Wrong things, right reasons?

I can remember the very first time I treated a person with cancer and the lasting impact it had on me.  I was a student physio on an orthopaedic placement.  I was in the second year of training, so by this stage would have my own patient caseload which I took responsibility for under the supervision of my clinical mentor.  Orthopaedic rehab then, I’m not really sure what happens now as haven’t worked in the area for so long, was vey protocol led – Day 1 post Total Hip Replacement = check the patient’s chest, teach the patient circulatory exercises to be performed on the bed and get them up for a walk.  The lady I was seeing had broken her hip as a result of metastatic bone disease in her femur.  The morning after her surgery, as I approached her bed, I could see the lady was asleep and her husband was sat beside her holding her hand with his head resting close to hers, and he appeared to me to be whispering into her ear.  I went over to the bed, said hello and explained who I was and asked how the lady had been through the night.  The husband ushered me away from the bed and told me that the family had received some very bad news and they would appreciate if I would leave them alone.  This seemed an entirely appropriate request, so after explaining to the husband that I would check back in with them tomorrow, to which he agreed, I went about my business with my other patients.  Later that morning on discussing my patient caseload with my supervisor I relayed the story – I felt like I was intruding on the families space, so I didn’t treat the lady, I would go back tomorrow.  It was then pointed out to me that this lady was under my care, and I hadn’t done my job correctly and should she get a chest infection or a pneumonia then she probably would never leave the hospital, plus the new hip needs the stimulation from weight-bearing activity to help healing, so I was to go back and treat the lady TODAY, not leave it until tomorrow.  I can remember spending the whole of my morning break time crying in the toilets, then when it was time to go back to work, cleaning the smudged mascara from around my eyes taking a deep breath and attempting to flush my humanity away with the crumpled, damp, mascara stained tissues.

 Writing about it still evokes strong emotions within me.  But to this day, I maintain that I did the right thing that morning..….or maybe I did the ‘wrong thing’ but for the right reasons.  And this is just an example of where medicine, healthcare, rehabilitation etc is never just black and white –  there are many policies, procedures, protocols, checklists etc to guide us in our practice, and these are vitally important in ensuring a consistent quality service is provided for all, but within all of this and at the centre of all of this is a person and their family and the humanity needed to appreciate and understand this is something that cannot be measured or accounted for by the ticking of a box.