END OF SHIFT


By Jo EllenWelborn, MSN, RN


ometimes routine encounters canremindus of the richlife experience that resides withinmany older patients. One cold winter while working the night shift, I was making


bedtime rounds when I came to a room in which two elderly gen- tlemen slept. I left the lights off and worked using the light coming in the door from the hall and the street lights shining through the window. I checked on the first patient, addressed his needs, and he settled back in to sleep. Imoved on to the other patient, “Sam,” and tried not towakehimas I evaluated the IVinfusionandobserved his breathing.Heturned over and begantalking softly. At first, I thought hemight be confused because he seemed to pick up the threads of a conversation in progress. He started to tell me a story from his youth about theharshwinterof1917-18,onthe plainsofOklahoma. Samwas a handsome, white-haired gentleman in his 80s who


had grown up in ruralOklahoma on a farm.His face was kind, but bore the imprints of a long life of hard work. Sam began telling me about the winter of 1917-18, when the Spanish influenza outbreak devastated communities all over the world, including his small community. He was 15 years old and had dropped out of school in the third grade to help support the family. Most people were cared for at home by family, especially in rural


areas. Sam told me how he spent the mornings driving the local doctor fromfarm to farm to make house calls. Automobiles were scarce, but the area’s only doctor had one. By Sam driving the car, the doctor could doze off between farms and houses. Samspent the afternoons digging graves in the frozen ground of the local cemetery.What a somber and heavy task for someone so young. One night on hisway home, Samnoticed that a neighbor’s house


had no smoke coming from the chimney. Sam went to the house to investigate and discovered that everymember of the family had died except one—the baby. He wrapped the baby up and took her home. His mother cared for the baby until relatives could be located. Sam’s eyes had a far-away look in themthat toldme he was back in the winter of 1918 recalling an experience that changed himforever. He providedme with a snapshot of life on the prairie, and a viewpoint of how difficult and harsh life could be.


30 JANUARY/FEBRUARY2016 • WEST


I retrievedan extra blanket for him,partly toprovide addedwarmth


and partly to shelter him from that cold night 70 years before. I thanked him quietly andwished himgoodnight. I drove home after my shift with the car heater on full blast, thinking about that cold lonely walk for Sam, trying to keep that poor baby fromfreezing. I often think of Sam as a teenager trying to endure a devastating


epidemic.The expertise ofhealthcarewas so limited then.Therewas little that could be done to ease the suffering. I wonder, would I be able to respond to a devastating epidemic?Would I be able to offer comfort?Would Ibe able tomove forwardorwould I fall intodespair? When older patients share their life experiences, I feel I have


been given a gift. There is something richer about an experience that has been lived, processed, recalled and kept that gives it added luster and depth. In his way, Samhonored thememory of thosewho shared that expe- rience — those who endured and those who could not. Sam remind-


ed me that each elderly patient I see was once a strong and vibrant youth with the hopes of a lifetime stretching before him or her. He reminded me that my elderly patients are a rich mosaic of a long life with all of its joys and sorrows. Sometimes I will be privileged to get glimpses into these lives as I seek to learn how to better listen to them and to resist the common attitude to treat elderly patients like they are wrinkled or incompetent children. I see how poorly that respects the person lying in the bed. I hope the next elderly patient will be met by a nurse whose eyes and heart are open, and provides an honest acknowledgment of the complete person,wrinkles and all. Thank you, Sam. •


Jo EllenWelborn, MSN, RN, is a professor in the ADN program at Weatherford (Texas) College.


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