I am about to conclude six months of working on the Bone Marrow Transplant (BMT) floor. Next week will be my last, then three weeks in Europe, then to my next assignment. On the floor, there are also solid organ transplant patients, an open-heart sub-unit, colo-rectal surgery patients, and whoever else needs a place to sleep while ill.
My initial job while in nursing school was also on a BMT floor. I found that I adored most of the staff, invested in the patients, and eventually absolutely without any doubt understood that I could not be a cancer nurse. That was in 2006. When I graduated, I got a job working on a sister unit where I did my senior practicum for school. It was a community hospital and the floor where I learned to be a nurse took any poor (operative word) fool with trauma, stroke, or a heart attack. I learned to spot a train wreck from a mile away, and, purely out of self-interest and professional pride how to steer clear of the disaster. If someone was going to "crump," it wouldn't be with me as their nurse, one goddamned way or another. I learned that life wasn't fair, everyone deserves to be treated with compassion (even doctors), and to work smarter and harder.
That was a different experience than the long, drawn out suffering over months, followed by a miserable and painful death on the oncology floor. I appreciated that very much. Heart attacks are quick. Stroke patients go to rehabs and SNFs. Bones are set and eventually heal. Better living through chemistry. And best of all, my 12-bed unit was surrounded by ICU's on all sides. All signs point to hell?...Get them next door STAT. Good luck to you, vaya con Dios.
But if I think about things a little more critically, where I learned to care about patients was on the BMT floor. The patients were there and they were not going anywhere. My actions regarding a patient in the present had consequences with that patient in the future. I learned that it behooves all involved for me to make these interactions purposeful and pleasant.
And despite the fact that I perform heroic professional feats and create logistical miracles, the patient is having the worst day of their life. They are in unimaginable pain confronting the reality I will spend my lifetime avoiding, life ends and death happens. The challenge then becomes how to meet that patient where they are and walk beside them for the day's journey. That's the most I can do. It is the least that I can do. Some patients welcome my company warmly, and some overly rely on it. And others prefer to turn inward and experience the solitude that demands to be acknowledged. In this case my role is to protect that choice, my efforts appreciated or not, it does not matter.
The BMT floor is where I came to the conclusion that outcomes don't actually matter. Everybody dies, it's a matter of when and how. All that is guaranteed is the present moment. Whether the present moment is bringing pain, anxiety, challenges, laughter, exhaustion, healing or final breath, experiencing it is the task. Realizing that decisions from moment to moment come to bare, and consequences are inescapable, that's the thing. That's all there is, and the universe with a capital-U will use the energetic throughput. It's pretty simple, definitely not very significant, small in scope, and the very essence of this human experience. I feel grateful for each moment there.
Nonetheless, I am ready to move on. I get back to my instinctual revelation that this type of medicine isn't my professional glass slipper. I know that I bring something to the table that nobody else can, and bone marrow transplant gives me a unique perspective enriching my experience of life. But I just don't have the fortitude for the few successes out of many attempts. The God complexes that run these endeavors embarrass me. So in light of this, life and death gets a bit heavy.
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