THE PATIENT IN ROOM 1B....

CONFRONTING OUR FEARS TO OVERCOME RESERVATIONS AND BUILD TRUST.

Brooklyn, N.Y., Spring of 1992. As I looked out of the New York City taxi window on Avenue T, I saw the building. It had always appeared to me as the most magnificent building I had ever seen that housed the elderly patients and other residents in need of rehabilitative care. I was happy, I was ready, I was in great spirit. “let’s do this!”, I remember thinking to myself as I stepped out of the taxi.

You see, having arrived from Eastern Nigeria, some 10 months prior, this was the third day at my first big job and I was darn determined to give it my all each day. The pep talk from Maggie, the nursing agency lady who referred me to this subacute facility to perform the duties of a nurse’s assistant, still echoed clearly in my mind. “Remember to appear each day in clean scrubs”, she said, “and always have a smile on your face and you’ll do just fine”. I had just completed an 8-month accelerated nursing assistant program in downtown Manhattan and this was the first of many facilities the agency assigned me to work. My first two days had simply been glorious and everything went smoothly. The patients loved me and I loved them even more.

So, in my brand new, crisp and freshly ironed blue scrubs, I got out of the taxi and took a deep breath of the fresh morning air. On the ground floor of the 12-story building, a heavy glass door opened into the reception area and as I walked in, I was hit by the scent of freshly brewed coffee. I hurriedly walked up to the friendly looking lady by the reception desk. “I’m here as a nurse’s assistant from my agency”, I cheerfully said. She smiled in return and said, “We’ve been expecting you!” as she buzzed me up to the 10th floor of the facility. At the nurse’s station sat whom I presumed to be the unit’s nurse manager. She handed me my assignment sheet for the day and afterwards, I briefly went to the rooms of each patient assigned to me for a quick, pleasant introduction.

I felt so excited! “what a dream come true!”, I thought to myself. I had finally made it to a clinical facility in America to provide care to patients in need of such care. I could not wait till the end of the day to contact my friends whom I left back home in Nigeria and to tell them of the wonderful experiences I’ve had in the first few days. These were mostly friends I met at the University of Nigeria, Nsukka from where I obtained a Bachelor of Science degree in Computer Science just about 6 months before I arrived at the United States. “My friends would be very proud of me, some might even be jealous of me”, I thought to myself with a smile in the unit’s dimly lit supply closet, as I gathered the supplies that I needed for the day to care for my patients. My warm feeling of euphoria was suddenly interrupted when I heard my name over the PA system to see the nurse manager at the nurse’s station.

“I am sorry to tell you this “, she began to say as she tried very hard to avoid my warm expectant gaze. “But you were assigned to the patient in room 1B in error and now you’ve been reassigned to a new patient”. “Oh, is she being discharged today?”, I asked innocently. “No, not to worry”, the nurse manager said, “just accept the new assignment, please”. I was a bit bewildered by this sudden change because I recollected that I had a brief, friendly introductory conversation earlier that morning with the patient in room 1B. I felt just a bit disappointed because I was really looking forward to knowing her but I kept my disappointment to myself as I resumed my duties.

By midday, in the small and crowded lunch room, a fellow nurse’s assistant, Constantine, sat next to me and quite nonchalantly exclaimed, “They got the assignment process all wrong today and that’s why your assignment was changed”. “What do you mean?’, I asked. “Well”, she started to say, “I was assigned the same patient last week but my assignment was switched because patient in Room 1B does not wish to be cared for by black people”. “Oh”, I said as I took a bite of my cold cut sandwich. While I slowly ate my lunch, I became lost in a newly found thought process that I hadn’t ever experienced. I looked at Constantine as she stared at me, a bit wide eyed with expectations for me to say more in response to the information she had just disclosed to me. But quite frankly, I was simply short of words because in my naivety, I grappled with the meaning of this new encounter that I had never experienced prior to that day. I clearly remember that I was not upset at all but rather felt quite puzzled. Today, I look back and I’m grateful for my inexperience about racism, discrimination, or prejudice at that moment in my life because this shielded me from the disappointing, negative, and unpleasant feelings that often manifest in life following such encounters. But even though I was not upset but rather bewildered, I could not help but feel a slight sense that I was probably tainted and perhaps not good enough and this made me uneasy and a bit sad. I guess it’s fair to say that a sense of separatism and discrimination creates an uneasy feeling because although I could not explain exactly how I felt, I knew I felt slightly less enthusiastic about my job at the subacute facility than I felt earlier in the week.

As we ate in silence, many thoughts flooded my mind. Patient in room 1B probably did not realize that I was quite excited and eager to get to know her while I cared for her during my first week of work in America. She probably did not know that I was looking forward to sharing many interesting stories about my recent migration from Nigeria, a country where many people struggled to leave each year in search of a better life in America. She obviously did not know that I was looking forward to bragging to my friends back in Nigeria of how proud I felt to be among those who “made it” to America and how elated I was to care for patients in such a clean and cozy health facility. Finally, she must not have known that I was looking forward to getting to know more about her, her journey, her culture, her reservations, and triumphs. She did not know all these and never got to know, simply because she didn’t give me a chance to care for her. As much as I respected her wishes and reservations, I still felt torn because we both missed the chance of genuinely connecting with each other and gaining a higher level of understanding about each other. I didn’t know this then, but many years later this patient would be “The suspicious Patient” in my newly published book.

Fast forward to 25 years after that encounter in Brooklyn. Currently a Family Nurse Practitioner with many years of interacting with patients of diverse backgrounds, cultures, attitudes and finally becoming a patient myself in 2013, it finally made sense to me. Although there was the lost chance of getting to know the patient in room 1B, I’ve had numerous opportunities over the years to interact with and make genuine connections with many patients of diverse races, religion, culture, and backgrounds (Christians, Muslims, Hindus, Black, White, Asian etc.) who were curious to know me and I was equally excited and curious to know them. Occasionally, of course I’ve come across and still have sporadic encounters with patients who are initially reserved about me. My culture, mannerism, background, and even my accent may seem strange to them at first. But by interacting with Godly compassion and use of effective communication techniques, such reservations are gradually overcome and trust is built. These patients quickly realized that our initial encounter may have seemed strange to them at first but when they got to know me, that I was actually a helper, a friend, and not a foe. The only difference between these patients and the patient in room 1B, is that despite their initial reservations about me, they gave me the chance to get to know them while patient in room 1B did not.

It is important to mention that the concept of “The suspicious Patient” is not only limited to race. The suspicious patient represents each one of us due to the reservations that we have concerning one another’s attributes such as gender, age, religion, values, nationality etc. Since we all are of diverse backgrounds and cultures, it is expected and almost inevitable that these reservations would always exist. What we don’t understand can create fear and anxiety in us. But for genuine communication and trust development to be achieved, we must not shy away from our reservations about one another as the patient in room 1B did 25 years ago in that Brooklyn facility. Although it seems uncomfortable at first to explore and face our reservations about one another, we must not abandon the effort to do so because for us to successfully build trust with one another and grow as individuals, it is vital that we go through periods of self-reflection to identify our individual reservations about one another. There are those questions that each of us can only truthfully answer for ourselves during moments of self-reflection, e.g. why are we more uncomfortable in the presence of one individual versus another? what innate fears and concerns lurk in our subconscious minds regarding other people’s values and attributes? And when we identify these fears and reservations, to further ask ourselves, what can we do to begin to face these fears and overcome such reservations? It is not an instant process, but it is quite rewarding when we commit to this process with the purpose of building trust with one another. With hearts of sincerity and Godly compassion, we must give ourselves the chance to confront and ultimately overcome our real and sometimes unreal fears. For only then would we make the genuine connections that not only improve performance and productivity, but also help us maintain our sanity and piece-of-mind in an inter-connected and increasingly diverse world.

Nonye Aghanya is a Family Nurse Practitioner, author, blogger, and speaker.

She is the Author of “Simple Tips To Developing A productive Clinician-Patient Relationship” available on author website www. ptdrsimpletips. com and www.amazon.com/-/e/B01MS36RZK

Stay tuned for her soon to be released second book!