When I was in nursing school, I was able to observe an open-heart surgery. I stood at the head of the bed on a stool, peering over the drapes. I saw the patient’s heart. I saw it stop beating and start beating again.
As my eyes remained fixated on the open chest in front of me, I could feel my own heart beating in sync with the patient’s. Our hearts were beating together, reminding me that we are two different people working towards the same goal: to live.
I cannot over emphasize the importance of the physical exam. When you place the stethoscope on a patient’s bare chest, you hear the heart. You hear S1 and S2. You hear lub-dub, lub-dub.
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I like to close my eyes when I am auscultating the heart. It helps me focus and truly listen. It is in that moment of the exam that I am reminded of the humanity of medicine, and its goal of preserving health. In that moment, there are no words — just the experience of listening to the body function.
I can feel and hear the filling of the ventricles, the squeezing of the atria and each valve opening and closing in perfect timing like a well-oiled machine. There are no distractions. There are no words. The heart beats, and I listen.
When I remove the stethoscope from the patient’s chest and from my ears, patients will often ask how their heart sounds, as if I’ve been told a secret about their health that they want to be a part of. For most of us, there is an innate desire to feel alive. As providers, we have an obligation to do our best to help our patients stay alive. We must assess their health in order to make recommendations.
There should be some element of touch in every physical encounter. We must not let time constraints and busy schedules eliminate the most important aspect of the patient encounter. There is power in touch. There is power in listening.
Listening to your patient’s heart holds the secrets to health. Take 60 seconds to truly listen, and let it renew in you a commitment to medicine and the desire to keep the heart beating.
Leigh Montejo, MSN, FNP-BC, is a National Public Health Service Corp scholar completing her service commitment as a Family Nurse Practitioner at Tampa Family Health Centers Inc. in Florida. Her areas of interest include adolescent health, health promotion and improving access to healthcare in underserved populations.
