Sam* reminds me of my dad — never caught without a cheeky grin and an ‘It was THIS big!’ fishing story up his sleeve. He has a grey handlebar moustache and wears a big woolly jumper. I liked him from the moment we met. And caring for Sam helped prepare me for my career change from nurse to design researcher.
When he came to the ward, Sam had surgery for fractures to his left tibia and fibula and couldn’t put weight on his leg for six weeks. He also had Parkinson’s, so hopping around on one leg was more difficult for him than most. He was in for the long haul, and I was there to help him out.
On one morning shift, I took Sam for his shower. He chatted in his usual way — talking rugby, tramping, fishing and hunting. But something seemed off. I heard a pang of sadness in his voice as he remembered the active life he used to live. He sounded even sadder as he compared past and future, to the point where I thought I saw a tear roll down his face.
“I guess suicide is always an option.”
Wait. Hold the phone. Back up the bus. Suicide? I knew Sam was on antidepressants, but until this moment I hadn’t seen any signs of low mood or suicidal thoughts.
I wheeled Sam back to his bed, where the consultant and her team were waiting. She did the usual checks, asked about pain, and looked over the obs chart. I whispered to the registrar what Sam told me in the shower. The registrar handed a note to the consultant, who asked Sam about his mood and if he’d had any thoughts about suicide. Sam denied it all — saying, “I’m fine.”
When the team left his bedside, I followed them out. As a student nurse, talking to the consultant was a scary thing. But this was for Sam. I’m his advocate.
“I notice the dosage of Sam’s antidepressant is being reduced while he’s in here, and I was just wondering if now is the best time to do it? Being stuck in here for six weeks is bound to make anyone feel low. I think it’s best not to play with dosages right now.”
My heart relocated itself to my oesophagus at this point, but it was worth it to get Sam what he needed. To my shock, the consultant had stern words with the house surgeon, who had reduced the dose without discussing it first.
As I walked back into his room, Sam stared longingly out the window.
“Sam, how would you like to go for a walk?”
The look on his face was priceless. I only wheeled him to the end of the street, and spent all of 10 minutes outside, but it made the world of difference. The walk became our daily ritual. It broke up his day and transported him to the place he loved most — the outdoors.
Despite being admitted for a broken leg, made even more obvious by his fluorescent orange cast, this injury wasn’t Sam’s greatest need. His true need couldn’t be seen.
Sam knew an illness was consuming his body and would one day have full control, robbing him of the activities he lived for. Memories that once gave him joy were becoming sad reminders of things he would never do again. He was grieving.
Sam needed fresh air in his lungs and the weight of a fish on his rod, and I had the ability to give him one of those things. So I did. The solution was simple, but the need was harder to find.
In different circumstances, it could have been wise for the house surgeon to reduce Sam’s antidepressant dosage while he was seemingly safe in hospital. Changing a dose can cause minor but unpleasant symptoms, so what better place to experience them than in hospital, where Sam could be easily monitored and treated?
But the house surgeon saw Sam for all of five minutes a day. Their interaction had to be functional, so how could he know what Sam was experiencing? I wasn’t experiencing Sam’s life either, but I had gained his trust. Maybe that’s why he revealed something to me that he denied to another person moments later.
Sam’s trust in me meant I could make sure he got what he needed. It was a my job as a nurse to understand and be an advocate for my patients. It’s now my job as a design researcher to understand and be an advocate for the people we design for.
When my placement ended, I had to say goodbye to Sam. The only other time I saw him was in passing, in the hospital foyer. He was being pushed in a wheelchair by his wife. They had just been for a walk — I could tell by the smile on his face.
*Sam’s name has been changed to protect his identity.