Come, “grow old with me.”
She sat stiffly on the chair in the gym. She had come with her ward for recreation time. Younger patients played basketball and rode stationery bikes. Two of my nursing students were playing table tennis with a twenty-something male patient. This lady looked lonely and isolated among all the younger patients and staff, and she struck a chord in my sixty-something heart. When I asked her if she wanted to play with me, she looked quizzically at me, and said, “Me?” To my great surprise, she got up and returned my volleys slowly, patiently, and pretty accurately.
I had observed this lady on the unit. She stayed in her room whenever possible, and did not interact with other patients or staff. She was refusing to leave the hospital because she believed that she owned a luxurious home north of the city, and wanted to return to it. When the social worker approached her with alternative residence offerings, she became agitated, loud, and accusatory toward the social worker.
The next day the patient greeted me in the morning, and we played table tennis again in the afternoon. As a nursing instructor, I don’t often spend a lot of time interacting alone with patients as my job is to be available to my students, and to facilitate their interaction with patients. However, a case can be made for role-modeling, especially for students who gravitate to patients closer to their own age, as is human nature.
The patient and I discussed topics familiar to our age cohort; difficulty with electronic devices, morning aches and pains, the recklessness of young people, and how older adults can sometimes feel discarded and devalued. We moved on to her desire to have her own residence and although she still believed she has a grand residence north of the city, she did agree to accept housing in a group home, “temporarily, only until the other house is available.” At the core of her anxiety was the desire to remain independent, “to take care of myself.”
When the social worker asked me what magic I had done to change the patient’s mind, I could only tell her that we shared some of the challenges experienced with entry into older adulthood.
When teaching signs and symptoms of mental illness, pharmacodynamics, and a myriad of psychotropic medications and their side effects, it is easy to lose sight of the transformative effect of interpersonal relationships in nursing care. Hildegard Peplau, the, “mother of psychiatric nursing,” viewed self-reflection and self-awareness as an integral process in the nurse-patient relationship. In this case, it was mutually helpful for nurse and patient.
Peplau’s command that we continue to grow, mature, and serve the society in which our practice is embedded is her ultimate gift to us as we progress and grow old in our own nursing practice.