, started my night with the same smile i usually start it with, and ended it physically tired and emotionally unfinished. i just didn’t find that moment to grieve. not until now. i know it sounds overly dramatic that i am taking that moment now, away and a long time after the fact, but i am. here, now, where i have the luxury of time.

it’s not that i do not welcome death. it is the uncertainty of when it is coming that i wrestle with. especially with people who seem to have so much more to live for.

it’s not that i do not understand others’ “death-doesn’t-get-to-me” attitude because i do, and have reacted that same way plenty of times. it’s just the fact that sometimes, we are left with no other choice but wear that i-couldn’t-care-less facade just because we don’t have time.

nursing is such a conflicting job sometimes.
we are expected to be human and sensitive so we can take better care of our patients by feeling what they are going through, for their sake.
and yet, we are also expected to detach ourselves from our emotions so we can take care of our patients and make intelligent decisions, also for their sake.

when i think of nurses who have done this for 20 years or more, i wonder how they cope with the conflicting expectations for so long. i wonder how they maintain balance and still be a good nurse. you know, the kind who is not immuned to human emotions but also the kind who does not get overwhelmed by human emotions.