A few years ago I worked at a hospital as a constant observer. It was a transitional job as I tried to figure out the next step of my life. What exactly is a constant observer? one might reasonably ask. A constant observer is basically a nurse’s aide who stays in one room to be with patients who might be a harm to themselves or others. Hospitals try very hard not to tie people down on their beds anymore. There are a lot of reasons I might be assigned to a patient: dementia, adverse reaction to medication, brain injury, detoxing, or suicide watch, to name some. I saw people at their most vulnerable state. This is the first in what I plan to be a series of vignettes on my experiences in the hospital.
He couldn’t get comfortable on the bed. And no wonder—his wife had told the nursing staff (and me) that normally at home he would sleep on a recliner for a few hours, get up to go to the bathroom, then lie down on another recliner. She said he could only sleep for a few hours at a time, suffering as he did from restlessness and frequent urges to urinate. I considered what this information meant for my evening. He had a catheter in place, so the urinating itself wouldn’t be a problem, but sometimes people still feel the urge to urinate. I’d also found that it’s hard to explain a catheter to someone who is already confused. I frequently would say “I know it feels like you have to go to the bathroom, but you have a tube that drains your bladder. It’s doing the work for you.” Sometimes I would show them the catheter bag filled with urine if I thought it would help them understand. With one guy I had to explain the catheter more than two dozen times in a day—he’d forget within five minutes what I had said. So the nurse brought a recliner—broken, but it was the only one on the unit—in an attempt to simulate the patient’s home environment. I put a garbage can under the foot rest to steady the chair. It wanted to lurch forward. He was cold so we put a few blankets on him. With that, he and his family accepted our illusion of home. But soon enough, after his visitors left, they put him back in the bed so they could put the bed alarm on. The alarm would let the nursing staff know if he tried to get out of bed, permitting them to dispatch me a few doors down to watch another patient. A short time later they asked me to return to his room because he was yelling and cursing. When I sat down next to the bed, he thought I was his wife there to comfort him. The lights were low and he was confused because of… I don’t even know. Old age? Alzheimer’s? A stroke? It was the middle of the night? He told me that he loved me so much. I grabbed his hand, thinking that might comfort him. He wanted to be comforted, so he was playing out the script of comfort. I didn’t want to break out of my role and shatter the scene. But then he started kissing my hand. Now I felt really uncomfortable. He was a total stranger, and he was kissing my hand. Also, it didn’t seem right, posing as his wife, letting him believe she was there. Still, I didn’t move at first because I was frozen. But the moments passed, and I still couldn’t yank my hand away. He was alone and disoriented in a place that was not his home, and I wanted him to be able to feel some comfort right then. I also hated the thought of facing his embarrassment if I made him realize his mistake. And I really didn’t want him to get upset again. I told him to relax and go back to sleep. I tucked him in, and then I withdrew back into the shadows of the room, thinking about how I had stumbled into misplaced intimacy.