Will you be back tomorrow?

I was doing my last rounding before the shift change - bathroom? pain? water? - one of my patients asked me, "Will you be back tomorrow?". That is when I know we had a good day today. 

It is quite satisfying to know that the effort I made was acknowledged and they look forward to seeing me the next day to take care of them. Sometimes being a resource nurse*, it is challenging to not always see your patients back the next shift and I don't get to have a continue relationships with my patients. 

Being a resource nurse can be a blessing and a curse though. I do think that having a continuing relationship with patients, you can build rapport with them, know their hospital course and better advocate for them. Sometimes, I find that I can better engage with my patients if I am just knowing them for the first time. Especially if some patients have been in the hospital for weeks or months; often time the nurses get frustrated when there's resistance to care or lack of progression to healing. 

Building relationships with my patients is something I value in my care. I think it has a great impact in their health outcome. Medicine has a lot of psychosocial component because it is science that deals with human. So, we can't just look at a patient with an uncontrolled diabetes and wonder why they don't exercise or eat healthy. Does this patient have access to nutritious food in their neighborhood, has the financial stability to afford healthy food, has other chronic illnesses they are dealing with that prevents them from putting their physical health as a priority, other social life stressor, was given the education, lifestyle habits, culture and practices etc. The list goes on...

Sometimes, I think the best way to care for my patient is acknowledged those challenges, and understand their goals - to use harm reduction strategy to discuss patient's care - maybe physical health is not their priority right now, but let me talk about what are the warning signs that they should look for, we call it red flags/ED precautions. Maybe this is not the best science, maybe people think that our job is to make people as healthy as they can be and allowing them to continue unhealthy behavior is doing harm. However, wouldn't it be more harmful if we use scare tactics, to use our authority to "do as I say or else..."? which may result them not seeking care at all because we don't respect their decisions or even attempt to understand their circumstances. 

There are so much more to discuss about approach to patient care...personal choice v. public health, shared decision making, patients who find medical knowledge from google...I can ramble all day about this.

* sometimes also known as float nurse, where nurses go to different units or even hospitals where nursing staff are needed to cover the shortage.