Between the Lines of Control

This story is based on a real nursing experience. Identifying details have been changed or limited to protect patient privacy. It is shared for education and reflection and is not a substitute for medical advice or professional nursing guidance.

Working on a med-surg unit means caring for all kinds of people.

Some are young. Some are older. Some have lived with chronic illness for years. Others are suddenly facing a diagnosis that may change their lives.

Some illnesses become lifelong companions. Others can be treated with surgery, IV medicine, or time.

As nurses, we meet people during some of their most vulnerable moments. Pain, fear, and loss of control can all come together at once.

That was the setting for one shift I still remember.

A Difficult Start

During shift change, I was told about a man in his early forties who had been admitted with a painful abscess in the perineal area.

Even hearing the report, I knew how uncomfortable that had to be.

Pain in that area can make it hard to sit, lie down, or find any position that truly feels comfortable.

He also had diabetes.

His blood sugars had once been tightly controlled in a very structured setting. Now that he was back to managing his health on his own, that control had slipped.

He did not like taking insulin.

The nurses who had cared for him before me had also warned me that he could be very direct when he was frustrated.

That morning, he was NPO, meaning he could not eat or drink because he was waiting for a surgical consultation and the possibility of surgery later that day.

Pain. Hunger. Uncertainty. Diabetes. Possible surgery.

He already had plenty to be upset about.

The IV on the Bed

When I entered the room to introduce myself, he was lying in bed with one arm draped over his eyes.

His mother sat quietly in the recliner beside him.

I gave him my name and was about to explain the plan for the day when something caught my attention.

His IV was no longer in his arm.

It was hanging loose, held only by tape.

I asked, “What did you do to your IV?”

He lifted his arm from his face and looked at me.

“What do you mean, what did I do to my IV? I didn’t do anything to it. It wasn’t my fault,” he said.

Then he added, “One of you nurses must not have taped it right, and I don’t like your attitude.”

My first reaction was not very gentle.

Inside my head, I thought:

Grow up. Great. I have to deal with this brat for the entire shift.

Years earlier, I probably would have answered him with a sharp tone.

But nursing had taught me something.

If I was going to care for this man for the next twelve hours, getting into a power struggle with him would help neither one of us.

So, I stopped.

I looked at him and said, “I’m sorry for the way I asked you that question and that you were offended. I did not mean it that way.”

That did not mean I believed I had done something terrible.

It meant I decided that winning an argument was less important than caring for the person in front of me.

Looking at the Whole Situation

I continued my assessment.

The abscess was red and swollen, just as I had been told.

His lungs were clear, although it was obvious that he was still smoking despite his health problems.

His blood sugar earlier had been 258.

Normally, insulin might have been given according to his treatment plan. But because he was NPO and waiting for possible surgery, I needed to clarify the plan with the physician.

He asked when the surgeon would arrive.

I explained that specialists do not always come at a set time. They may be seeing patients in the office or already in surgery.

There was no exact answer I could give him.

“I hope it won’t be all day,” he said. “I’m hungry.”

I told him I would let him know as soon as I heard anything.

Before leaving the room, I asked his mother if she needed anything. I also reminded her that the cafeteria was open if she wanted something to eat.

She nodded quietly.

She had been watching everything.

A Small Choice Made a Difference

During the nine o’clock medication pass, I noticed there was an order for a nicotine patch.

He declined it.

I also needed to start his IV antibiotics.

I explained what the medicine was and told him the infusion would take several hours.

Then I asked him a simple question.

Did he want to take a shower before the antibiotics or after?

He chose after.

It sounds like a very small thing.

But sometimes small choices matter.

He could not decide when the surgeon would come.

He could not decide when he could eat.

He could not decide whether he needed the antibiotics.

He could not decide whether he might need surgery.

But he could decide when he wanted to take a shower.

That little bit of control seemed to help.

The tension in the room slowly began to ease.

By the End of the Shift

As the day went on, our conversations became easier.

We began making light conversation.

We even joked a little.

Eventually, I learned that his surgery would not happen until the next day because the surgeon’s schedule was already full.

When I went into his room to tell him, I was carrying his dinner tray.

He was not happy about waiting another day for surgery.

But he was very happy that he could finally eat.

As I was leaving the room later, he looked at me and said:

“Thank you for taking good care of me.”

His mother smiled.

And so did I.

Nothing about his diagnosis had changed during that shift.

He still had an infection.

He still had diabetes.

He still needed surgery.

But something had changed between us.

Nursing Points

• Pain, hunger, fear, and loss of control can affect the way a patient communicates.

• A patient who seems angry may also be scared, uncomfortable, or overwhelmed.

• Diabetes care works best when patients understand the plan and are willing to take part in it.

• Avoiding a power struggle does not mean ignoring unsafe behavior. It means addressing the clinical problem without turning the interaction into a battle.

• Small choices can help restore dignity and give a patient some sense of control.

• A calm response can sometimes change the direction of an entire shift.

Spiritual Reflection

“Let your gentleness be evident to all. The Lord is near.”— Philippians 4:5

Gentleness does not always come naturally.

Sometimes it is a choice.

It is choosing not to answer anger with anger.

It is choosing not to prove that we are right simply because we can.

It is remembering that the person in front of us may be hurting in ways we cannot see.

By the end of that shift, nothing about this man’s medical condition had been fixed yet.

But the atmosphere in the room had changed.

Sometimes care begins before the medicine works.

Sometimes it begins with patience.

Sometimes it begins with humility.

And sometimes it begins with giving another person one small choice when it feels as though everything else has been taken out of their hands.

One Faithful Step

The next time someone seems difficult, angry, or demanding, consider asking yourself:

What might this person be afraid of losing right now?

A little gentleness may not change the situation.

But it may change what happens next.

Real Faith • Real Health • Real Life