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That One Patient with a Bullet in His Lungs

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By Jaclyn Calderon, RN

Nursing is one of those distinct professions where you get to encounter people from all different walks of life. Nurses cannot explicitly choose who to care for or even decide what kind of behavior you will get from them. Nurses are there to openly welcome every patient that comes. And most of these patients come to the hospital not because they wanted to, but because they needed to be treated and cared for. Because of their condition, patients are likely to be easily annoyed and short-tempered, and often put a little or no effort in participating with their treatment.

This is where my story begins.

I was assigned to care for Mr. M., a 65-year-old male diagnosed with liver cirrhosis. He is a bit withdrawn and always have the tendency to shout at his caretakers even his nurses. He is your typical uncooperative and snob patient.

How many times has he pulled out his much needed nasogastric tube? Probably more than the times he refuses to have it reinserted. The stubborn Mr. M. doesn’t even want his vital signs taken and just pleasures himself to binge sleep as much as possible and avoid nurses coming and attending to his medical needs. Much to my dismay, it was very difficult for me, his nurse, as well as my colleagues,  to give him proper nursing care.

I am the kind of nurse who is very cheerful and loves to exchange stories with my patients. My colleagues know me well that when I’m missing during break times or after endorsement, they know they’d find me in my patients’ rooms havings chitchats or saying long goodbyes. With that personality embedded in my character, I get to know my patients well and establish a good rapport not only to the patients but also their families. However, for Mr. M. it’s different.

Very different.

How can I possibly give the best quality nursing care if Mr. M. is being hard on me as well as to himself? What can I do to help him and how can I approach him to even have a small conversation? Those were my dilemma. I would have to try a unique approach to have him cooperate.

I have kept my cool many times and understand the condition of Mr. M. better. There are times that I would be waiting for him to personally reach out his hand and offer it to have his blood pressure taken. But he would just keep his arm still and firm in his chest.

Then there was this one time where my patience with him was tested. On a bright sunny wonderful day, a perfect day to work, Mr., M. needed to empty his bowel. As his nurse, I need to assist him since he cannot tolerate standing up much as ambulating to the toilet. He found that helping him was bothersome and even shouted at me. There I simply apologized for “troubling” him with my duty. I was still his nurse and did my other duties to care for him. Every time I go into his room, I would ask him how he is and encouraged him to help himself recover but many times I was replied with a straight face with no acknowledgment or whatsoever. Most of my colleagues are giving up on him but giving up is the last thing I would do on with my patients. Even if Mr. M. is giving up on himself, I will not give up on him.

When the doctors ordered a clear liquid diet to prepare him for NGT removal, I spent a full hour just to feed him. With a gallon of patience and a bucket of perseverance, I was able to establish rapport with him. Finally, I was able to start small conversations with him. When I asked about his life and work when he was still young, he raised his brow and gave me an unkind look. Right there I knew I stepped my boundaries a little. There was a moment of eerie silence for a while then he took a deep breath and looked at me again with a defeated demeanor.

He smirked and with an irritated look on his face, he said, “You’re annoyingly persistent, aren’t you?”

I knew I went beyond the line and I was ready to give my most elaborate apology when he said, “This is my second life, you know?”

I can’t believe that Mr. M. is sharing something! I got so ecstatic and nervous at the same time with this fact that I couldn’t think of a better reply than “Please, eat your sou–I mean, why?” He made that t unflattering smirk again nudging his tube.

“This has been my second life. I was shot in my chest during the war,” he said after gulping a spoonful of soup.

“You’re a soldier?” curious, I asked and realizing why he was stoic all this time.

“During the second World War…against the Japanese,” he uttered.

I gave a nod as a reply and he probably saw how big my eyes got when I saw him talking with me.

“Piece of the bullet is stuck on my left lung. For all I know, the doctors opted not to remove it. They said it’s better to leave it like that to avert a possible massive bleed. It has been in me since,” he explained.

I listened intently trying to convince myself the veracity of his story. Nonetheless, I was happy that Mr. M. is conversing with me.

Minutes passed by and I just sat there listening to him. He shared how he persuaded his wife to marry him. And day after day, I can see how sharing his stories made him smile. It made me happy inside so during my shift, I allot time to hear his rants about the government, how he adores his grandchildren, his joys and his pains of every day. I can see his health is improving and how he is cooperating in his treatment. Hence, the art of listening was indeed effective! Nurses are in with me when I say that seeing your patients recover is like winning a lottery. You just can’t explain the extreme happiness that it brings to your heart. It’s that “feel good and feel proud” moment. I felt more than accomplished.

A day before Mr. M. was discharged, he asked me to wheel him around the area. My colleagues were all happy to see him smile as they wave at him. He continued sharing his stories of how life was difficult during the war and so on. Then I wheeled him back to his room and held my hand, with a teary eye, he said, “Thank you.”

Upon hearing those words, I felt a lump on my throat as he continued saying, “Thank you for taking care of me despite me being pigheaded. Thank you for listening to all of my stories including my rants.”

I couldn’t hold by a tear in my eye when I heard him say, “Amongst all the nurses that handled me–you are my favorite.”

My heart melted from what I heard as I clutched to his hands tighter. The stoic and straight-faced Mr. M. softened and gave me a look of delight and gratitude.

“You were always there even if I asked you to go away,” he said while I was about to burst my tears. I was appreciated and it made me feel jubilant.

After Mr. M. was discharged, I organized his chart’s notes and by chance saw his chest X-ray results. I can’t help but smile because I remembered his story about having a bullet stuck in his lung. That story opened up everything else for him.

As a nurse, we took an oath to care for our patients and we work hard to give them the best care in the world. We do carry out the doctor’s order, take vital signs, and administer medications, but most of all, we become their support system during one of the most trying time of their lives. It was said by one of my professors that we must treat our patients as if they are our relatives, in that way we can give them the best nursing care.

You cannot just simply give up and provide mediocre care to a patient who is giving you a hard time. Take it as a challenge. And remember that it’s during those times that they need our care the most. Even with a busy schedule and rushing to get the job done, we sometimes just have to stop and take it slow, be there to our patients and remember the core of being a nurse. Listen to them and give them a pat on the back saying “I am here and I will help you get well.” After all, there is no greater joy than saving a life and a broken faith.

As a nurse, we have the opportunity to heal the HEART, SOUL, and BODY of our patients, their families and ourselves. They may forget your name, but they will never forget how you made them feel.
-Maya Angelou

Jaclyn is a registered nurse and a contributor for Nurseslabs.

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