You walk into your shift, never knowing how the day is going to go. You see your assignment, look up your patients and get report. But things can change in a matter of minutes. Where one minute you have a patient who was talking and not in any distress, you suddenly have to call a code blue. The patient who was calm and asleep all night is now agitated and combative. The patient who was lucid is now confused. Your day seemed nice and steady, then the doctors make their rounds and you have 20 new orders. Plans change, conditions change drastically within seconds, and you must be prepared to act at any given moment.
You are their emotional support. There is fear, anger, frustration, anxiety. You see the strongest in their weakest moments, and the weak remain strong. You get to understand what it truly means to be family and witness what it means to die alone; where friendship is stronger than blood or where blood is thicker than water. You see the tears, you hear the prayers. You are their last source of comfort and assurance.
Your are their advocate for when things don't go right. You are their eyes and their ears. You are their voice. Your knowledge, understanding and awareness makes you the gatekeeper, making sure that the care they receive is the right one for them. And should things go wrong, you will be reprimanded because it was your responsibility to check it.
You are their coordinator, making sure that they receive all the care they are supposed to at a time that is right for them. Ensuring that things are done efficiently and safely. Should any needs arise, it is you who must make the call - the doctors/specialists, the social workers, the physical therapist, the occupational therapist, the speech therapist, the dietitians/nutritionists, the radiology department, the pharmacy, the phlebotomist, the ECG technician, specialists, the patient transportation team, the turning/lift team. Every single one of them is important in the care of your patient. You are the one to ensure their daily needs are met, down to brushing their teeth.
You are their teacher, providing them education on how to care for themselves at home. How to prevent further diseases and complications. How to look for signs and symptoms that their conditions are worsening. And most of all, what kind of self-care is involved. You show them how to continue their care when they get home. Making sure that they take their medicines safely and as prescribed, and what their medications are for.
You help to ease their way to death or guide them back to life. You learn to understand what the phrase "death is a part of life". And as strong as you seem in front of the patient and the family, they don't see the tears you cry when turn around, or the heartache you truly feel, even when you know it's for the best.