Tough Love Can Be Tough

I’m used to patients being terrified of getting worse. But it took me awhile to realize that the main issue I was now dealing with was that this patient was terrified of getting better. I’m sure there are plenty of psychological publications and blog posts by some really smart people that have already covered this phenomenon, so I certainly don’t claim to be discovering anything new. But it was a new situation for me to find myself in, particularly as I had been with this patient for over a month and had a more intricate relationship with him than with patients that I have for only one or two days. There is an inherent emotional and psychological distance that you can keep from patients and families whom you care for for only a shift or two. But this changes, inevitably, when you are with them as their nurse for an extended period of time.

He had a physical disease process with some setbacks during his recovery, which sentenced him to a prolonged hospital stay. But he also had some psychological and emotional dysfunction that went even further back, which appeared to have gone unaddressed until now. He was intensely needy, refusing to let his primary caretaker from home rest, and fearfully reluctant to let go of various hospital treatments that had become his source of security over time. On the morning of my final shift with him, knowing that he would soon be transitioning out of the ICU, I started off the shift by saying, “Our big goal today is to work on boundaries.” His response: “What’s that?” Oh dear. Each step in this final push towards recovery meant that there would less of all the external support – less treatment, less comfort and coddling, less urgency of response for issues that were not true crises. The growing expectation on him to work through the uncomfortable changes and responsibilities of recovery was almost more than he could handle. I’m so used to my therapeutic nursing role being that of one who brings comfort and relief as much as possible. I wish someone had told me in nursing school that sometimes, the therapeutic nurse is also the one who will hold his or her ground with a firm ‘no’ when the patient is crying, pleading, throwing a tantrum, suffering (but not really suffering).

There is a big part of my ego that wanted him to love me as his primary nurse. I wanted him to thank me for everything I had helped him through. But my final shift with him involved me being a big source of his frustration and discomfort, perhaps some disappointment as well. There would be no thanks offered – just his desperate plea that I would somehow let him go back to the less healthy state that he was in before. It was at that point that I knew for certain I had truly given him the very best that I could as his nurse, and as his friend. Because more than wanting his thanks, I wanted him to get better.

I can see myself in him. It’s how I am sometimes too, towards life, towards others, and towards God. I have a deeper appreciation now for the times when God allows me to struggle. That is a wisdom and love that I still plead against. I kept asking my patient if he still trusted me. I think that is what my Father in Heaven asks me too.

loving little, loving much

The plants from my old home show signs of being loved too little. Dry soil, brown-ish stems, undesirable flowers from basil plants that expose my lack of regular pruning and harvesting. For the new place, friends gave us fresh herbs in these brilliant biodegradable pots that could easily be replanted into larger pots, complete with potting mix and plant food, as the most lovely housewarming gift. After receiving a second collection of herbs as party favors from the wedding of two beloved friends, we now have a wonderfully fragrant mix that I diligently repotted and placed in our back deck. Now I face the danger of loving these plants too much. Overwatering is such a strong temptation. But for many of these delicate plants, less is more. They need challenges that will push their roots to grow. They need space to breathe, to absorb nutrients, to not be drowned out by my insistence on loving them with all the water I can flood them with.

Neglect in love is easy. But restraint in love can be so hard.

I had a gently confrontational, gracious but uncomfortable, expected but somewhat unexpected conversation with someone the other day. I suppose you could call it a mild form of discipline. This person, many years my minor, is dear to my heart for so many deeply heartfelt reasons. My heart longs for so much for this person, but I found that everything I wanted to say was going to come out sounding like a lecture. This person did not want or need a lecture. The discipline was needed but the love had to come through. And I felt in my gut that the love had to take the form of restraint. Making the point short and sweet, and letting the person work through it on their terms, in their time. Let the roots grow. Give space to breathe. Don’t drown out their thoughts with too many of my own.

I know how to neglect love too well. Once in a while I know how to love much. But restraint in love. That can be so hard.