She said that she had never understood before what
a difference a single day could make
I first met Jill (a pseudonym to maintain confidentiality) when she laid in CCU, her arms and legs were in bandages which were sodden with blood, the staff had called me to see her as they needed some super absorbent pads which they just couldn’t find. Jill had undergone major surgery after she had contracted necrotising fasciitis, she was awaiting further surgery and a transfer to a larger hospital specialising in plastic surgery. I did all I could at this point but was sad to think that I may not see her again, I remember thinking how young she was; only in her 30’s with young children, a life that had not been given a full chance. Luckily Jill proved to be strong and after several operations returned to our hospital on the road to recovery. I met her again the morning after she had arrived. As I approached the bed I found her in tears, her face and eyes puffy where she had been sitting crying for so long. I sat beside her and asked what was wrong fully expecting her to talk about her near death experiences or sudden rather rapid disfigurements of her arms and legs. She told me how she was a nurse and knew about her case however she knew very little about wound management and felt ashamed that she was petrified of having her dressings changed. As I sat beside her it became more and more apparent that she had gone through several traumatic experiences when having her dressings changed at the previous hospital. She regaled the horror of screaming at each dressing change and being told that “she of all people should know better”, as if being a nurse could prepare you for this.
I sat with Jill for a while as we chatted about dressings and her wounds; she said that no one had ever told her about the dressings that were on her, she didn’t even know if her wounds would ever heal properly. She was aware that the areas were extensive and as she felt that she was not brave enough to look at herself she found that most practitioners would not speak to her about her wounds which made Jill more scared of what they looked like. To make matters worse Jill had been reluctant to see her children as she did not want to scare them, whilst telling me this she broke down in tears again saying how ashamed she was as all these people had worked to save her life and but she did not know how to cope.
We chatted for a while about dressing changes and what went wrong previously, it turned out to all be very simple…no adequate pain relief and dressings that had stuck to her causing trauma on removal. I started the process of gaining her confidence by sorting out analgesia which I let take effect before starting the dressing changes. Careful soaking and allowing Jill to help by holding her arm in a comfortable position we removed the dressing relatively pain free. The tears rolled down her face again but this time they were tears of absolute joy and relief as it had not hurt, it was more uncomfortable than painful she explained. We managed the other dressings in the same way. Jill’s wounds were indeed extensive; much of the adipose tissue and muscle had gone leaving cavities which would heal leaving large scarring.
Over the next few weeks I watched as Jill grew in confidence. Each time we changed the dressings I explained what I was doing and told her about her wounds. We were able to involve her husband in the process which at first was a daunting experience for Jill as she was concerned her husband would find her “repulsive”, as I had kept her husband informed of her progress he was able to confidently be involved and the experience brought the 2 closer then ever.
The first time Jill looked at her wounds was overwhelming experience. They had greatly improved but her arms and legs were still disfigured. I was so surprised when I looked at her to find she was smiling; almost laughing! She looked at me and said she suddenly understood what everyone was talking about, she realised how lucky she was to be alive.
I last saw Jill in an outpatient clinic, she had a light stocking that covered her arms and only wore trousers but she looked really well and happy. She came up to me and gave me a big hug, she thanked me for the giving her the time she needed. She said that she had never understood before what a difference a single day could make, before she could only see a life of pain and trauma but that all changed because I cared enough to take the time. As she left she put her arms around her family, I watched them leave happily; it was hard not to have a tear in the eye.
I hope that Jill has continued with her nursing and that if she has her experiences have enabled her to take the time with others, understanding that sometimes it’s the small things that can make a huge difference.