I work in a small, busy ER in a small town. Over the years a nurse gets to know the people that frequent the ER, coming in by ambulance when a taxi would do, abusing alcohol or drugs and then hoping that they will get a helping hand when their existence is just too much for them to cope with. We often feel helpless as we patch them up and return them to the same circumstances that brought them through our doors. One young woman, we’ll call her Janet, came back in 3 nights ago – the place was hopping, we had police in 3 times with suicidal and psychotic people, we had the left overs of bar brawls, we had chest pains, and we had children with sore ears. There are only 2 RNs on at night and so no breaks and no time to sit. And then the ambulance comes in with Janet who is Hepatitis C and HIV positive. Fortunately she is not vomiting blood this time, but she has abdominal pain – I get a urine sample, it shows she has a bladder infection, I get an IV in, run some fluids, give her something for the nausea, and move on. A while later I sit in the chair next to her stretcher to have a look at her medication pack. Some of the spaces are empty, some still are full of pills to be taken at regular intervals, and I begin the usual “Why won’t you just take your pills as ordered….” and then I stop. I look at her. She is still as a statue. I hold her hand, and she lets me. I stop and match her breath. It is quiet. We sit. We breathe. Then I ask, “Janet, can you read?” “No” I have an answer that just stops me in my tracks. We talk about her meds, she doesn’t know that she was supposed to take them at certain times – she can’t read the package. Her boyfriend picks up her meds – but he can’t read either. We decide on a bed with a sun over it for the morning medications, and a bed with a moon for bedtime – she drinks soup for lunch so that is a soup bowl and a spoon. She feels better. She is a person, a collaborator, a being that I am honored to have a chance to be with. I tell the other nurses during shift change – some are astounded. I mark her chart, and contact the pharmacy who are also not aware of the problem. She had been without her medication because we didn’t just sit, and we didn’t just listen – I am so grateful that this time I could sit and breathe with her. I hope it makes a difference for her, it did for me.

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