S T U D E N T E S S A Y

‘Do we ask? Do we listen?’

Kyoko SaekiPhD Student, Chiba University Graduate School of Nursing (Center), Chiba, Japan

Accepted for publication February 13, 2013

Saeki K. International Journal of Nursing Practice 2013; 19 (Suppl. 2): 61–62‘Do we ask? Do we listen?’

As years have gone by, I have learned to listen to mypatients more carefully. Some patients were my teacherand gave me a chance to reflect on my practice. Severalyears ago, one of my patients, in her eighties, was admit-ted repeatedly with aspiration pneumonia and fever. Onthese occasions, the doctor would order to hold her mealsfor a few days. While she was febrile, we could startnaso-gastric tube feeding for nutritional support. As thefever went down, she was permitted to eat gradually andthen go home. While she was hospitalized, she oftenpulled out her nasal tube, so we would have to place thetube again. She was frail, but she pushed our hands back aswe tried to place the tube, so we always needed twonurses. Sometimes she put up with our efforts with hereyes closed. She tried to accept the tube, but I am not ableto forget the expression on her face as she endured theprocess.

While working at a nursing home some time later, Imet another woman who was in her nineties. She wasadmitted to the nursing home after having a cerebral inf-arction. She spent most of the day in the bed or in thewheel chair because she was paralyzed on her left side.However, she was still able to communicate with othersbut with some difficulty. A night shift nurse reported thatshe heard noise from the woman’s room and went to seeafter her. She noted that the patient’s right arm was reach-ing across the bedside table. Several items had fallen underthe table and the bed. The night nurse reported to us thatthe patient was likely developing delirium and needed

more observation. Later, I went to see this patient toassess her myself. I spent some time at her bedside, justletting her speak as best she could. She explained that shedeveloped pain in her paralyzed arm and tried to reach forher cold poultice on the bedside table. Older people inJapan commonly use these hot or cold packs to relievetheir aches and pains. Apparently, the night nurse enteredher room in haste and did not ask the patient what sheneeded. Instead, the nurse scolded her, pick up the itemsthat had fallen and quickly left the room.

These events teach me a great deal about nursing andcaring or others. The woman with difficulty swallowingsuffered great discomfort from our treatment. Now Iworried that I should have asked her what she wanted todo. She could speak, but we never asked her about hercare. She might not have wanted to have tube feedingsbecause of her age and condition. Perhaps we needto speak with patients about the discomfort of treat-ment and what it means to survive. Otherwise, wecontinue to repeat the harm we cause by replacingtubes or restraining the hands of patients. We fail to behumane.

I should know better. When I was a nursing student,our teacher told us of a similar experience. She wasresponsible for a patient who underwent surgery for thy-roidectomy. This attractive young woman seemed to beworried about something, but she did not speak of it. Aninexperienced nurse herself, my teacher thought that thepatient was concerned about having a noticeable scaracross her neck. She was quite lovely, and the surgical scarwould mar her appearance. As the patient was leaving, shefinally voiced the true nature of her worries. She ownedseveral caged songbirds that she kept as pets. While in the

Correspondence: Kyoko Saeki, PhD Student. Chiba University Gradu-ate School of Nursing, Chiba, Japan. Email: saeki@chiba-u.jp

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International Journal of Nursing Practice (2013) 19 (Suppl. 2), 61–62

doi:10.1111/ijn.12060 © 2013 Wiley Publishing Asia Pty Ltd

hospital, she had to leave them with neighbors who hadnever cared for small birds.

Was the night nurse just too hurried and too tired toproperly assess the patient? How often do we act quicklywithout thinking? Perhaps I did the same thing to thewoman who had problems swallowing. I might be thenurse who acted quickly without asking her what shewanted. The longer that I work, the more I learn frommy patients. I have learned not to assume so much about

my patient’s preference. We must take time to understandwhat the patient really wants and give the person as muchcontrol as possible. Ultimately, I have learned thatsomeday I will be the patient. When I am patient, willanyone ask me what I need?

DISCLOSURESThe author declares no conflict of interest.

62 K Saeki

© 2013 Wiley Publishing Asia Pty Ltd